10 February 2017 | By Neil Carberry Insight

The future of healthcare

Insight: Neil Carberry, CBI director for people and skills

Health and social care are a challenge for us all

Winter is traditionally a tricky time for the NHS. In some respects, this year is no different. Our TV screens show hospitals struggling to keep pace with patient demand, while people in suits point to graphs explaining why the health service needs more money.

This week, a surfeit of statistics from the independent Institute of Fiscal Studies tells us that spending on adult social care has fallen by 6.4 per cent since 2010, while the number of pensioners has risen by 16 per cent. Demographic realities mean that the long-term sustainability of the NHS is a real concern.

There is a role for the private sector and employers in helping to alleviate the strain. Increasingly, business is playing its part in supporting its employees’ health. Indeed, the majority of employers understand that supporting workers is not only the right thing to do but there is a clear business case for doing so. CBI research from 2012 puts the cost of unaddressed health issues and absence at around £14bn. Healthy staff are more likely to be engaged and productive, improving a firm’s performance.

For years companies have offered employees health benefits through salary sacrifice schemes. Private medical insurance can support staff recruitment and retention while freeing up NHS capacity. It was therefore disappointing to see the Government slap a double-whammy of disincentives on those who use private healthcare. Specifically, removing employee health benefits from salary sacrifice schemes could affect take up and therefore opportunities for prevention of more costly conditions. Increasing the Insurance Premium Tax also sends a negative signal to those employees looking to invest in their own care.

Is integration the answer?

Integrating health and social care is another area where business can help. A new report from the National Audit Office concludes that progress on integration so far has been "slower and less successful than envisaged". It concludes that more than £5bn has "not achieved the expected value for money, in terms of savings, outcomes for patients or reduced hospital activity". Through investment and innovation, firms can help local authorities plan and deliver health and social care integration. One such example is a partnership run by Hampshire County Council. Argenti Telecare provides technology which has helped improve more than 4,000 elderly people’s lives by allowing them to live more independently whilst also making cash savings. 

While funding is ultimately provided chiefly by central government and then disbursed through local authorities, the private sector is critical in the delivery of social care. Care providers, which are a major national employer, bear the brunt of growing demographic pressures, squeezes on funding and challenging legislative changes such as the National Living Wage and the forthcoming Apprenticeship Levy.

The long term

The NHS and social care face a plethora of challenges. That is why the role of employers is so important. The Government must take decisions which embraces this role rather than disincentivises it. Finding longer-term solutions to tackle the growing issues facing the care sector calls for the Government and industry to work in partnership, particularly when you consider that the majority of migrants working in social care (191,000) come from non–EU countries. As the Institute for Public Policy Reserach (IPPR) sets out in a new report, Care in a Post-Brexit Climate, establishing an industrial strategy for the care sector could be a promising first step. With the winter crisis showing little sign of slowing, we must all recognise the responsibility we have in protecting and preserving the NHS and social care.

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