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There is a lot of talk about integrating health and social care. It’s difficult because health is free at the point of delivery and social care is means tested. Social care is also more strictly rationed than health. Just imagine you had to pass a critical and substantial test before getting an appointment with your GP! “I’ve got a pain in my leg doctor” “Sorry that’s not critical and doesn’t sound substantial, so go away.”


Of course we all know rationing happens in the health service. Sometimes treatment is denied on the grounds of age, sometimes waiting lists are a form of rationing, but most of all a shortage of beds and / or staff have that effect.


A recent report by MPs highlighted the very poor provision of adolescent mental health services – MPs concluded that a suicide attempt was needed to get admission to treatment and that where and when children got help was a lottery.


Everyone talks about investing more in preventative services. Even the council talks about targeted early help – “helping those who need it most to nip problems in the bud.” The problem is it is very difficult to target and prove you have prevented something, when a lot of other factors may have contributed as well.

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