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Social Care Debate Review

At a Leaders Club event a couple of years ago, addressed by the chief fire officer of Manchester Fire Service, we were posed the question “Why are fire stations located, as they are, in city centres?”. We were able to offer at best a few guesses. We learned that whilst there have been massive technology increases in equipment and training, fire stations are located to best ensure they can quickly extinguish Hitler’s incendiary bombs!

Ian & Professor Stephen Smith fundamental proposition was that there is a significant parallel for the NHS; equipment, technology, training and procedures have enjoyed huge advances but the system that delivers NHS services hasn’t changed since inception in 1948 and is no longer fit for purpose.

Based on a paper that they have offered within the health community, the brothers led us through a series of statistics that illustrate the challenge and stretch the NHS is under. Whilst these may have been known to some degree by the audience of some 50 to 60, the diagnosis and prescription set the scene for the variety of contributions that followed from a diverse and well qualified panel.

Their presentation was the second part of the evening, which had enjoyed two presentations from two very different organisations, IBM and HB Villages houses. IBM have been pioneering, under their Dr Watson programme, the assimilation of medical data, particularly cancers, with a technology that can understand the information presented and replay it back to clinicians who have made searches for which that data may add understanding. A paper scanned in South America this morning is able to offer diagnostic and prescriptive advice to clinicians in Liverpool this afternoon. HB Villages houses described their hands on accommodation solutions for vulnerable adults who were a challenge to the system; providing them safe and secure accommodation utilising the best and newest in building technology to offer a highly cost effective place of residence for those the NHS was never geared up to manage. Excellent both.

Returning to that key second half, following the Smith brothers presentation, Sir Malcolm Thornton steered a diverse group with great skill, to give us a hugely informed debate with great contributions from the panel and some good audience involvement. A view that was expressed by many on the panel, in different ways and from very different perspectives, was the dual need to see the future as patient led and to find a way to abolish the dichotomy of NHS and LA provision. Patients are only patients whilst being treated by the NHS, if they pass to the LA they are service users – same people, same problems, but as patients with a health need the NHS provides care free at the point of need, move back to the LA and a whole other system kicks in. A capitated budget, one that provides monies across a geographic area and meets people’s needs, those needs being delivered wherever appropriate – NHS or LA – seems to offer a way forward, but how to achieve this, when central government is diverted elsewhere remains a local problem with those of good will doing their best.

We all felt suitable challenged.

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