Liberal Democrat health spokesman Norman Lamb MP outlined his review of the party’s health policy at the first of the NHS Confederation’s Westminister Lectures.

In a frank and wide-ranging presentation and question-and-answer session, Mr Lamb suggested that the issue of co-payments for social care could come onto the agenda. urgently, social care is provided by local councils, and is means-tested, with any individual wealth above £21,500 meaning that recipients of care are charged for non-core services.

Unststainable cost
The Lib Dem policy has hitherto been that social care should be made free of charge (as it is in Scotland), paid for by a 1 pence increase in the basic rate of income tax.

Mr Lamb told the audience that “this looks unsustainable, and they're reviewing their policy up in Scotland. We need to learn the positive lessons from Scotland – they’ve now got more, and better quality care and public support. The problem is sustainability.

“I endorse Derek Wanless’s suggestions on funding social care – that 2/3 is paid by the state, with every pound thereafter match-funded by the individual and the state. The state would pay the bulk, but individual contribution is incentivised.”

This policy switch resonates with the NHS Confederation’s recent debate paper, Funding Tomorrow Today. Written by its policy director Nigel Edwards, the Confederation’s paper argued that social care funding must be fairer if provision of social care is to survive.

Pro-choice Liberals
The Lib Dem health policy had also been opposed to the principle and practice of patient choice in the NHS. Mr Lamb announced that this too would go, reflecting that it was “an odd thing for Liberals to want to be denying the opportunity of choice to the poorest in society”.

He also added that the Lib Dems may consider health ‘entitlements’ for some conditions such as mental health and physiotherapy – guarantees of NICE-approved treatment within a set time-frame. “The NHS could offer a health entitlement, personal to the individual for access. Obviously, there would have to be a lead-in period to build capacity to offer treatment approved by NICE within 13 weeks. If the NHS doesn’t or can’t create that access, you’d be paid for privately”.