Millions of people will be grateful to Kate Garraway for opening up the debate on social care - Jayne Dowle

Angry not just at the failure of successive Conservative governments to create, support and implement a much-promised National Care Plan, but angry also at the cruel treatment being meted out to Derek’s wife, Kate Garraway, following the broadcast of the programme.

The well-paid Good Morning Britain presenter and mother-of-two, 56, has been lambasted on social media for “pleading poverty” because she has the temerity to speak out about the colossal debt racked up to meet the costs of her husband’s care, estimated at between £500,000 and £800,000.

Kate has disclosed that the cost of Derek's basic care, without any additional therapy on top, was nearly £4,000 a week.

“How can I afford that? How can anyone afford £16,000 a month?” she’s reported as saying in the documentary.

This widow, bereaved only in January, is forced to bear the brunt of the vile trolls, but should take heart from two things; soon the cowardly online individuals will move on to another target, and millions of people will be grateful to her for opening up the debate on social care.

This is vital, because government after government has stopped listening. Do you remember Boris Johnson promising action on adult social care in 2019? He made encouraging noises, proposing the introduction of a cap on lifetime care costs, changes to the means test and a White Paper on wider reforms.

Then Covid arrived, at once throwing open the inherent failings in social care – elderly patients testing positive for coronavirus being sent back to their care homes being a particularly heart-breaking turn – and providing the government with a handy get-out.

In the midst of a global pandemic putting huge amounts of pressure on both the social care system and the NHS, there was no time – it would seem – or cash, to support a root and branch re-think.

Four years on from 2020 and we’re still no further forward. What is particularly galling is that Chancellor Jeremy Hunt served long years in charge of health – from 2012 - and latterly, added social care to his brief, in 2018. He also became chairman of the Commons health and social care select committee, producing searching reports spelling out what was needed to reform the twin systems.

No-one in government is better qualified to understand what really needs to be done to tackle the spiralling situation in social care. Yet in his Spring Budget it didn’t even merit a mention.

Instead, social care has to rely on headline-grabbing hand-outs, typically over the winter period; in January, Hunt gave local councils £500m for emergency repairs to social care.

That’s just a drop in the ocean. In England, total expenditure on adult social care rose to £28.4bn in 2022/23, an increase of more than £2bn compared to 2010/11, according to research by the Kings Fund.

The independent health and care charity also points out that there’s been a shift away from residential care into community care; the share of spending on residential care has fallen since 2015/16 and community care has increased.

Between 2021/22 and 2022/23, the average weekly fee paid by local authorities in England for care home places for working-age adults rose by 1.1 per cent, from £1,523 to £1,540. The average weekly fee for older people’s care home places increased 2.8 per cent to £842. The average hourly rate for externally commissioned home care rose 2.1 per cent to £20.57.

All of this is public spending; individuals needing care who fail a local council means test must fall back on their own savings or sell the family home.

Also, there are systemic failings in the relationship between the NHS and social care. There are nowhere near enough social care beds or homecare packages to release the estimated 13,000 NHS beds blocked by medically fit patients who can’t go home and look after themselves.

And nowhere near enough people taking up jobs in social care, because the “at or near the national living wage” remuneration doesn’t merit the demanding work.

I am no economist, so I have absolutely no idea how the books might be balanced to make access fairer without bankrupting local councils. But for all the Kate Garraways out there, the next government simply cannot shirk tackling social care.