Rebranding the Department of Health
12 January 2018
One of the more significant announcements from this week’s Government reshuffle was the re-branding of the role of Secretary of State for Health as ‘Secretary of State for Health and Social Care’, along with a similar change of title for the ‘Department of Health and Social Care’ (DHSC).
These changes are welcome although full details of what they will mean in practice are not yet clear. According to the BBC the planned summer green paper on social care will be published by DHSC rather than the Cabinet Office (DHSC already had responsibility for national social care policy and guidance). But even if the change is only titular, it represents a positive step forward in two ways:
- It formally recognises the inherent links between health and social care, and presents an opportunity to bring social care to an equal footing with health; and
- It is, we hope, a show of intent to simplify and align the arms of government behind an integrated health and care system, with one Whitehall department very clearly in the driving seat.
In our 2016 publication, Redrawing the Health and Social Care Architecture, we argued that the role of Whitehall departments needed to be clarified. Part of this included creation of a shared objective between DHSC and the Ministry of Housing, Communities and Local Government (MHCLG) to act together to facilitate evolution towards a single care system in England. We also proposed a longer-term change whereby national funding for social care services would be allocated directly from DHSC to local authorities.
These suggestions for changes within Whitehall were accompanied by recommendations for a simplification of the current national institutions in the NHS and better coordination across local services. We argued for a re-organisation of responsibility within a single Whitehall Department to facilitate the rationalisation of arm-length bodies and to create clearer governance above local care systems.
There are still unanswered questions about what the reshuffle changes mean longer term for aligning health and care financial flows and incentives throughout the entire system. We are exploring these questions through new research with the Healthcare Financial Management Association, to be released in the spring, on how health and care funding structures can drive change to support the delivery of better outcomes. Among other questions, the research will explore how money should flow through systems and how to incentivise behaviours to deliver the outcomes that users need.
The challenges that the health and social care system faces are significant: growing demand for services; increased complexity; an aging population with greater prevalence of long term conditions; and a legislative structure that is better aligned to the policy objectives of the last decade than those of the current one. Dealing with these challenges requires careful thought and some bold decisions. Let's hope that the change of nomenclature for the Department and the Secretary of State will help bring about an acceleration in the evolution of the health and care system towards one that is better designed to deal with these challenges.