INTERVIEW: ANDY BURNHAM
PA PHOTOS/NEWSWIRE
“What I want is the right people in the right place and I don’t think that is the case at the moment. We’ve seen a hollowing out of expertise.”
although Nuffield Trust chief executive Andy McKeon recently said its research on integrated care initiatives showed no evidence of lower costs. ‘I believe the future is integration and the fuller and deeper it is, the more successful it is likely to be. Barriers to integration and collaboration need to be completely removed,’ Burnham says. ‘I think there is no doubt that it will produce savings. If you reduce unnecessary hospital admissions of old people that has to be better. What I would not want to do is say that integration solves everything, but it takes you a hell of a long way down the path. It is just the right thing to do.’ This will require dropping any ‘silobased’ divisions between the NHS and local government. ‘It’s not possible for people to work in glorious isolation,’ he warns. healthcare manager | issue 21 | spring 2014
This whole-person care would see physical, mental and social care united in a single service with the emphasis on keeping people healthy at home. But social care remains a difficult conundrum for all political parties. While everyone sees it as key to caring for people at home, few want to bite the bullet and fund it. Labour has been no exception to this, and Burnham says the party is ‘still wrestling’ with the right funding mechanism. However, he suggests there is ‘logic’ in shifting resources from the acute sector towards preventative care in the home. ‘If you look at Torbay, they are providing social care of a higher standard than anyone else in England,’ he says. ‘In a whole-person care model more social care would be provided because it is preventative and funded by that transfer from acute care.’ He suggests there are inefficiencies
in the system which could be eliminated under an integrated system: 15-minute care visits are ‘pretty worthless’, he says, and visits from multiple professionals can be a waste of resources. One of the consequences of failing to support people in the home is that large sums are spent on hospital admissions. ‘It’s inefficient and very bad in human terms.’ But Burnham is not in a position to promise additional funding overall for the NHS. ‘I can’t work on the basis that I’ve been promised all kinds of money. I have to see that we are getting the best that we possibly can for the money; I don’t think we can look people in the eye and say that at the moment. If we ever reached that point, then a debate on the right level of funding could follow,’ he suggests. He firmly believes that closer links to 13