Ministers throw money at NHS, yet still the vulnerable are neglected

Ministers throw money at the NHS, yet still the vulnerable are neglected writes IAN BIRRELL

When Jeremy Hunt was asked about his biggest regret from his six-year stint as health secretary, his response was unequivocal: failing to fix the disintegrating social care system.

That was less than a year ago, when Hunt – who had by then left the Cabinet and become chairman of the Commons health and social care committee – was calling for an additional £7billion a year to salvage the crumbling system while also promoting his book Zero, which offered his prescription for the ills bedevilling the NHS.

In the book, Hunt explained how many citizens suffer as a result of the country’s chronically underfunded care system. Low pay and a lack of career structure, he added, had led to an ‘utterly demoralised’ workforce.

Now, after a remarkable political comeback, he is Chancellor – with power to loosen state purse strings and improve millions of lives by turning his warm words into action.

Instead, his continuing failure to tackle the problem is only highlighting the tragic lack of trust in politicians.

When Jeremy Hunt (pictured) was asked about his biggest regret from his six-year stint as health secretary, his response was unequivocal: failing to fix the disintegrating social care system

For his Government is not even paying out the paltry sums proposed in its half-baked efforts to tackle some of the most acute care problems, despite a staff crisis that has intensified over the past year with an estimated 165,000 vacancies.

In a 2021 White Paper, the Government promised £1.7billion for improving services in the care sector. Yet its latest announcement, clad in fuzzy talk of reform, is worth only about £600million. 

It halved small sums proposed for investment in staff and has ditched spending to explore innovative new housing models. No wonder there is furious talk of ‘betrayal’ amid the rising cost of living and an ongoing struggle to retain staff. 

Sally Warren, policy director at the King’s Fund think-tank, said she had rarely felt such fury over what amounts to a ‘massive retreat from what was already bare minimum first steps’.

Ministers previously postponed wider reforms – a cap on lifetime care costs and widening rules on eligibility – until after the next election. 

Yet needless to say, they continue to chuck endless cash at the NHS, most recently to appease striking medics demanding higher pay with reports that another £3billion will be pumped into their pockets. 

Meanwhile, the care system – staffed by many people earning less than supermarket shelf stackers while a few greedy fat cats fleece the state – has been rejecting 14,000 desperate requests for help every week.

There is talk of better training, certificates for carers and smarter technology. All fine. But decent care depends on dedicated human beings – and they need to be paid properly. 

This latest setback is hypocritical: ministers won their seats under Boris Johnson promising to fix the system after years of broken promises. But it is also ridiculously short-termist.

In his book, Hunt highlighted the case of one woman who ended up unnecessarily spending seven months in hospital before dying in a care home, detailing how the stress caused her dementia to deteriorate much faster. 

Incredibly, 101 different professionals looked after her ‘at enormous expense’ – while that hospital bed, at £300 a night, cost six times more than home care support.

This shows the urgency of sorting out social care, especially when there is such a backlog for NHS treatment. Unfortunately, continued failures expose a society that simply does not seem to care about millions of its most vulnerable citizens.

National Illness Service: Call to focus on preventing poor health as social care cash is halved 

By Shaun Wooller Health Editor

The NHS should axe a raft of targets and give the best bosses more freedom to make decisions locally, a review said yesterday.

Former health secretary Patricia Hewitt, who led the study, says the NHS is now more of a national illness service than a national health service.

Her report came as ministers were yesterday accused of betraying the elderly by halving the funding promised to develop the social care workforce, from £500million to £250million. 

Ms Hewitt, calling for rapid change after the government-commissioned review, warns that excessive red tape is preventing managers from delivering better patient care.

Senior health leaders yesterday largely welcomed her report into boosting efficiency and collaboration, which also calls for a greater focus on preventing ill health and reform of GP surgeries.

Former health secretary Patricia Hewitt (pictured), who led the study, says the NHS is now more of a national illness service than a national health service

Her report says a few targets can concentrate minds but having too many makes them less effective.

It comes as the NHS continues to miss major targets on A&E waits, ambulance response times and cancer treatment times.

The review says adding targets and being inconsistent with funding make it impossible to plan new services and recruit staff.

Ms Hewitt, a health secretary under Tony Blair, also says some targets, such as those on A&E waits, leave less room for medics to use their clinical judgment. An excessive focus on hitting targets by managers or boards can lead to ‘disastrous neglect of patients themselves’, the review argues.

In her study, Ms Hewitt says ministers should consider slashing the number of national targets to ten.

Cutting waiting times for key surgery should be matched by a focus on cutting waits for mental health treatment, the study says.

Local leaders running integrated care systems – partnerships of organisations that plan and deliver joined-up health and care services – should be given more space and time to lead, according to the report.

Ms Hewitt concludes that the contract between family doctors and the health service is ‘not fit for purpose’. It follows calls to scrap the GP model, whereby self-employed GP partners hold contracts with the NHS, and instead employ GPs directly.

Ms Hewitt suggests the contracts could be held between networks of surgeries. And she says a new ‘centrally held fund’ could buy out contracts or premises in areas where patients are not getting a good service. 

The review also calls for the public health grant to local authorities to be increased. The shift to preventative services is vital to prevent more older and increasingly unhealthy people entering hospitals that will never be ‘large or efficient enough to cope’, the review says.

Sir Julian Hartley, chief executive of NHS Providers, said: ‘We hope the NHS at all levels will commit to the cultural shift necessary to bring this about.’ A Department of Health and Social Care spokesman said ministers would respond to the review.

The Government’s decision to halve promised funding for the care workforce was yesterday described as ‘cruel’ and ‘short-sighted’. 

A further £300million to integrate housing into local health and care strategies has also been shelved. The Independent Care Group said the sector needs ‘every penny of funding’.

The Government has insisted no funding has been removed, saying £600million has ‘not yet been allocated’. But various organisations nevertheless accused the Government of betraying the sector.

Health think-tank the Nuffield Trust said the development was ‘another ill-judged raid on a social care system already on the brink’.

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