24/09/2014 12:15 BST | Updated 24/11/2014 05:59 GMT

From NHS to NHCS? A Plan Fit for Our Ageing Society

Ed Miliband has put the future of the NHS at the heart of Labour's campaign to win the 2015 election. Investing in more nurses, doctors and midwives were central to his party conference leader's speech on Tuesday.

The NHS is in crisis. A £30 billion funding hole by 2020. Record numbers attending A&E, increasing waits to see a GP, and an ageing population putting pressure on the service.

Underlying the NHS crisis is an even bigger crisis facing adult care services. Growing numbers of older people need care but fewer are getting help as council funding for home care and care home services has been squeezed.

As a result more older people are being admitted to hospital for inappropriate and expensive care. This is not good enough for older people and it is not sustainable financially.

That's why the NHS and social care need to change.

Labour's plan is to bring health and care together - one budget, one team, one point of contact for the person needing care, addressing their physical, mental and social needs together.

It's what many experts have called for. The Barker commission, the Oldham commission and many others have argued for care to be integrated with the NHS creating a national health and care service.

Andy Burnham, Labour's shadow health secretary, will explain further how this NHCS will be developed without massive structural change in a ten year plan.

Lots of questions need to be answered, not least about how much extra funding will be made available and used.

One of the key challenges will be improving home care services so that older people can get the care they need where they live rather than in hospital.

Good Care Guide gets more poor reviews about home care than any other form of care. Families and older people complain about rushed 15 minute visits, poor communication and high turnover of carers meaning little continuity or consistency of care.

Every day we hear about inadequate care that leaves very vulnerable older people without the support they need with more care scandals waiting to happen.

The first major challenge for Labour therefore will be getting to grips with homecare. Better regulation and better funding are key to underpinning a service that needs to valued, with proper training and decent pay for homecare workers.

Without good homecare services, Labour's plans for integrated health and care will fall at the first hurdle.