Health and social care must be prioritised, whatever the cost - Andrew Vine

Finding and paying for care for his chronically-ill wife is draining his savings and pension at an alarming rate. Short-staffed care companies are often unable to provide the cover he needs and the cost of those which can increase on a regular basis.

His own health is now starting to fail, undoubtedly partly because of the worry over care, and he is in constant pain from a hip joint that needs replacement.

But he faces a wait of up to two years for surgery because of NHS backlogs, and by then, if his current rate of physical decline continues, he will hardly be able to walk, severely compromising his ability to look after his wife.

There are tears and desperation in every conversation I have with him over this appalling predicament. The knowledge that similar personal tragedies are being played out behind closed doors all over the country is no consolation.

The twin crises in healthcare and social care are undoubtedly getting worse, but the problems have been a long time in the making.

When my father, who had dementia, was in care before his death more than 20 years ago I saw at first-hand a system that even then was creaking badly.

The council home he was in had a permanent air of only just being able to manage. Though the staff were faultlessly kind, they were rushed off their feet. There were never enough of them, and that spoke volumes about the shortage of money in the system, as did the home’s fading décor.

The intervening years have only increased the strains, with massive staff shortages in care and providers warning that the system is at breaking point.

And so is the NHS, with 7.1m on hospital waiting lists, up from 4.4m before the pandemic and almost 44,000 accident and emergency patients waiting at least 12 hours for a bed last month. That’s before winter puts even more pressure on hospitals.

Every one of those people – and my friend and his wife – knows that urgent action is needed to improve how people are looked after when they are ill or at their most vulnerable.

But it’s difficult to have any faith in the Government coming up with an effective response to the crisis when the Chancellor delivers his autumn statement on Thursday.

Against the backdrop of a £50bn black hole in the public finances, a recession and briefings that painful cuts lie ahead, the chances of the Government taking decisive action on health look remote.

At best, it appears likely that funding will be maintained at present levels, which isn’t good enough.

And on social care, there is every chance the Chancellor will pull the same trick as his predecessors and shift responsibility onto local authorities for sorting the problems out, which is no solution at all.

Councils are being slowly bankrupted by care costs, which now account for so much of their budgets that vital services in other areas are being cut to pay for it.

Meanwhile, the inability of hospitals to discharge older patients because there are insufficient care places constantly adds to the waiting times for operations and the delays in admitting emergency cases onto wards.

Whatever plan the Prime Minister and Chancellor come up with to address the economic mess Britain is in, one thing is clear. There is a public expectation and demand that health and social care must be prioritised, whatever the cost.

If there are going to be tax rises, as seems certain, Rishi Sunak and Jeremy Hunt will be failing the country if they do anything other than use the money raised to improve health and care services that are at the heart of national life, relied on by millions.

Paying down public debt – and repairing the damage inflicted by the economic idiocy of Liz Truss’s brief and disastrous premiership – count for nothing compared with people dying because they cannot get the treatment they need, or spending their twilight years in worry and discomfort for lack of care.

As Chancellor, Mr Sunak pushed through a rise in national insurance to fund the NHS and social care, a policy that had widespread support. Its abandonment by Ms Truss was one of the most disgraceful acts of her brief tenure.

Reviving the policy would demonstrate that Mr Sunak and Mr Hunt are serious about trying to address the crisis. Nobody likes paying more tax, but if the NHS and care system are to avoid collapse, there is simply no other way.