Merge NHS and social care, says Labour
The NHS and social care budgets in England should be combined to create a super pot to meet the needs of the ageing population, Labour says.
The money - worth £119bn this year - could be used to provide more joined-up care across the hospital, mental health and care sectors, the party believes.
In a speech on Thursday, shadow health secretary Andy Burnham will say the current arrangements are outdated.
He will claim "dangerous" gaps between services put the vulnerable at risk.
The proposal could see councils get much more involved in making decisions about the NHS, while the biggest hospitals may end up expanding into the community, perhaps even running care homes.
End Quote Mike Farrar NHS Confederation
A cocktail of financial pressure and demographic change means that the NHS needs to adapt to meet the needs of today's patients”
But government sources suggested such a move could end up undermining clinical commissioning groups - the new bodies which are taking control of the health budget under the government reforms.
That would mean "taking power away from doctors and nurses", they said.
Combining the budgets will also require changes to the way money is distributed round the system.
And it would raise a question mark over the means testing of social care.
Currently those with assets over £23,250 have to pay for help, but how that could be enforced in a combined system is unclear.'Incentive'
But Mr Burnham will deny the plan is any sort of reorganisation when he addresses an audience of health professionals in London.
He will dub the proposal, which is being put out to consultation, as "whole-person care".
"As we live longer, people's needs become a blur of physical, mental and social.
"It is just not possible to disaggregate them and meet them through our three separate services.
"But that's what we're still trying to do."
He will say that hospitals are at risk of becoming "warehouses" for the elderly as social care support is being cut back.
"We are paying for failure on a grand scale, allowing people to fail at home and drift into expensive hospital beds and from there into expensive care homes.
"The trouble is no-one has the incentive to invest in prevention."
Mike Farrar, chief executive of the NHS Confederation, which represents health managers, said: "Mr Burnham is absolutely right to highlight the long-term pressures facing the NHS and the need for radical change to address them.
"A cocktail of financial pressure and demographic change means that the NHS needs to adapt to meet the needs of today's patients.
"We urgently need an all-party debate about these issues, with radical solutions very much allowed. The NHS will judge the plans of all politicians on how they help the service tackle these massive problems."