The Minister for Health (Edward Argar) With permission, I would
like to make a statement on the integration White Paper. The
covid-19 pandemic has been a living example of the importance of
working together as one. Whether it is the extraordinary success of
the vaccination programme or the work to identify and protect the
most vulnerable, we were at our best when we were working across
traditional boundaries towards a common goal. We must learn the
lessons of the...Request free trial
The Minister for Health ()
With permission, I would like to make a statement on the
integration White Paper.
The covid-19 pandemic has been a living example of the importance
of working together as one. Whether it is the extraordinary
success of the vaccination programme or the work to identify and
protect the most vulnerable, we were at our best when we were
working across traditional boundaries towards a common goal. We
must learn the lessons of the pandemic and channel this spirit of
collaboration.
Although huge progress has been made in bringing together our
health and care services and local government, our system often
remains fragmented and too often fails to deliver joined-up
services that meet people’s needs. Thanks to incredible advances
in health and care, people are enjoying longer life expectancies,
but may be living with more complex needs for longer. Navigating
a complex health and care system to meet those needs can be hard,
especially when services are often funded, managed and delivered
separately. People too often find that they are having to force
services to work together, rather than experiencing a seamless,
joined-up health and care journey.
If we are to succeed in our goals of levelling up our nation, we
must keep working to make integrated health and care a reality
across England. Today, we are publishing the integration White
Paper, which shows how we will get there. It is the next step in
our ambitious programme of reform, building on the Health and
Care Bill and the social care reform White Paper, which this
Government introduced to the House in December.
This White Paper has been shaped by the real-world experience of
people, as well as by that of nurses, care workers and doctors on
the frontline, drawing on some of the great examples of
collaborative working we have seen, particularly during the
pandemic. It will make health and care systems fit for the
future, boost the health of local communities and make it easier
to access health and care services. It is a plan with people and
outcomes at its heart—no more endless form filling, no
impenetrable processes and no more bureaucracy that sees too many
people getting lost in the system and not receiving the care they
need.
First, we will ensure strong leadership and accountability, which
is critical to delivering integration. Local leaders have a
unique relationship with the people they serve. Our plans will
bring together local leaders to deliver on shared outcomes, all
in the best interests of their local communities, and encourage
local arrangements that provide clarity over health and care
services in each area, including aligning and pooling budgets.
This arrangement has already been successfully adopted in several
local areas. We have suggested a model that meets these criteria,
and we expect areas to develop appropriate arrangements by spring
of next year. Local NHS and local authority leaders will be
empowered to deliver against these outcomes, and will be
accountable for delivery and performance against them. They will
be supported by a new national leadership programme addressing
the skills required to deliver effective system transformation
and strong local collaboration.
Integration supports transparency, and joining up NHS and local
authority data means that we can provide local people with better
insights about how their area’s health and care services are
performing. With access to more information, they will be more
empowered to make decisions about where and how they access care.
There will be a new single accountable person for delivery of a
shared health and care plan at local level. In practice, that
could mean an individual with a dual role across health and care
or a single lead for a place-based arrangement.
Secondly, we will do more to join up care. At the moment, too
many people are bounced around the system or have to tell their
story multiple times to different professionals to get the care
that they need, which is frustrating for people and frontline
workers alike. There are so many opportunities here. Closer
working between primary and secondary care can allow care that is
closer to home, keeping people healthy and independent for
longer, and closer working between mental health and social care
services can reduce crisis admissions and improve the quality of
life for those living with mental illness. The White Paper sets
out how we will get there, using the power of data to give local
leaders the information that they need to establish new,
joined-up services to tackle the issues facing their
communities.
Thirdly, we will make the best use of the huge advances in
digital and data. We have seen throughout the pandemic how
digital tools can empower people to look after their health and
take greater control of their care—for instance, through the NHS
app or remote monitoring technologies. Where several
organisations are involved in one person’s care, there is a real
opportunity to bring together data safely to create a seamless
and joined-up experience. The White Paper reiterates our
commitment to having shared records in place for all people by
2024, providing local people with a single, functional health and
care record that everyone involved in care can access in a secure
way. That will mean every professional having access to the key
facts relating to a person’s condition, such as their diagnoses
and medications. That will improve care, too, with professionals
able to make care plans in full knowledge of the facts.
