The government’s cash boost for the NHS isn’t going to solve its problems. That’s the verdict of pretty much every independent spending scrutiniser, including the National Audit Office’s Comptroller, Amyas Morse. He’s said today that the £20bn founding increase announced by Theresa May and Jeremy Hunt will maintain current standards, but won’t enable the health service to grow as the population needs it to.
There is also no way that the cash set out recently will solve one of the biggest drains on the health service: the crisis in social care. The Treasury only agreed money for the NHS, not the services that many patients need to be able to go home, and ministers are clear that spending on social care now needs to be discussed separately. They still haven’t decided the funding mechanism for the sector, and the Treasury will only discuss this as part of a normal fiscal event, rather than the extraordinary manner in which the NHS money was agreed.
The problem is, as I say in my column in today’s Guardian, that Theresa May seems to be procrastinating on social care reform. It’s a big, controversial subject, for sure, and aside from her rather bruising experience of attempting to address the crisis in last year’s snap election manifesto, any Prime Minister would struggle to work out how to implement a solution (indeed, every Prime Minister from Tony Blair onwards has failed to implement a solution).
There’s a green paper coming in the autumn, but while that might give the impression of progress, it could be a mirage: every solution to the social care funding black hole will upset voters, partly because so many people wrongly think social care is free-at-the-point-of-access in the same way as the NHS is. They therefore rather resent being told that they are going to have to stump up any cash at all.
Another mirage could be the promise of ‘cross-party talks’. These sound like an important ingredient in a solution to a problem this big. But experience suggests not: neither the Tories nor Labour have stuck by the other when a social care proposal is made close to an election. It’s not just brutal politics, but also a clash of ideas: of course the two parties are going to have vastly different ideas on the role of the state in social care provision, and on how to fund that provision.
The problem is, those working on getting some kind of solution tell me, is that no matter how much process the government goes through in terms of consultations and so on, at some point it is going to have to upset one group or another – or, once again, fail to make a decision at all. The normal Whitehall solutions just won’t work: the only thing that will is a Prime Minister who thinks making a decision is all that matters.
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