NHS cash likely to go on to social care

A significant part of the NHS’s promised budget increase will end up being spent on social care, the body representing NHS organisations has warned.

Despite the coalition’s promise of a real terms increase for the health service in Wednesday’s spending review, it will still be “hard hit by spending cuts”, said Nigel Edwards, the acting chief executive of the NHS Confederation.

The service faces “a potent cocktail of financial pressures”, he said, with a small increase insufficient to meet rising demand at the same time as up to £20bn of efficiency savings are being sought and the government is proposing “one of the biggest reorganisations in NHS history”.

But the NHS is also “deeply worried” about expected cuts of at least 25 per cent in council budgets and the effect that will have on social care, where councils support people at home and in residential and nursing care.

Three-quarters of councils already provide only statutory help to adults who meet the top two of four criteria for eligibility. The Association of Directors of Adult Social Services has warned that “achieving savings on the scale of 25 to 40 per cent”, the cuts it has effectively been asked to plan for, “is simply not feasible” without higher charges and changes to statutory responsibilities.

Andrew Lansley, the health secretary, has earmarked £70m this year for so-called “re-ablement” services to help people adjust to returning home after hospital and there are rumours that could rise to £400m next year.

But Richard Jones, the association’s president, said that would make a limited contribution to the cuts of £3bn to £6bn that social care is facing.

“It is clear that NHS money will go into social care, either deliberately or not,” Mr Edwards said. Without social care support, the NHS would not be able to discharge people ready to leave hospital, he said, and without investment in preventive services at home more people would end up in hospital unnecessarily.

“There will be strong pressures to divert money into social care, and that is probably the right thing to do,” Mr Edwards said. “But that will obviously eat into the money available for healthcare.”

Whatever limited real terms increase the NHS receives on Wednesday will be eaten into by the rise in VAT to 20 per cent – an increase likely to cost the NHS about £200m to £300m a year, according to the King’s Fund.