We have seen a rapid expansion of digital channels in primary and
secondary care services in recent years, but there is plenty more
that we can do. This year, one million people will be supported
by digitally enabled care pathways in the comfort of their home.
The White Paper sets out how we will open up even more ways for
people to access health and adult social care services remotely.
We will also support digital transformation by formally
recognising the digital data and technology profession within the
NHS “Agenda for Change”, and including basic digital, data and
technology skills in the training of all health and care staff.
Integrated care systems will be tasked with developing digital
investment plans so that we can ensure that digital capability is
strong right across the board. That means data flowing seamlessly
across all care settings, with technology transforming care so
that it is personalised to the patient.
Finally, the White Paper shows the part that the workforce can
play. The health and care workforce is one of the biggest assets
that we have, and we want to make it easier for people working in
health and care to feel confident in how the system works
together in the best interests of those they care for and to feel
empowered to progress their careers across the health and care
family. To drive that, integrated care systems will support joint
health and care workforce planning. We will improve training and
ongoing learning and development opportunities for staff. That
means creating more opportunities for joint continuous
development and joint roles across health and social care,
increasing the number of clinical practice placements in adult
social care for health undergraduates and exploring the
introduction of an integrated skills passport to allow health and
care staff to transfer their skills and knowledge between the
NHS, public health and social care.
The White Paper represents a further step in our journey of
reform, building on the foundation laid in the Health and Care
Bill, looking ahead to a future of health and care in this
country with people at its very heart. It paints a vivid picture
of a health and care system with more personalised care and
greater transparency and choice, where early intervention
prevents the most serious diseases, using the power of
integration to give people the right care, in the right place, at
the right time.
2.24pm
(Bristol South) (Lab)
I thank the Minister for advance sight of his statement, which I
got about 30 minutes ago, but I confess that I read most of it
some 30 years ago when I was developing joint services. After
waiting an eternity for the Department of Health and Social Care
White Paper, the Government are spoiling us with their third
paper of the year. All these papers are necessary to try to
remedy the disastrous Lansley Act—the Health and Social Care Act
2012.
We acknowledge that reversing that Act and the integration of
health and social care, however it is defined, is extremely
difficult, but this integration will not be delivered by the
White Paper and it is certainly not well defined. It is not clear
how this fits with the Health and Care Bill, which is currently
in the Lords. Even the experts involved in the Committee and
elsewhere are repeatedly tripping over crucial issues such as the
relationship between integrated care boards, integrated care
partnerships and integrated care systems. How do they work with
health and wellbeing boards? Where is the clinical leadership?
Where is the accountability to local people? I banged on a lot
about accountability in the Bill Committee so I am glad that
somebody was at least listening and that we seem to have a bit of
progress, but where are the voices of local people who are
increasingly being asked to pay more for less?
Like a house made of crepe paper, this gossamer-thin White Paper
collapses with the faintest breeze of scrutiny. Let us be clear:
it is not a plan, nor is it even a starting strategy. It is just
a series of woolly claims about how things could be better,
unsupported by any evidence or analysis of the resources and
organisational and funding flow changes that will obviously be
necessary. It could have been written at any time over the past
30 years. It contains little that is new and nothing to
illustrate new thinking or new attitudes. It relies on the bogus
assumption that because something may work for a while on a small
scale, it will obviously work everywhere. It is not any kind of
plan for integrated care that people will recognise; these are
just aspirations about integrated systems.
There is little to explain how a joined-up system would be
managed, how it would be accountable to the public, patients and
service-users, how the funding will be allocated and shared or
how performance would be assessed and weaknesses addressed.
Nothing in the White Paper addresses the key issue of balancing
what is locally determined against national standards and
national entitlements.
Crucially, there is nothing to address the key barrier to
integration—that social care and the NHS are in different empires
with no level playing field. One is means-tested and one is not.
