Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-27T07:34:18.648Z Has data issue: false hasContentIssue false
  • English
  • Français

Could local integration of health and social care finally overcome the pull to the centre?

Published online by Cambridge University Press:  25 April 2018

Anna Dixon
Anna Dixon*
Affiliation:
Chief Executive, Centre for Ageing Better, London, UK
*
*Correspondence to: Anna Dixon, Chief Executive, Centre for Ageing Better, 407 St John Street, London EC1V 4AD, UK. Email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

There are several advantages of Bevan’s design, such as progressive funding through taxation and equity of access regardless of income, that we must not lose sight of as we celebrate the NHS’s (National Health Service) 70th birthday. However, there remain historical fault-lines dividing health and social care. The challenge is how to preserve equity if a more radical reform were implemented to fully integrate both the funding and delivery of health and social care. Funding from national taxation with defined entitlements could preserve both equity in funding and geographical equity. This does not solve the issue of the pull to the centre, which has been a feature of the NHS throughout its history, according to Klein. This will require a fundamental shift in the use of data. Data must be wrenched from the hands of the regulators and put back in the hands of those who generate them for the purposes of improvement.

Type
Perspective
Information
Health Economics, Policy and Law , Volume 14 , Issue 1 , January 2019 , pp. 15 - 18
Copyright
© Cambridge University Press 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Day, P. and Klein, R. (1997), Steering But Not Rowing? The Transformation of the Department of Health: A Case Study, Bristol: The Policy Press.Google Scholar
Goodwin, N., Dixon, A., Anderson, G. and Wodchis, W. (2014), Providing Integrated Care for Older People With Complex Needs: Lessons from Seven International Case Studies, London: King’s Fund.Google Scholar
Ham, C. (2014), Reforming the NHS from Within: Beyond Hierarchy, Inspection and Markets. Case Study 2: Intermountain Healthcare, London: King’s Fund. www.kingsfund.org.uk/publications/reforming-nhs-within/case-study-2-intermountain-healthcare [14 January 2018].Google Scholar
Schneider, E. C., Sarnak, D. O., Squires, D., Shah, A. and Doty, M. M. (2017), Mirror, Mirror 2017: International Comparison Reflects Flaws and Opportunities for Better US Health Care, New York: Commonwealth Fund.Google Scholar