Philip Hammond, the chancellor, is coming under mounting pressure from Tory MPs to bring forward help for the NHS and social care services, amid dire warnings that council budget cuts are causing unsustainable problems.
A string of Conservatives have begun to express dismay that Hammond did not address the issue in his autumn statement. Their voices add to the senior doctors, council leaders from all parties, two Tory former health secretaries and the Labour frontbench, who are warning that increasingly hospitals are unable to discharge elderly patients as struggling social care services are not able to make appropriate arrangements.
Among those raising concerns about a crisis are Dr Andrew Murrison, a Tory former minister, who said on Monday that Hammond’s decision to miss out mention of healthcare in autumn the statement was “strange”.
“Ministers should be in no doubt of the impending financial crisis or of the demands likely to come from people like me to deal with the shortfall in cash going into our NHS. If this requires tax rises, so be it,” he said in a statement, suggesting it should be accompanied by an end to the triple-lock on pensions to ease the burden on working people.
Kit Malthouse, a Tory MP for North West Hampshire, warned that pressure was building on Hammond to ease the difficulties facing councils and the NHS.
“MPs across the House are raising this as an issue,” he told the BBC’s Westminster Hour. “The frustration for me, having worked in local government, was that health and social care, putting the two together and getting them to coordinate, has been the holy grail for such a long time and yet still, in large parts of the country, they haven’t got their act together.”
Another to raise concerns is Sir Hugo Swire, a Conservative former minister and East Devon MP, who wrote to Hammond before the autumn statement asking for more resources for social care.
“As it stands at the moment, with council budgets for social care falling behind demand by £5bn nationally, I am concerned that the loss of hospital beds will not be compensated by the social care system, resulting in an overall and unacceptable loss of healthcare provision,” he said in his letter to the chancellor.
“In my opinion, the only answer to this complex issue is an increase in the social care budget which would not only be good for patients but, ultimately, reduce the pressure on the NHS budget.”
The Treasury points to an extra £3.5bn of social care funding for councils by 2020 and ability to charge a 2% precept. A HM Treasury spokesperson said: “The government has committed to increase NHS funding by £10bn above inflation by 2020/21, going beyond what the NHS requested. In addition, we have given local councils £3.5bn extra funding by 2020 for social care. Many councils are already providing high-quality social care services within existing budgets.”
However, critics say this barely covers the extra salary cost of the higher minimum wage and Tory MPs are privately warning that the government could face unrest similar to the tax credit rebellion if more cash is not brought forward to deal with immediate shortcomings in provision.
It is understood other Tory MPs who represent areas with high proportions of older voters have registered their alarm with the chancellor, especially as councils with few working-age residents are unlikely to be helped by the devolution of business rates.
In the House of Commons on Monday, Peter Bone, a Conservative rightwinger and MP for Wellingborough, called for cross-party talks to solve the problems with social care provision.
“Social care should not be a party political matter, and there are concerns on both sides of the House,” he said. “Would it not be a good idea if the government worked with the opposition to see whether we could agree on a way forward so that social care progresses satisfactorily?”
Martin Vickers, Tory MP for Cleethorpes, said he did not agree with those criticising Hammond but would like to see the problems urgently addressed.
“The Departments of Health and Local Government and all those involved do recognise the problems. I’ve spoken to ministers. Yes I’m concerned and yes I’m making the point to ministers at every opportunity. But am I part of a revolt? Not at this stage.
“The government’s official position is they have given the councils a 2% precept on council tax and to some extent that is cumulative but council leaders will repeatedly tell you that is not bridging the gap. So clearly there have got to be further negotiations.
“The joined-up working that we hear so much about is part of the package but that takes time to come together and the pressures are there now. So it may well be at some time there has to be an emergency top-up.”
Dr Dan Poulter, a Tory MP who has previously called for a new tax to help the NHS and social care, said the issue was causing a mounting unease on the Conservative benches, as they begin to get complaints from their local councils and constituents.
“Over the past six months there has been a growing feeling among Conservative colleagues that the health and care system is running into severe difficulties and that more money and a big intervention from government is becoming increasingly pressing and necessary,” he said.
“As the reality of an ageing population being cared for by a social care system that has seen a reduction in funding over the past five or six years begins to bite there is going to be an urgent need for the government to take action and not just look at providing a one- or two-year bung of extra money but providing a long-term funding solution for maintaining a health and care system that is free at the point of need.”
Previous warnings about the problems facing NHS and social care funding have been sounded by Sarah Wollaston, the Conservative chair of the health committee. She said there was now an urgent need for immediate cross-party talks on NHS funding and the difficulties for people in accessing social care.
“I’m very very concerned not only about what I’m seeing on the ground in my own constituency but what I’m hearing in my capacity as health committee chair,” she said. “If there are more MPs finally prepared to say this absolutely has to be dealt with I am very pleased.
“Personally I think we need a cross-party agreement just like we did with pensions. This is going to be a problem for whoever is in government. It is time to just get away from this as a political squabble.”
Tory MPs press Philip Hammond over NHS and social care