One has national criteria for entitlement and one does not. The
way in which they are governed and funded is totally different
and they are kept going by two separate workforces with no
aligned terms and conditions.
I welcome the announcement of a skills passport and we will
certainly look at the detail of that. However, unless there is
pooled funding on a major scale—out-of-hospital funding—there
will be no system drivers to really improve integration. This
White Paper is again about simply encouraging, but we have had 30
years of that.
The reality is that the White Paper is remarkable for what it
does not do. It does not seem to help children and young people.
It does not address the challenge of how to care for and support
working-age adults with a disability. It does not really value or
assist the informal workforce or carers.
Our NHS and care system is under enormous pressure after years of
austerity funding made incalculably worse by the impact of the
covid pandemic, but the challenges that it faces are manifest,
from a legacy of a “hospital first” approach to a decades-long
failure to share care records. That runs alongside chronic
underfunding and devaluing of public health, huge gaps in the
workforce and wholly inadequate social care provision, with more
than 500,000 people waiting for assessment and hundreds of
thousands more denied access to care of any kind because the
barrier for access is far too high.
This is a will-o’-the-wisp White Paper: one minute it is there
before us only to vanish at a glance. The truth is that there
does not seem to be anything of note that cannot already be done.
Fundamentally, what is the point of it? As things stand, the
number of patients waiting for care will continue to rise for the
next two years, and there is no plan—not even the ambition—to get
waiting times and waiting lists down to the record lows seen
under the last Labour Government.
Worse still, these proposals will see patients paying more in tax
but waiting longer for care. The Government are blaming covid,
but will the Minister tell us when the target for NHS patients in
England to be treated within 18 weeks was last met? If he cannot
remember, it was in fact in 2016, four years before the pandemic.
It is clear from the announcement yesterday and here today—just
as it is from the decade of Tory mismanagement that left the NHS
ill-equipped to cope with covid—that the longer we give the
Conservatives in office, the longer patients will wait. Their
time really is up.
Today is not a serious endeavour; it is a greatest hits of
soundbites and buzzwords, randomly assembled to make a decent
press release and get an outing on the evening bulletins. It is a
desperate desire to own the news cycle and calm Tory Back
Benchers’ nerves. It really is disappointing and it is simply not
good enough.
It is a pleasure to see the shadow Minister in her place—she will
know that I genuinely mean that, because she and I spent many
happy days upstairs in Committee debating exactly these issues.
This White Paper sets out clearly the next steps and builds on
the strong foundations of integration that that legislation put
forward, with the integrated care boards, integrated care
providers and integrated care systems, which our deliberations in
Committee and in this House demonstrated were clear,
understandable and effective in providing locally based
governance; bringing together at an ICB level NHS services within
a locality, and within an ICP broader ranges of services,
including housing providers and others. This has been bringing
together the national health service we have with the localised
delivery we all seek.
That is one of the key points of the White Paper: the next steps
in how to deliver place-based solutions and allow the system to
continue to evolve organically through that permissive approach
that characterises the legislation we are putting through
Parliament, rather than the prescriptive approach that the Labour
party at times appears to prefer. The White Paper contains new
thinking on new ways forward, drawing on not just the lessons of
the pandemic but much longer-standing arrangements within
localities, recognising best practice for integration between
health and social care, and reflecting that organic development
that occurs within a place as local leaders, local communities
and those using the services work together to deliver services
that work best for them.
The hon. Lady touched on how some of this might work in practice
and talked about funding and budgets. We have made it clear—I
used to use this when I was a local councillor—that section 75 of
the National Health Service Act 2006, on the ability to pool
budgets, has been effective, but it is time to go further and
explore whether that remains the most effective vehicle by which
that sharing of budgets can be undertaken, so it is right that we
look at this.
The hon. Lady touched more broadly on social care and the NHS. I
have to say to her that we announced our White Paper for social
care last September. She mentioned the plethora of White Papers.
