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Health and wellbeing boards should take over CCGs' health budgets, says shadow health secretary

Health and wellbeing boards should take over the health budgets from CCGs to create a truly integrated system, according to shadow health secretary, Andy Burnham.

In a speech to the King’s Fund yesterday, Mr Burnham said health budgets should be merged with social care budgets into a single £120 billion pot to create a system based around the needs of the individual.

He said: ‘Health and Well-Being Boards could come to the fore, with CCGs supporting them with technical advice.’

Mr Burnham denied his proposals amounted to another top-down reorganisation of the NHS, saying he intended to re-focus existing organisations within the care system.

And he restated Labour´s intention to repeal the Health and Social Care Act 2012, labelling it ‘a confused, sub-optimal piece of legislation not worthy of the NHS.’

Mr Burnham used his speech to to launch a review of health and care policy focusing on what he termed ‘Whole-Person Care’.

He singled out work by GPs in Torbay - where an integrated care trust has been created with a budget of 125 million for 2012/12 - claiming more people there die at home than in any other part of England and suggesting it could serve as a model for the whole country.

‘For 65 years, England has tried to meet one person’s needs not through two but three services: physical - through the mainstream NHS, mental - through a detached system on the fringes of the NHS and social - through a means-tested and charged-for council service, that varies greatly from one area to the next.

‘One person - three care services. For most of the 20th century, we just about managed to make it work for most people.

‘Now, in the century of the ageing society, the gaps between our three services are getting dangerous. As we live longer, people’s needs become a complex blur of the physical, mental and social.

‘It is just not possible to disaggregate them and meet them through our three separate services,’ he said.

Mr Burnham said Labour´s care review would be led by the Shadow Minister for Care and Older People, Liz Kendall, and would run alongside a separate public health policy review run by Shadow Minister for Public Health Diane Abbott.

‘Over the next six months, we will be holding events in all parts of England seeking views on two central questions. First, do you see merit in this vision of Whole-Person Care and support the proposals for the full integration of health and social care? Second, if you do, how far down this path of integration do you think we should go?’

Dr Michael Dixon, interim president of NHS Clinical Commissioners said: ‘One of the very great strengths of clinical commissioning is that it brings commissioning closer to the patient.

‘We full support putting the individual at the centre and NHS Clinical Commissioners would be concerned about any moves that undermined the link between patient and commissioner.

‘At a time when the clear direction of travel is to move services away from secondary care, we believe that locating commissioning with primary care is the right place. As CCGs are just about to take up their responsibilities they need certainty to deliver transformational change.’

Professor Chris Ham, chief executive of The King’s Fund, said: ‘Andy Burnham’s diagnosis of why the NHS and social care needs to change is the right one. The demands of an ageing population, changing burden of disease and rising patient expectations mean that fundamental change is needed.

‘His prescription for change is ambitious and his vision of delivering integrated care, co-ordinated around the needs of the individual, will be widely welcomed. But it leaves a number of unanswered questions, not least how plans as radical as these could be implemented while keeping his promise not to embark on further structural change.

‘We have argued that it is time to think differently about how to respond to the future challenges facing the NHS and social care. Andy Burnham has responded to the challenge to think differently, but the ideas he has articulated today leave many questions unanswered.’

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