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Labour defends national pay bargaining

Shadow health secretary Andy Burnham confirmed Labour’s commitment to national NHS pay at his party’s conference yesterday.

At a fringe meeting in Manchester, he maintained that the ‘N’ in NHS related not only to access for treatment but also to staff and their terms and conditions.

His views echo those of the BMA, which is campaigning hard to retain national pay and terms and conditions.

Mr Burnham warned that the government’s health reforms were ‘a fast track to fragmentation’ that would see national pay broken down into local and regional systems.

He said: ‘We are already seeing moves in the south west to break national pay in the NHS and I believe it is an essential part of the infrastructure that underpins a truly national health service.’

Out on a limb

A consortium of 20 NHS trusts in south-west England are considering plans to break away from national terms.

The MP vowed again to repeal the Health and Social Care Act and said his main speech to the conference on Wednesday would focus on the need to integrate care in the face of an ageing population.

He insisted: ‘We can’t have this system carrying on where we’ve got one person’s needs being met through three disjointed and fragmented systems – the social care system, the NHS and the mental health system. We need to bring those three systems together in an integrated approach to people’s care – I call it a “whole-person” approach to care.’

Mr Burnham suggested this might involve a ‘year-of-care’ approach, with a single fee to manage all of a person’s physical, social and mental needs.

He maintained: ‘The big choice here really is between a fragmented, broken-down market-based system or, what we are going to propose, a much more integrated approach to care and, at long last, truly integrating health and social care.’

All in one

Speaking at the same event, commons health select committee chair Stephen Dorrell agreed with the aim of integrated care but said the key to this was integrated commissioning and moving beyond a familiar healthcare landscape.

He said: ‘I think, two years on, the landscape of the institutions of the NHS will look extremely familiar.

‘There will be what used to be called regional health authorities — what Andy called strategic health authorities — what we now call branches of the national commissioning board.’

Clinical commissioning groups would be primary care trusts ‘with significant changes, but roughly the same number’, the Conservative MP maintained.

He said: ‘The key is that we have to move beyond the landscape that is very familiar — recognise that it is nonsense for us to have separate bureaucracies dealing with primary care, community health services, social care services, social housing services…

‘Without integrated commissioning I don’t believe we’ll ever deliver the integrated care… which is what I am really interested in.’

In a second fringe meeting today, Mr Burnham clarified that while the NHS should lead on the provision of care, local authorities should lead on commissioning ‘whole-person’ care.