We rightly recognise the different parts of the health and social
care system and have clear plans for each of them. Those
different White Papers together form a coherent whole, putting
forward reform proposals that will make a difference for patients
and others alike. I have to say to the Opposition that, much as
they may gently chide us on this, in 13 years in government they
had two Green Papers, one royal commission and one spending
review priority, but still no reforms to improve social care
provision in this country. This Government have seized the nettle
and brought forward proposals that will genuinely move us
forward.
Finally, on the hon. Lady’s points about yesterday’s announcement
on NHS waiting lists, this Government have been transparent with
the British people about the challenge ahead of us and about our
plan to meet that challenge. Our approach, which combines
ambition with realism, has been welcomed by stakeholders across
the health and social care space. Ours is the party of the NHS.
We are the party that has put the resources into that NHS, with
£33.9 billion put into law at the start of 2020, and then record
funding through the health and care levy, which the Labour party
voted against.
(South West Surrey) (Con)
As one in the long line of former Health Secretaries with scars
on their back—to quote Sir Tony, if we are allowed to—from when
they tried to integrate the health and care systems, I warmly
welcome this White Paper. I think it is more than aspirations.
But there are three central elements of the plumbing that we have
to get right, and I want to ask the Minister, who I know is very
committed to this, for his response.
First, previous attempts to have pooled budgets for vulnerable
people have been bedevilled by the fact that the NHS has not
wanted to pool its budgets with an underfunded social care
system. The grant to local government is still not generous, to
say the least. The Select Committee on Health and Social Care
recommended an increase of £7 billion a year by the end of the
Parliament, but it is actually going up by £2 billion a year.
What will we do to overcome the resistance in the NHS to merging
budgets with a social care system that is feeling very
stretched?
Secondly, it is a very big step forward that everyone will have a
single electronic health and care record by 2024, but my simple
question is whether the public will be able to access the data.
Patients are the best guarantors and defenders of their own
health, so they should be able to access everything that
professionals can see about them.
My third question is about having a single professional
responsible for someone’s care. What is the role of GPs in that?
For most members of the public, the central person responsible
for their care is their GP. Is it not time to go back to the days
when everyone had their own family doctor, instead of a different
doctor every time they call the surgery? They might not see the
same person every time, but there should be someone at the GP
surgery who is responsible for their overall care, whether that
is in the health system or the social care system.
My right hon. Friend speaks with typical wisdom and common sense
on these issues. I will briefly address each of his three points
in turn.
On pooled and shared budgets, I have to say that I think section
75 of the National Health Service Act 2006 has worked well. When
I was cabinet member for health and adult social care at my
council—I had more hair then, and it was not grey—I also sat on a
primary care trust board as a non-executive member. I had a
senior director of that PCT on my management team; we forged a
common purpose, recognising that there would be some areas in
which NHS moneys were greater than those put in by the local
authority and vice versa, but the shared goal was achievable only
when we worked together. I think that there is genuinely
something to build on, and the ICSs, ICBs and ICPs at the upper
level will be the vehicle to move the process forward. When I was
doing it, there was a degree of personal relationship moving it
forward, rather than necessarily a systematised approach, but I
genuinely think that there is a willingness and a recognition of
the need for this.
On public access to electronic records, my right hon. Friend’s
central point is absolutely right: it is important to recognise
that such data is our data and individuals’ data. We must always
be wary about doing something to someone, as opposed to in
partnership with them. That principle will underpin our approach
in this space.
Finally, my right hon. Friend referred to a single responsible
professional—not a single point of contact, but someone who
brings together an individual’s care. He is right to highlight
the importance of general practitioners. May I put on record my
gratitude to GPs not only for all their work over the past two
years, and for all they do day in, day out, but for the wisdom
and care that they bring to addressing their patients’ needs?
Since my right hon. Friend’s time as Secretary of State, there
has been a continual drive to increase the number of doctors in
our health service. Not all will become general practitioners,
but we need to continue to make general practice accessible and
to encourage people to choose it as an incredibly exciting and
rewarding career. One of the key elements of making what he
describes work is building up a body of general practitioners who
are able to perform such tasks. I pay tribute to his work; we are
continuing that work and building on his foundations. I am
grateful for his questions and for his contributions.
