6 Healthcare Business April 2010

"Dear Chief Secretary, I’mafraid there is nomoney. Kind regards –

and good luck!” So read thenote left by outgoing Labourtreasury minister Liam Byrne tohis coalition successorfollowing the 2010 GeneralElection. The coalition govern -

ment has held this note up as asignal of the last government’s

profligacy in office, a justificationfor coalition cuts and a symbol ofthe Labour Party’s callousdisregard for the consequences ofthe economic contraction itpresided over. Embarrassingly forthe coalition, current TreasuryChief Secretary Danny Alexandermay well leave the same note forhis own successor following nextyear’s election.

This has profoundrepercussions for health policy andthe health sector in the period2015-20. Despite its budget beingring-fenced from the cuts, NHSEngland has predicted that it willface a funding gap of £30bn by2020. Whoever wins the nextelection will have to either deliverfurther cuts or find new taxes andcharges to fill this black hole. Thisharsh reality is compelling bothmajor parties to think theunthinkable on health policy.

Labour’s Shadow HealthSecretary Andy Burnham hasambitious plans for the NHS. Heplans to integrate health and socialcare into a single, unified ‘wholelife’ service. The policy is designedto address the challenges posed bythe fact that, by 2030, the numberof people aged over 80 in the UKwill double to six million. However,it raises far more questions than itanswers on the issue of funding.That is why, according to anumber of reports, the Labourhigh command is currentlydebating whether or not to makean election pledge that they willraise income tax specifically tofund a revolution in care for theelderly. Many in the party fear thatsuch an open commitment couldcost them the next election in the

same way that accusations of animpending ‘tax bombshell’ costthe party power in 1992. CertainlyConservative election strategistLynton Crosby would have a fieldday attacking such a policy but it isworth remembering that in the1990s a pledge to add 1% toincome tax to fund education bythe Lib Dems added to the party’spopularity rather detracted from it.

The Conservatives are alsowrestling with their own solutionsfor squaring a rising healthcare billwith the need to reduce spendingoverall. Conservative MPs continueto question how long the ring-fencing of both the NHS and theaid budget can last when otherdepartments – including thosecloser to Tory hearts, such asdefence – are being cut to thebone. It is in conservative-leaningthink tanks, however, where thereal revolution is being plotted.Respublica, the think tank foundedby ‘Red Toryism’ advocate PhilipBlond, recently published apamphlet urging the mutualisationof healthcare, with friendlysocieties and other mutualsplaying a valuable role inintegrating services. Reform, acentre-right think tank that countsa number of ministers and formerministers amongst its alumni, hasgone further, publishing a report(co-authored by former Labourhealth minister Lord Warner) thatproposes a range of patientcharges and higher ‘sin’ taxes ontobacco, alcohol and sugary foods.Reform calculates that a £10charge for missed GPappointments could net the NHS£55m whilst a £10 ‘hotel charge’for overnight stays in hospitalcould bring in between £93m and£196m and reform of theprescription charges regime couldgenerate up to £1.9bn. TheConservatives have long debatedthe introduction of charges withinthe NHS but have always shiedaway from doing so, fearing thepublic backlash that it would incurfrom the public.

Even with a recoveringeconomy, it is clear that bothmajor parties not only face somehard choices after 2015 but musteach resolve their own internalschisms that pit cherished ideologyagainst much-desired popularity.Whoever wins, expect sacred cowsto be challenged.

James Ford is a Senior Adviserat PLMR. Previously he was an aideto Mayor of London Boris Johnson,advising him on transport, digitaland environment policy between2010 and 2012.

Austerity 2.0

Craegmoor, part of the PrioryGroup of Companies, is openinga new supported living

development on the outskirts ofLochwinnoch, Renfrewshire.

Corsefield will provide support for11 service users with Autism orlearning disabilities. The service willprovide accommodation in seven self-contained apartments, each with itsown outdoor space and a smaller unitof four en-suite rooms with sharedcommunal living areas.

Each service user will have a teamof highly trained support workers toimplement a social care model ofsupport aimed at ensuring they attainmaximum independence andintegration into communityemployment and education.

Based on the former Garpel andParkhill site, t he unit will be managedby specialist Autism, learning disabilityand positive behaviour experts, offeringappropriate and evidence-basedsupport 24 hours a day.

Craegmoor is holding a recruitmentopen day for people interested in rolesat Corsefield, followed by a publicinformation event to engage with thelocal community and other interestedorganisations and individuals.

The event, to be held at McKillopTown Hall, Lochwinnoch onWednesday 7th May, will providerecruitment details between 1pm and6pm and community engagementbetween 7pm and 8.30pm.

Sarah Hughes, managing directorof Craegmoor, said: “Corsefield will beat the forefront of supporting peoplewith Autism or learning disabilities.

“The management and supportteam will all be experts in their fieldand fully trained to meet the needs ofthe service users and support them tolive as independently as possible. Wehope they will become an integral partof a supportive local community.

“We are recruiting for high calibreindividuals with a passion for deliveringthe best possible care and support andare looking forward to meeting peopleinterested in working with us, andthose who want to find out moreabout this exciting development.”

New specialistautism andlearningdisability unitto open inLochwinnoch