Tories protected richer pensioners at the expense of those in need of social care - a crisis awaits

In their refusal to end universal benefits for rich senior citizens, the Tories have been protecting the wrong sort of elderly

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Social care receives far less attention than the NHS. This is to be expected: the long-term care given to vulnerable people in the community, in care homes or in their own residences, lacks the life-and-death significance that attaches to queues in A&E, delays to cancer treatment, and much of the other work that takes place in hospitals.

But such comparative invisibility has its costs. The decline of social care over the past five years has been far more precipitous than that of the NHS and is now reaching a severity that will not only discomfit thousands of the ill, elderly and disabled, but cause ructions in the working of the health service itself. Talk of a “catastrophe” is not unfounded.

While NHS budgets have been ring-fenced since 2010, funding for social care – which falls under the purview of local authorities – has undergone dramatic cuts. At this stage support is increasingly available only in the severest of cases, or for those wealthier citizens who can afford to pay their own care costs. Funding for social care for the elderly has fallen some 17 per cent, as the number of over 85-year-olds has increased by 7 per cent. More of the population is requiring social care as the prospect of receiving it retreats from view.

That will affect the NHS, as a new report from the think-tank ResPublica makes clear. It foresees the loss of some 37,000 beds in community care over the next five years, which would force many more individuals to seek care in hospitals. According to ResPublica the bill to the NHS would reach £3bn per year by 2020, wiping out – and then some – the Conservatives’ proposed injection of £8bn spread over the next five years. The picture only darkens bearing in mind The Independent’s report this weekend which raises the prospect of US hedge funds seeking to take over care-home providers and squeeze them for all the profit possible.

The simplest solution, in theory, is to merge the healthcare and social-care services. This has been suggested, with increasing desperation, by the King’s Fund charity, and politicians on both left and right. There are already a number of patchwork initiatives to cross the borders between the two, including the NHS’s Better Care Fund. Yet the priorities of the two services are so different – one looking to bounce patients out of beds at the earliest opportunity, the other there to provide holistic care – that true co-operation remains fragmentary. One of the many beneficial consequences of merging health and social care would be forcing the NHS to treat patients more in the round, thus not leaving social services to pick up the pieces of scattergun-style treatment.

Unfortunately, a union appears some distance off. Though David Cameron promised one in 2012, the reform would require enormous political and bureaucratic resources and is to be found dwelling deep in the long grass. In its absence, more easily achievable solutions must no longer be ignored.

In their refusal to end universal benefits for rich senior citizens, the Conservatives have been protecting the wrong sort of elderly – namely, those who need state support the least – while presiding over cutbacks that leave poorer pensioners with health issues in dire straits. Some £6bn was allocated for the Dilnot plan, another social care proposal that has sallen by the wayside. That money should go towards maintaining services in general. Similarly, a marginal levy should be placed on the national insurance contributions of citizens over the age of 40, as the King’s Fund recommends. Otherwise, by the time they need someone to help with getting dressed, or taking a bath, they are likely to be left to fend for themselves.