House of Lords committee on the long-term sustainability of the NHS

Worries about the affordability of the NHS have a long history. Almost as soon as it opened its doors, concerns were expressed about its cost. Then, in 1953, health minister Iain Macleod announced an independent parliamentary committee to investigate the long-term costs of the NHS and to make recommendations about possible structural and funding changes. Three years later, Claude Guillebaud’s committee reported that the NHS was not particularly inefficient, that costs were not as high or rising as fast as feared, and that little structural reform was needed.

The Select Committee on the Long-term Sustainability of the NHS of the House of Lords, chaired by Lord Patel, is conducting an inquiry into the sustainability issues facing the NHS and the impact they will have over the next 15–20 years.

Pressures to spend more on social care will inevitably grow overtime, and other sustainability problems are inherent in this area given its funding sources and traditional separation from health.   

We will end up paying more for social care one way or another – either through higher taxes for improved services; directly from the public’s pocket; or through non-financial costs arising from reduced access to publicly funded services. The issue is how to ensure extra spending delivers what we want from social care, including, we argue, equal opportunity of access for equal needs.

The investigation into long-term health and social care spending and sustainability should not just be an ad hoc exercise. There is a need for a wider-ranging independent review of the long-term future for care every three-to-five years to inform public and political debate.