Queen’s speech: health bill and extra funding, but no details on social care

The Queen outlined the government’s plans for the next Parliament during a pared back ceremony to mark the state opening of Parliament. She outlined a programme that promised to ‘level up opportunities across all parts of the UK’ and address the ‘impact of the pandemic on public services’.

The speech included plans for legislation covering constitutional reform, housing, education and infrastructure. It also confirmed plans to bring forward a health and social care bill that will establish integrated care systems as statutory bodies and move to a model based on collaboration not competition.

‘My government will protect the health of the nation, continuing the vaccination programme and providing additional funding to support the NHS,’ the Queen said. ‘My ministers will bring forward legislation to empower the NHS to innovate and embrace technology. Patients will receive more tailored and preventative care, closer to home.’

Health and wellbeing will also be targeted with a specific focus on tackling obesity and improving mental health. However, the speech provided no detailed plan for changes or investment in social care, promising only that proposals on reform would ‘be brought forward’.

Chris Hopson (pictured), chief executive of NHS Providers welcomed the commitment to more funding to support recovery and transformation in the years ahead. ‘Just £1bn in non-recurrent funding has been promised to the NHS to date to help clear the backlog for non-urgent operations, alongside £325m for diagnostics equipment,’ he said. ‘As a bare minimum, we need at least three years’ extra dedicated funding, on top of what was promised in the May government’s settlement and the money that’s already been set aside for extra Covid costs.’

He added that trust leaders ‘broadly welcomed’ the direction of the health and care bill, but wanted further clarity in some areas such as the roles of providers and integrated care systems. ‘It’s also vital that the bill puts a proper, funded, long-term NHS workforce plan in place,’ he said. ‘This is all the more important given the sheer scale of the challenge facing the NHS in the years ahead, such as clearing the backlog of care.’

But he described the failure to provide details on the radical change needed for social care as ‘deeply disappointing’. ‘The prime minister made a personal commitment to fix social care once and for all. He must now be true to his word,’ he said.

Danny Mortimer (pictured), NHS Confederation chief executive also welcomed the promise of additional funding, but said that the detail of this investment would be crucial. ‘We will await further clarification in the coming months and as part of the comprehensive spending review,’ he said.

But he was ‘disheartened’ that the government had again kicked the social care reform issue into the long grass, with health and social care inextricably linked. ‘[This] means the very real risk that no real progress will now be made on this issue during this Parliament,’ he said. ‘Social care reform is desperately required and we need a timetable for reform now, not at some distant future point and this must be coupled with significant long-term investment.’

Natasha Curry, deputy director of policy at the Nuffield Trust said that further delay to social care reform was a betrayal of manifesto promises. ‘How can the country “level up” when many people are unable to access the care they need to live fulfilling, independent lives; no one is protected against catastrophic costs; and care workers are underpaid and undervalued?’ she said. ‘The devastating impact of the pandemic on the already fragile care sector should be the wake-up call needed to bring forward proposals urgently.’

The Treasury’s objection that reform is unaffordable did not stand up to scrutiny, according to Jennifer Dixon (pictured), chief executive of the Health Foundation, arguing there were ‘pragmatic and workable solutions’ on the table that would cost ‘just 2% of what we currently pay for the NHS’. ‘Given the weight of the case for change, the question is not whether social care reform is affordable but whether the government can afford to delay progress on an issue that could become its Achilles heel,’ she said.

Local Government Association chairman James Jamieson said a clear timeline was needed for any proposals on social care reform. ‘It is vital that this is also urgently converted into concrete funding proposals to provide sustainable support to people of all ages across the country who draw on social care to live the life they want to lead,’ he said. ‘We are keen to work with the government and other stakeholders on a cross-party basis to achieve this. We cannot keep kicking this can down the road.