Conservative conference: call for pooled primary and secondary care budgets

NHS budgets should be pooled across primary, secondary and specialist services, but Labour plans to put councils in charge of commissioning are a long way off, a senior Tory has warned.

Stephen Dorrell: health select committee chairman
Stephen Dorrell: health select committee chairman

Stephen Dorrell, chairman of the House of Commons health select committee, and a former health secretary, told the Conservative party conference in Manchester on Tuesday that he is ‘strongly in favour of single commissioner budgets’.

But he warned that Labour’s plans to hand CCG budgets to health and wellbeing boards is not the solution because a large proportion of commissioning – including for primary care – is not done through CCGs.

He told GP: ‘I am strongly in favour of single commissioner budgets because the longer we go on running separate commissioning budgets, the longer we preserve the historic silos. The ability to take cash from one bit of the system and move it to another is fundamental.

‘We shouldn’t imagine that in any time soon we are going to get to a world where the NHS budget is simply accounted for through local government. The "N" of the NHS does remain important.

'It is more complex than simply giving the CCG budget to the health and wellbeing board. We shouldn’t forget that a huge proportion of the budget doesn’t go through the CCGs.

‘There are specialist commissioning processes and more importantly in terms of local services there is the GP commissioning budgets as well. Achieving joined up commissioning through the agency of the health and wellbeing board in my view is the direction of travel but it will be a process not an event.’

Health minister Dr Dan Poulter said: ‘Health and wellbeing boards do have an oversight function for CCGs and that means that it encourages a more holistic approach.

‘We do need to see how joint commissioning can also work more effectively in the system and the benefits that can bring.’

On CCG budgets, Kent County Council leader Paul Carter told the conference: ‘I am told we have sort of got it. As I understand it the commissioning budgets of CCGs will have to be endorsed by the health and wellbeing boards.

‘It will have influence in shaping what is commissioned by the CCG, particularly around community integrated health.’

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