Maude wants private firms to get health service work under £5.3bn Better Care Fund aiming to knit health and social care

A senior minister has criticised the government’s £5.3bn central policy to save the NHS and claimed it will only work if private firms are given a much bigger role.

Speaking at a recent event in London, Francis Maude described the Better Care Fund as a disappointment which was unlikely to lift the pressure from overcrowded hospitals because of “endless process and bureaucracy” in the NHS.

The Cabinet Office minister’s comments are at odds with those of Jeremy Hunt, the health secretary. Hunt has praised the scheme’s “tremendous strategic importance” and said it will play a vital role in helping the NHS.

Launching next April, the Better Care Fund will see unprecedented investment in schemes involving GPs, local councils and hospital staff working together to keep patients healthier at home for longer so they do not need hospital care.

Ministers hope the fund’s determined effort to integrate health and social services in England will arrest the continuing increase in the number of patients seeking help from their GP surgery, local hospital A&E unit or ambulance service.

Hunt has claimed that it will tackle an increasing shortage of hospital beds by avoiding 163,000 unnecessary admissions for emergency treatment every year.

A tape recording of the event – Efficiency and Reform – The Next Chapter – at the Royal Society of Arts on 8 December shows that Maude referred to the fund as “absolutely the right idea”. But he then went on to say that: “I think the disappointment about the Better Care Fund has been how public-sector a lot of these solutions proposed have been and it would have been, I think, better if we had seen coming out of it more ideas for different groups forming themselves together.”

He then lauded the usefulness of “the freedom that ‘spinning out’ [of services] gives you” and cited the apparent ability of Inclusion Healthcare, a private health firm, to provide some care more cheaply and simply than the NHS.

Maude, who is among a group of ministers who attend Cabinet meetings but do not have Cabinet rank, then cited how the firm had helped a homeless man with leg ulcers who was refusing to go into hospital because he did not want to be parted from his dog. As a result, added Maude, the firm “say actually if we had still been in the NHS we could never have done that without endless process and bureaucracy and auditing and which budget does it come out of, and how do we account for it, and it would never have happened”.

The Department of Health declined to respond to Maude’s starkly different view of the fund to Hunt. A spokeswoman would only say: “For years, successive governments and NHS leaders talked about joining up our health and care services. Our £5.3bn Better Care Fund is making this a reality for the first time ever. Local plans approved for next year are likely to improve care for thousands of vulnerable people, prevent 160,000 emergency admissions and save over half a billion pounds [a year].”

Andy Burnham, the shadow health secretary, said Maude’s comments “show that the government’s hidden agenda is NHS privatisation. Jeremy Hunt continues to deny that privatisation is happening. But that simply flies in the face of the facts.”

Maude appears unhappy that local NHS bodies have already awarded scores of contracts to mainly groups of public sector workers – GPs, community nurses and domiciliary care staff – to set up schemes to keep older people and those with long-term conditions in better health while remaining at home.

NHS Providers, which represents hospitals and other NHS care organisations, suggested Maude was wrong.

“Although not everyone agreed that the Better Care Fund was necessarily the right way to tackle the need for better integration, everyone in the public sector has worked very hard to make the fund work”, said Saffron Cordery, its director of policy and strategy.

“The Cabinet Office’s comments do not feel supportive and do not begin to recognised the immense effort that has gone into trying to make this initiative work by stretching very tight funding across health and social care in such a short timescale.”