(Linlithgow and East Falkirk)
(SNP)
I am grateful to the Minister for advance sight of his statement.
I think it fair to say that England is late to the integration
game; Scotland and Wales have been legislating and moving in that
direction for 20 years. The Scottish Government are pushing
forward plans for a national care service to ensure that social
care is fit for the 21st century, and have developed the NHS
Pharmacy First Scotland scheme to spread the burden of frontline
care and make pharmacies the first port of call for patients when
GP and hospital visits are not necessary.
What lessons have been learned from the devolved nations? Any new
plan for the NHS will not change the reality of the challenges
facing the NHS organisation across all four of our nations,
including that of vacancies. While Scotland’s workforce has grown
by 20% under the SNP, Brexit is still hampering our ability to
recruit from EU nations. Will the Minister discuss loosening
Brexit and immigration controls with his fellow Ministers to help
alleviate that situation?
I saw the hon. Gentleman’s final point coming. To his original
point, we are always happy to speak to the devolved
Administrations and learn from their ideas, just as I am sure
they occasionally look to England to see what they can learn—that
is part of being a member of this Union. I speak regularly to the
hon. Member for Central Ayrshire (Dr Whitford), including about
such matters. To his final point, all I would say is that since
2010 we have seen around 30,000 more doctors and 38,000 more
nurses in the English NHS—I have highlighted the role that my
right hon. Friend the Member for South West Surrey () played in that—so I think we
are doing a pretty good job of continuing to grow the workforce.
There is much more to do, but we have a plan and we are
delivering on it.
(Telford) (Con)
I welcome this ambitious and much-needed programme of reform. One
of the greatest challenges is ensuring the accountability of NHS
bodies to local people, and I wonder whether the Minister could
say a bit more about how these plans will ensure that local NHS
bodies are accountable to the local people they serve.
These plans build on what we are proposing in our legislation. At
the heart of the Bill are integrated care systems, which bring
together at ICB level and ICP level the local authorities that
are elected to represent their areas, local people—Healthwatch
will have a key voice in this space—and of course the local
NHS.
(Barnsley East) (Lab)
The clinical commissioning group in Barnsley says that it is
struggling with unprecedented capacity issues. With a record 6
million patients waiting for planned NHS treatment across the UK,
can the Minister explain how we will tackle the crisis in waiting
times through this White Paper?
The hon. Lady will have seen yesterday the announcement and
publication of our plan to tackle waiting lists caused by the
covid pandemic, the investment that underpins that, the approach
to the workforce and how we will bring those waiting lists down.
This White Paper builds on that; they are complementary and work
together. This is about looking to the future to improve how our
systems work together, but we set out a clear and comprehensive
plan yesterday to do exactly what she speaks of.
(South West Wiltshire)
(Con)
I declare my interest as a doctor. I wonder what the practical
consequences of this will be. Can I suggest to my hon. Friend,
whom I admire greatly, that one of those practical consequences
might be to end the awful business of people waiting for weeks
and weeks in acute hospital beds for discharge to more
appropriate settings in the community? It does them no good, it
is massively expensive to the system, and it prevents them moving
on to places that can better care for them and give them what
they need while allowing the acute sector to do what it can do,
which is to manage people who are acutely unwell. At the moment
we have 10,000 people in the system waiting for discharge. That
will not do, and I would be interested to know from my hon.
Friend how these proposals will help.
I am grateful to my right hon. Friend in this respect. Discharge
of people from hospital safely, either into a care home setting
or back to their own home with support, is vital not only for
their own health outcomes but for the flow of patients through
our acute hospitals to enable A&Es and other parts of the
system to function effectively. Through the national discharge
taskforce and through the work we have done throughout the
pandemic, we are bringing together acute hospitals and local
authorities, and we have made huge strides together within
localities in improving this and learning lessons. This White
Paper sets out a way in which they can be embedded to ensure that
they continue to deliver long-lasting benefits.
