“NHS, give us our money”

There is a scene in ‘Yes, Prime Minister’ when Humphrey the civil servant shows how changing the way things are phrased can either lead somebody into thinking that national service is what we need to instil discipline or that national service is like giving guns to thugs and showing how to use them.

I see the same tricks being used when it comes to local government making decisions. It’s either local people having control in their own communities or something that leads to postcode lotteries where people living across the street can get treated differently.

Would you want a bureaucrat stuck in a London office deciding what happens in your rural community or would you like a dedicated public servant who has spent years working in different communities and has gathered information about what works best from all over the country and internationally? The two can be the same.

Most people I have spoken with favour local people deciding what happens in their local communities but don’t want postcode lotteries. Most seem to want policy based on evidence and learning from what has been tried and tested, but abhor the employment of any ‘bureaucrat’ to do this.

So what do people think about the Government’s decision to give the NHS £400m over four years without ring-fencing to supporting carers? They probably think that Labour tried this with £150m over 2 years and our research showed that only 25% of it was used to increase support for carers. So what’s different this time? Hopefully a couple of things which will help.

  • Primary Care Trusts (and then GP commissioning consortia from 2012/13) will know how much of the annual £100m their share is, allowing local people to know exactly how much they have received to spend on carers.
  • PCTs will be monitored on their performance regarding support for carers

These didn’t happen before and I hope that they will lead to more than 25% of the £400m being used to increase support for carers, but certainly not all of it will. Some will say that Government shouldn’t announce £400m for carers when the NHS can spend the money on anything it chooses. I understand this, but I can also understand that there would be an outcry if Paul Burstow said that he as Minister for Care Services was not going to do anything to support carers – that it is a matter for local government.

We look to national government because that is who we elect to govern for us. And yet we then want local control but without the variation that inevitably brings. Our opinion on this probably changes according to the particular issue; it depends on where you are sitting at the time. One thing I know is that where carers are sitting at the moment is a place full of overburden, isolation and turmoil, which makes the right call unequivocal: “NHS, give us our money.”


December 1, 2010 - Posted by | Budget, Carers Strategy, Conservatives, David Cameron, Liberal Democrats, Young carers | , , , , , , ,


  1. I thought the Government policy re carers was to move to more Direct Payments. How does this fit in with giving carer respite money to the NHS when Direct Payments are administered by Local Authorities.

    Gordon said: “We look to national government because that is who we elect to govern for us. And yet we then want local control”

    You are using this as an argument in favour of what the Govt are proposing but your logic escapes me (although that could be my fault lol). The money is being given to the NHS, an unelectd body over which the public have no real local control rather than to Councils where we the public at least have a slim possibility of influencing local policy by using our vote. If the National Govt over which we have democratic control (supposedly) is going to try and take credit for awarding respite money to carers but then leaves it to the discretion of an unelected body whether or not to spend the money on carers how can you not be cynical about the motives of national govt. Could it be they want all the kudos but none of the blame?

    Comment by Philippa | December 1, 2010 | Reply

    • Very well said.

      Comment by exilednzer | December 3, 2010 | Reply

    • Hi Philippa, I actually agree with you. Certainly with the previous £150m announcement, there was good publicity for the national politicians making it but said it was a local issue when it was clear the money was being spent elsewhere. We have to make sure that if that the Government is held accountable having taken the good publicity for this announcement, as well holding to account the local people who decide how the money is spent. Local authorities can investigate their local NHS organisations even if they don’t run them – this happened before. But you are right, the NHS has to be held to account.

      Comment by Gordon Conochie | December 6, 2010 | Reply

    • Hiya
      Forgot to answer the bit about Direct Payments and the NHS. The NHS can currently give out personal budgets which is like a virtual Direct Payment. The previous Govt didn’t think the legal framework allowed the NHS to give Direct Payments although others disagreed. However, they and now this Government do want the NHS to be able to give Direct Payments.

      Comment by Gordon Conochie | December 6, 2010 | Reply

  2. Some hope! They’ll spend it on employing more paper pushing managers – unlikely that any of us will see a penny of it and let’s be honest – if anyone manages to access any of this money they will end up totally demoralised by the amount of grovelling they’ll have to do to get it!

    Most of us still don’t know what the system was for accessing the previous funds so unless they are going to post detailed info on how to access this lot to every carer in the country there isn’t a hope in hell that this will be any different! Are there any figures for where the last lot was actually spent?

    Comment by Boggle | December 2, 2010 | Reply

    • Hiya
      Unfortunately, it’s not a case of carers accessing the money, it’s more a case of the Primary Care Trust receiving the money and then deciding how it is spent. Some PCTs have previously set up a process where carers can be referred and given a direct payment of say £300. Others gave it to local authorities to dispense with through personal budgets/direct payments or other services. Then others just didn’t use it for carers at all.
      So, get your councillor to find out what the PCT is planning to do with the money is the best way to start.

      Comment by Gordon Conochie | December 6, 2010 | Reply

  3. The money disappeared into a “black hole” last time and will this time unless the government is more prescriptive. Asking what PCTs have done for carers will trot out any old stuff. One PCT in my area claims to have spent more than its allocation on carers: but not one penny went for respite. Even so, it’s in the 25% figure you quoted.

    As you say, Gordon, it’s all in how you word it.

    Comment by charles47 | December 4, 2010 | Reply

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