Integration White Paper

Jeremy Hunt Excerpts

Wednesday 9th February 2022 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

As one in the long line of former Health Secretaries with scars on their back—to quote Sir Tony, if we are allowed to—from when they tried to integrate the health and care systems, I warmly welcome this White Paper. I think it is more than aspirations. But there are three central elements of the plumbing that we have to get right, and I want to ask the Minister, who I know is very committed to this, for his response.

First, previous attempts to have pooled budgets for vulnerable people have been bedevilled by the fact that the NHS has not wanted to pool its budgets with an underfunded social care system. The grant to local government is still not generous, to say the least. The Select Committee on Health and Social Care recommended an increase of £7 billion a year by the end of the Parliament, but it is actually going up by £2 billion a year. What will we do to overcome the resistance in the NHS to merging budgets with a social care system that is feeling very stretched?

Secondly, it is a very big step forward that everyone will have a single electronic health and care record by 2024, but my simple question is whether the public will be able to access the data. Patients are the best guarantors and defenders of their own health, so they should be able to access everything that professionals can see about them.

My third question is about having a single professional responsible for someone’s care. What is the role of GPs in that? For most members of the public, the central person responsible for their care is their GP. Is it not time to go back to the days when everyone had their own family doctor, instead of a different doctor every time they call the surgery? They might not see the same person every time, but there should be someone at the GP surgery who is responsible for their overall care, whether that is in the health system or the social care system.

[Edward Argar]

My right hon. Friend speaks with typical wisdom and common sense on these issues. I will briefly address each of his three points in turn.

On pooled and shared budgets, I have to say that I think section 75 of the National Health Service Act 2006 has worked well. When I was cabinet member for health and adult social care at my council—I had more hair then, and it was not grey—I also sat on a primary care trust board as a non-executive member. I had a senior director of that PCT on my management team; we forged a common purpose, recognising that there would be some areas in which NHS moneys were greater than those put in by the local authority and vice versa, but the shared goal was achievable only when we worked together. I think that there is genuinely something to build on, and the ICSs, ICBs and ICPs at the upper level will be the vehicle to move the process forward. When I was doing it, there was a degree of personal relationship moving it forward, rather than necessarily a systematised approach, but I genuinely think that there is a willingness and a recognition of the need for this.

On public access to electronic records, my right hon. Friend’s central point is absolutely right: it is important to recognise that such data is our data and individuals’ data. We must always be wary about doing something to someone, as opposed to in partnership with them. That principle will underpin our approach in this space.

Finally, my right hon. Friend referred to a single responsible professional—not a single point of contact, but someone who brings together an individual’s care. He is right to highlight the importance of general practitioners. May I put on record my gratitude to GPs not only for all their work over the past two years, and for all they do day in, day out, but for the wisdom and care that they bring to addressing their patients’ needs?

Since my right hon. Friend’s time as Secretary of State, there has been a continual drive to increase the number of doctors in our health service. Not all will become general practitioners, but we need to continue to make general practice accessible and to encourage people to choose it as an incredibly exciting and rewarding career. One of the key elements of making what he describes work is building up a body of general practitioners who are able to perform such tasks. I pay tribute to his work; we are continuing that work and building on his foundations. I am grateful for his questions and for his contributions.