Another NHS reorganisation is needed, says Conservative minister and former Norfolk hospital chief
- Credit: Bill Smith - Archant
A former health minister who left the department just weeks ago has raised the prospect of another reorganisation of health and social care 'within years' and said a tax rise to pay for healthcare is 'possible'.
Lord Prior, a former North Norfolk MP, became chairman of the Norfolk and Norwich University Hospital after losing his seat to Norman Lamb.
He left the N&N in 2013 to head the care watchdog, the Care Quality Commission, until he was made a life peer and health minister by David Cameron in 2015.
Reflecting on the NHS after he was moved to the Department for Business, Energy and Industrial Strategy in December, Lord Prior acknowledged the 'huge stress' on the NHS amid an ageing population suffering from more long-term conditions.
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Speaking last week before the Red Cross labelled the current shortage of beds in some hospitals as a 'humanitarian crisis', the business minister said far too many people who could be treated at home were ending up in A&E departments and long stays in hospital.
'The problem we have is that having had a huge reorganisation a few years ago, another one now is not very appealing, but it will happen within years not months.
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'There will have to be a reorganisation at some stage to bring health and social care closer together.
'I just think that, however it is done, health and social care will become more closely aligned and integrated.
'The whole system will benefit from a greater degree of devolution as we are doing in Greater Manchester where the health budget is largely devolved to the mayor and local people.
'They have control over the health and social care budget. I think that is probably the direction of travel,' he added.
Plans for an elected mayor for Norfolk and Suffolk were rejected by a number of Norfolk councils last year.
While the blueprint for the plan was focused on infrastructure, economic growth and housing, local policy makers had hoped it would pave the way to more control over spending on health and social care.
In 2010 the coalition government reformed the NHS giving GP-led clinical commissioning groups control over health budgets – a move widely criticised at the time.
Lord Prior said: 'I think the reforms in 2010 were good in parts, but they didn't address fully this fundamental issue of bringing together health and care.
'I think it will be for the next parliament to do that probably. I would be very surprised if all the parties were not going to bring this forward at the next general election as the right move forward, but we shall see.'
Lord Prior's successor in North Norfolk, Norman Lamb, the Liberal Democrat health spokesman, has raised the prospect of his party campaigning for a ringfenced tax, which would involve a one penny increase in either income tax or National Insurance.
Questioned if he would back the move, Lord Prior said: 'Well, people don't like paying tax.
'What people say in a hypothetical way is different from the actual reality.
'But I think of all the areas of government spending people value the most it is healthcare as it happens. It is possible.
'Health demand grows at around 4pc a year by and large, whereas the economy grows at 2pc a year and therein lies the problem.
'If you don't rein back healthcare demand it will take a growing percentage of the economy.
'What do you do then? Education is vitally important, defence is vitally important. We are into some difficult choices which have to be made.
'They are best made at the time of a general election.'
But he added that bringing health and social care together would enable people to be treated more at home than in hospitals.
'Medical technology is changing rapidly and will allow people to be treated more remotely from hospitals – the use of e-consultations over the internet.
'This new app they are trialling in London – you can get a diagnosis without seeing a GP. All these things will have a part to play.
'On the other hand there are more expensive drugs coming down the pipeline, I have no doubt. I think we have an obligation to deliver care in the most efficient way.
'There is always waste we can squeeze out of the NHS, but it doesn't alter the fact, I know it is under huge pressure at the moment.'
Treatment at home – Page 16
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Lord Prior on Brexit:
There would be a sense of outrage if unelected peers stopped the starting gun being fired on Brexit negotiations, said Lord Prior.
Having called for people to vote to remain in the European Union ahead of the referendum, he said he was now an 'excited former remainer'.
The former health minister, who became an MP in 1997 at the same time as Mrs May, said coming out of the EU would give Britain a 'chance to shine' and it was 'not all downside by any means'.
Questioned about whether Britain should seek to stay in the single market, Lord Prior said: 'I certainly hope our companies can trade on equal terms in Europe. That must be an objective of the negotiation. But there is such a complex, multi-layered, multifaceted negotiation that you can't just pick on one item.
'It is going to be a very complex series of negotiations. The extent to which we can maximise trade in Europe has got to be good for everybody.'
He said that Mrs May's most important task was to reconnect with people who felt left behind and forgotten about – but backed her to do the job.
'There is something about the British people, when we can have the most profound change in British politics since 1945 by coming out of Europe and have Theresa May as prime minister and Philip Hammond as chancellor. The lunatics are not in charge of the asylum. We have absolutely solid and sensible people running the country. That is not necessarily the case in other countries in Europe.'
Questioned about whether members of the House of Lords could block Brexit, he said: 'People like me who were against Brexit are not going to stand in the way of the referendum result.
'I think the vast majority of people will go along with that argument. My guess is that we will get it though.
'There would be such a sense of outrage if we didn't.
'There would rightly be outrage.'
Questioned if the blocking of the triggering of Article 50 could prompt reform of the Lords, he said: 'Rightly so, I don't think it is a function of the House of Lords.'