Speaking exclusively to GP, Mr Lamb set out his priorities for primary care. The party has pledged to meet NHS England’s demand for £8bn a year additional funding for the health service by the end of the next parliament to help plug a projected £30bn black hole.
The minister said £500m a year of that would be targeted at integrating out-of-hospital care.
Mr Lamb, who joined the DH as care minister in September 2012, said the Conservative-led coalition had been too slow in starting to integrate health and care services, and should have ‘focused on integrated care from day one’.
NHS integration progress
‘We have made massive progress, now,' he said, pointing to the Better Care Fund, integrated care pioneers and the new models of care vanguards.
But he admitted: ‘We should have started sooner. As soon as I was in that department, we went for it.'
A Liberal Democrat government would create a department for health and care and pool local budgets, said Mr Lamb.
The £500m-a-year Care Closer to Home Fund would be spent on linking up fragmented parts of the system and extending the range of services provided by GPs working collaboratively and in federations according to locally determined priorities, Mr Lamb said.
One area where ‘significantly improved outcomes’ and more effective use of funds could be achieved, he said, was better integrating mental health into primary care and general practice. ‘There are very many GPs who strongly believe in this approach,' he said.
Mental health reform
Mr Lamb gave the example of Intermountain Health in Utah, USA, where ‘significant improvements’ were made in mental health care and use of resources.
The party has also pledged £400m to increase early support for people with mental health problems.
Last week deputy prime minister Nick Clegg announced a £250m transformation fund from an NHS asset sale to pay for new technology including more use of online, phone and video access to GPs.
Mr Lamb told GP the schemes would free up GP time to deal with patients with complex needs face-to-face.
A GP-led programme in Seattle, USA where a significant number of consultations were dealt with by email had also significantly improved the well-being of GPs, the minister said.
Mr Lamb said: ‘If you can free up time by dealing with those people who can be dealt with by email and Skype, then the GPs' real value in managing the conditions of people with chronic conditions comes into its own, and I suspect it improves significantly their experience of work.’
Better use of GP time
Mr Lamb acknowledged the danger that creating more access points could increase demand, but said the experience where it had been done was that it led to better use of GPs’ time.
Another urgent priority for the technology fund, which Mr Lamb said could go beyond the initial £250m, would be to improve links between GP, hospital and other NHS and care services.
Everything the Liberal Democrats propose, the minister admitted, ‘necessitates an increase in the GP workforce’. As part of the Coalition, he said, his party was signed up to increase by 5,000 the number of GPs, but he added, Health Education England ‘needs to do more work to properly analyse the workforce requirements over the next five years.’
‘We need to make the commitment to meet whatever that requirement suggests’, he said.
GP workforce review
Mr Lamb repeated his call for a cross-party commission to initiate a public conversation on a new settlement for the NHS and how to meet the £22bn efficiency savings NHS England chief executive Simon Stevens has said are required.
‘The risk of not doing that now and now engaging the public ... is that the system could buckle under increasing pressure,' he said.