Health crisis made worse by chronic social care underfunding

Wes Streeting claims the NHS is “broken but not beaten” and looks set to prescribe the health service with increased privatisation. His diagnostic test was provided by a former health minister under Tony Blair, Lord Darzi, whose report laid bare the NHS crisis. Just the NHS would need an additional £38 billion a year by 2030 if patient outcomes are to improve, according to the Health Foundation. If this Labour government was to match NHS spending increases from the Blair era it would need an extra £477 billion by 2030.

Samantha Erin, Tower Hamlets Socialist Party, looks at an important omission from the report:

I want to talk to the lack of focus on social care in the report – this is an area which has and continues to experience chronic underfunding by Tory and Labour governments.

The report shows that, despite spending over half the health budget on hospitals, the government hasn’t invested in creating a healthy system for them to operate in. There is a lack of investment in primary, community and social care services that keep people out of hospital and allow them to be discharged safely when they are ready to leave. The report makes a few references to shifting care ‘upstream’ and closer to home, close partnership between health and social care is key for meaningful change.

The scope of the investigation was decidedly focused on the NHS, highlighting only at a high level the impact of social care not having been resourced and valued sufficiently on health. So yet again there is no decent long-term plan for the social care sector. But why is this? Everyone knows that social care and health are closely linked.

Darzi blamed choices made by the Tory government for the damage to the health service and said it would take more than five years to fix. However, we know that the problem is wider than the Tory government and the problem has outlasted them already. For example, the Labour Party is not prioritising social care in its health budget and they have no funded plan for social care.

Meanwhile, local councils including Labour-led councils have been cut to the bone, including the investment needed for adult social care services. A 2024 report by the Association of Directors of Adult Social Services found that “£914 million of additional funding is needed in 2024-25 to meet the same level of need as the previous financial year”.

Adult social care is in a vicious cycle, where needs escalate into more severe problems. But councillors do have a route to fight back. They must fight for the funding needed to meet rising demand, and pay and treat staff fairly, which would improve the quality of care. By setting budgets based on objective, social need, then using reserves and borrowing powers to implement this, huge support could be harnessed to build a campaign for the funding required from central government. Care should be brought back in-house, stopping greedy private interests siphoning off profits and to give workers, service users and communities democratic control.

In a socialist system, based on the nationalisation of the key industries, the vast wealth that exists in society could be harnessed to fund quality services, reduce the working week, and fund decent living conditions. In such circumstances, workers may choose to spend more time caring for friends, relatives and those in the community. This would reduce the epidemic of loneliness faced by disabled people, those with mental health issues, and older people. The Socialist Party fights for a fully funded NHS and social care system run democratically by workers and service users.