On the 70th anniversary of the founding of the NHS, readers celebrate its achievements and worry for its future

It was no surprise to read that the very first lesson you suggest could be learned from overseas (Five things the NHS could do to improve service, 3 July) is the establishment of integrated health and social care, as has happened in New Zealand. The achievements of the Attlee government are at the heart of my socialist beliefs but the compromises which led then to the split between free NHS care and means-tested social care remain the achilles heel as the NHS celebrates 70 years. It is utterly ludicrous to have separate systems which imply distinct and neat boundaries between health and care, with rather a lot of people making a good living arguing on which side of the fence some poor demented soul belongs. Disputes around the funding of continuing care have become a major industry.

The recent NHS funding announcement, making no reference whatsoever to social care, evidenced the fact that the government still hasn’t the least idea of how the two are umbilically linked. From as far back as 1998 to as recently as last month, the health select committee has argued for properly joined-up provision. The Treasury opposes a formal integration but continuing separation is costing billions in terms of delayed discharges and other inefficiencies.
David Hinchliffe
Former chair, Commons health committee, Holmfirth, West Yorkshire

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