(St Albans) (LD)
My constituent Lynn is a powerful and loving advocate for her
husband Andy, but she is at her wits’ end because she has to
repeat the same information time and time again to nurses,
consultants, dementia specialists, carers and the Department for
Work and Pensions. When will the White Paper make her life a
little bit easier? Despite her frustrations, she knows that all
those professionals are working incredibly hard, but there just
are not enough of them. How can it be that the Minister has said
in this statement that he wants integrated care systems to have a
joint health and care workforce plan, but he is still refusing to
put that commitment to a workforce strategy into the Health and
Care Bill?
I am grateful to the hon. Lady for her comments and for
highlighting the situation Lynn and Andy find themselves in. What
we seek to do, through what I said about care records, is exactly
what she and I think they would wish to see, which is to reduce
the number of unnecessary or duplicative interactions with the
system.
She touches on workforce. I set out in my remarks earlier that
since 2010, under this Government, there have been over 30,000
more doctors and 38,000 more nurses. In just the past year, we
have seen a huge increase in the number of nurses—I think
11,000—and an increase of about 5,000 doctors. We continue to
grow the workforce and we are already working to do so. My right
hon. Friend the Member for South West Surrey (), who is no longer in his
place, set a lot of that in motion. We have also commissioned
from Health Education England and NHS England, now that we have
announced their merger, the long-term 10-year workforce strategy,
which I look forward to with interest.
(Kettering) (Con)
Kettering General Hospital and Northampton General Hospital have
between them 1,100 beds, 300 of which are occupied mainly by
elderly patients who have completed their medical treatment and
await discharge either into a care home or a domiciliary care
setting. Meanwhile, adult social care is provided by the two
unitary authorities, which contract with over 80 different
domiciliary care providers. Would the Minister welcome ambitious
proposals from Northamptonshire along the lines of those already
being pursued by Northumbria Healthcare NHS Foundation Trust,
whereby the NHS itself provides domiciliary care? Unless we get
those 300 patients into an appropriate setting out of hospital,
our hospitals will for ever be clogged up.
I am grateful to my hon. Friend, who quite rightly never misses
an opportunity to pay tribute to his local hospital trust. As he
knows, I am always happy—as is my hon. Friend the Minister for
Care and Mental Health—to hear any ideas for innovation that may
improve outcomes for patients and communities.
(Blaydon) (Lab)
As we have heard, councils and health service bodies have been
taking the opportunity to work together in the absence of
Government action. In Gateshead, we have a joint commissioning
director for health and care, which has worked out very well. So
things have been happening without the White Paper. The key to
addressing integration is the workforce. With thousands of NHS
vacancies and thousands of social care vacancies, we really need
to address that issue. We need a comprehensive, detailed plan on
restructuring the social care workforce to ensure it is
recognised as much as the NHS workforce.
I am grateful to the hon. Lady, although I am not entirely
convinced on her point about the absence of Government action.
Yes, co-operation has been happening organically from the ground
up, but that has been encouraged and supported by Government
action—including various pots of funding, for example relating to
discharge during the pandemic—driving that activity and helping
to foster that culture of co-operation. She highlights the
importance of the workforce and the need for increasing numbers.
That is a point I have already acknowledged. I have made clear
that the Government have a plan and are already delivering
increases in the workforce.
(North East Bedfordshire)
(Con)
I welcome the White Paper, not least because we have had to put
through a very painful tax increase and want the Government to
get on with things, but also because the Minister faces
considerable challenges, including demoralising intransigence
between competing bureaucracies, a hugely complex task of
integrating information systems, and the need to rip up and
replace the truly horrendous workforce planning system for change
of pay and other conditions, as other Members have said. All
those things are going to bog the Minister down, so will he do
two things? First, will he set up a special taskforce to look at
quick wins to start to deliver improvements? Secondly,
reinforcing what my right hon. Friend the Member for South West
Surrey (), the Chair of the Health and
Social Care Committee said, will the Minister agree to put
control of, and full information about, patient records in the
hands of patients, so that they can use effective choice?
