Miliband backs integration of health and social care in NHS to save billions

Ed Miliband is to risk accusations of backing another massive NHS reorganisation when he says he supports the integration of health and social care in a move that is designed to save billions and produce a more rational whole care service.

The idea, widely supported within the NHS, will be the subject of a year-long independent commission chaired by Sir John Oldham. He has been told to achieve the reform without extra cost or any top-down reorganisation.

Integration already has the support of the shadow health secretary, Andy Burnham, who wanted to make the pledge in his conference speech last autumn but had to stop short after objections over the potential costs.

The announcement on Monday is Miliband's first intervention since a spate of criticisms that he is not doing enough to project a clear image of where Labour would take Britain in office. It is also seen as his major intervention in the county council election campaign.

Labour sources regard the proposals as a genuine big idea but are aware that they have opposed further NHS reorganisation, the chief plea of many health professionals. The idea is likely to have the broad support of the Liberal Democrats.

Miliband will cite figures from the Nuffield Trust that show that unless Britain improves the way services are delivered, growing care needs will leave a shortfall of up to £29bn a year by 2020 in NHS funding.

He will claim his planned reorganisation represents the reforms the NHS really wanted as opposed to the changes imposed by the former health secretary Andrew Lansley. He will claim the Lansley-Hunt reforms are putting the financial sustainability of the NHS at risk.

At the launch of the commission on Monday, Miliband will say: "The NHS is facing the biggest challenge in its history. The toughest financial pressures for 50 years are colliding with our rising need for care as society gets older and we see more people with chronic illnesses like cancer, diabetes and dementia.

"The NHS will always be a priority for expenditure under a Labour government, but we must make every pound we spend go further at a time when our NHS faces the risk of being overwhelmed by a crisis in funding because of care needs by the end of this decade.

"When the NHS was in crisis in the 1990s, Labour was able to save it by combining reform with unprecedented increases in funding. We know that budgets will be tighter under the next Labour government. But even in these tough times we want the NHS to provide a better service for patients.

"The changes we propose will ensure that – but they do something else too. They will save billions of pounds which can be better spent elsewhere in the NHS."

Miliband will argue that the growing number of older people and those with chronic illnesses requires a new model of integrated care. At present social care is handled by local government but acute care by the NHS.

He will say there is a case for integrating physical health, mental health and social care into a single service to meet all of a person's care needs. This would require care being arranged with "a greater focus on preventing people getting ill and more care being provided directly in people's homes so they avoid unnecessary hospital visits".

Burnham will say: "Whole person care is a vision for a 21st century health and care service. By uniting social care with physical and mental, it builds a single service that can deal with all of one person's needs. It updates and extends the vision of the post-war Labour government and makes it ready for the challenges of the century of the ageing society."

Liz Kendall, the shadow social care minister, said the "state of the public finances demands that our care system does far more to prevent people from having to use more expensive hospital services and residential homes when they don't need to".

Oldham said social care at present crosses organisational boundaries and is fragmented. He claims: "Those patients say: 'I want you to treat the whole of me, and act as one team, which also leads to better outcomes and greater efficiency for the whole system.' We need to bring that about."

Like Miliband, he stressed the long-term funding pressures faced by the NHS and projected his reforms as one means of combatting them. "If we don't change, the crisis of need approaching rapidly will make the NHS and care system unsustainable, and reduce the competitiveness of our economy, driving a spiral of decline. It is that significant."

Oldham was the Department of Health's former national clinical lead for quality, innovation, productivity and prevention (QIPP) programme and member of the National Quality Board.