Radical review proposes free social care and NHS merger

Social care should merge with the NHS and be provided free at the point of use, a landmark blueprint for the health and care system has proposed.

The independent review, set up by the King's Fund think-tank and chaired by business economist Dame Kate Barker, has been billed as the most radical shake-up of Britain's health and care system since 1948.

With the rise in long-term illnesses and the ageing population, Barker says the system put in place 66 years ago is simply "not fit to provide the kind of care we need and want".

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The NHS is currently free at the point of need, but costs for care homes and home support for the elderly and chronically ill is means-tested.

Barker has called for free social care for people whose needs are "critical", expanding the free service to those with "substantial" needs once the economy improves. The move would be funded by a rise in National Insurance contributions and less generous benefits for pensioners.

"We propose radical change, greater than any since 1948, that would bring immense benefit to people who fall between the cracks between means-tested social care and a free NHS," says Barker.

This would be partly funded by:

• Scrapping the current prescription exemptions for groups such as pensioners, children and pregnant women. However, Barker recommends that prescription costs are reduced from £8.05 to around £2.50, with an annual cap for individuals and exemptions for people on low incomes.
• Limiting free TV licences and winter fuel payments to older people, with only those on pension credit receiving the benefits.
• A one per cent increase in National Insurance contributions for those aged over 40 and anyone earning more than £42,000.

A Department of Health spokeswoman suggested there were no plans for the measures to be introduced, but the Financial Times says Barker's calls will "fuel a wider debate on the affordability of a universal health service as the issue moves centre stage in the run-up to next year's general election".