My hon. Friend is absolutely right. He is, I think, alluding to
the fact that quite considerable inputs in the form of taxpayers’
money and resources go into the system. Members sometimes fall
into the trap of talking about inputs as the ultimate result,
whereas my hon. Friend quite rightly talks about outcomes for
patients and ensuring that money is well spent and delivers
reform and improved outcomes. That is exactly what this paper is
determined to achieve.
On my hon. Friend’s final two points, I will certainly consider
taskforces. We have used one on tackling delayed discharge, so I
know their value. I also take his point about data, and
underpinning that is something that underpins all our work:
co-design and doing things with patients, not to them. We must
recognise that it is their data and that they should have control
of it.
(Wirral West) (Lab)
The Minister talks about ICBs, but he knows full well that they
are able, under his Bill, to delegate functions and budgets to
private providers, which represents a clear Government
privatisation agenda.
The Minister talks about transferring skills and knowledge across
the NHS, public health and social care, but how will that work in
practice? Will the NHS be running training courses for private
sector care organisations? If so, why should the NHS hand over
valuable intellectual property and spend time gifting it to big
business? Will he explain what that will mean for NHS staff?
We have had these debates before. The hon. Lady knows that the
pace of privatisation was fastest under the last Labour
Government, when the increase in spend on the private sector was
much steeper. We have always been clear in our belief in the
founding principles of our NHS, which is free at the point of
need, but we have also been clear, as have every other Government
since the foundation of the NHS, that there continues to be a
role for voluntary sector organisations and private sector
providers in that context.
On the hon. Lady’s final point, it is important, as in this White
Paper, that we bring out the opportunity to help increase
knowledge and share skills across the NHS, local authorities and
the voluntary sector.
(Bracknell) (Con)
Given this excellent statement, it would be remiss of me not to
thank the Minister publicly for the decision to retain the
Frimley integrated care system, which was absolutely the right
thing to do.
Will the Minister outline his plans for lessons from the
best-performing ICSs to be shared across all ICSs, so that we can
keep costs down and improve efficiency right across the
network?
My hon. Friend knows, by virtue of the outcome, the persuasive
and compelling case made by him and other right hon. and hon.
Members from both sides of the Chamber in respect of Frimley ICS
and its boundaries. As so often in this place, my view is, “If
you ain’t broke, don’t fix it,” and his ICS is doing a fantastic
job and other ICSs can learn from its success. Mechanisms and
organisations through which chairs of ICSs get together and share
best practice already exist, but we will continue to examine
whether that could be better systematised, so that best practice
can be disseminated more widely.
(Luton South) (Lab)
We have heard already how budgets can be pulled, how place
leaders can be appointed and, importantly, how shared outcomes
can be set between health and care through our health and
wellbeing boards with local authorities. Will the Minister assure
me that accountability of the single accountable person will come
through democratic structures, such as health and wellbeing
boards or local authorities, to ensure that that if the public
are unhappy, they can change things by voting them out?
The hon. Lady will know from the debates on the Health and Care
Bill that we are moving forward with opportunities for local
authorities to be engaged not just at partnership level, as some
are already, but more directly with the NHS at the ICB level.
Health and wellbeing boards will continue to be a hugely
important part of that.
(Bristol East) (Lab)
There is a lot of what, to me, seems to be rather mind-numbing
jargon in the statement, but only one mention of nurses. Could
the Minister tell me—ideally without the jargon—about the impact
of the statement on the nursing profession?
As I mentioned in my earlier answers, this White Paper needs to
be taken in conjunction with what we announced yesterday in
respect of waiting list recovery, the September social care White
Paper and, more broadly, our approach to growing our nursing
profession, through increasing the skills and numbers in that
profession. We are already well on target for 50,000 more nurses
in the profession.
This White Paper looks at the specific aspect of the integration
of social care and health and permissive ways for local areas to
come up with their most effective place-based arrangements, many
of which are already in development. It is, quite rightly, not
specific about any individual profession, nor do we believe it
should be, because it is for local places to develop their own
local plans to reflect their local needs.
Madam Deputy Speaker
I thank the Minister for his statement.
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