Two former health secretaries and chair of select committee call for end to short-term thinking as crisis grows

Philip Hammond is facing a backlash from senior Tories after failing to provide any extra funds for social care in the budget and announcing only a “short-term fix” for the NHS.

With health bosses set to discuss rationing of services at a crunch meeting this week, two former Tory health secretaries and the Conservative chair of the Commons health committee said that it was time to tackle the long-term health and social care funding crisis, which remains unresolved.

The chancellor attempted to fend off a winter NHS crisis by handing the service an immediate £335m bailout and an extra £1.6bn next year. Analysts believe it amounts to about half of what the service requires to keep up with demand.

Furthermore, the Observer has learned that the government has confirmed to local authorities that it has dropped plans to impose a cap on care costs by 2020 – a measure proposed by Sir Andrew Dilnot’s review of social care and backed by David Cameron when he was prime minister. New draft plans dealing with the social care crisis are not now expected until next summer.

Budget's £1.6bn cash boost for NHS less than half of experts’ advice Read more

The former Conservative health secretary Stephen Dorrell, who is now the chair of the NHS Confederation, the membership body for health service care providers, said the budget boost did not resolve the “unsustainable” long-term levels of health and social care funding.

“It is extremely important that the two words ‘social care’ didn’t pass the chancellor’s lips on budget day,” Dorrell said. “Having relieved short-term pressure, what we are now committed to is a set of budget numbers that, by the chancellor’s own implicit admission, will lead to a rebuilding of the pressure that he recognised in the spring was unsustainable.

“We know that, looking at the sector as a whole, no one thinks this is sustainable in anything other than the short term, and the short term is running out again. Will this [money in the budget] reverse the trends on waiting times? Clearly it doesn’t. The level of demand continues to grow. That can only lead to added demand going unmet.”

Andrew Lansley, health secretary under Cameron, said the short-term funds were welcome, but added that a long-term solution and further efficiencies in the system were now crucial.

Facebook Twitter Pinterest Former health secretary Andrew Lansley: ‘The government must plan, in my view, for year-on-year 4% cash increases.’ Photograph: Dan Kitwood/Getty Images

“The new budget may meet the minimum requirements next year, but it again depends on structural efficiencies if an NHS-wide deficit is not to emerge again in later years,” he said.

“For the later part of this parliament, the government must plan, in my view, for year-on-year 4% cash increases in the NHS budget and to implement the Dilnot recommendations from 2020, with funding ... if the service is to be sustained and outcomes improve – as they have largely done in recent years.”

A crucial NHS board meeting this week will be used to make clear that the level of funding will lead to difficult decisions about greater rationing and longer waiting times. It means that the chancellor could be engaged with a public spat with NHS chiefs just days after his autumn budget.

Nigel Edwards, head of the Nuffield Trust thinktank, said: “Before this budget, the NHS was heading for a crunch year, with the amount pledged not set to keep pace with what patients need. The chancellor’s announcements have provided some welcome but temporary respite … meaning the NHS has dodged the bullet for now.

“But the new money levels off fast: we may find ourselves staring down the barrel once again the year after next, when spending increases look set to fall well short of what’s needed.”

Sarah Wollaston, the Tory chair of the Commons health select committee, said that the extra money announced in the budget had to be seen in the context of “seven years of 1.1% increases when the long-term average is closer to 4%”.

“We are failing to take the long view and see how serious the situation is,” she said. “Health and social care is like a balloon – if you squeeze one part, another part pops out. The idea that you can fix the system in this way is nonsense. Let’s actually be realistic about the scale in increase and demand and how we will fund it. There has been a big push to look at this across party boundaries and I’m disappointed that the government hasn’t taken that opportunity.”

Izzi Seccombe, chair of the Local Government Association’s community wellbeing board, said the budget was “hugely disappointing” on social care: “The government needs to put this right in the local government finance settlement or else risk failing the ambition to support people’s independence and wellbeing with quality care and support,” she said.

“If government wants to reduce the pressures on the health service and keep people out of hospital in the first place, then it needs to tackle the chronic underfunding of care and support services in the community, which are at a tipping point.”

A government spokesman said: “We are committed to publishing a green paper on the future of social care – this will include proposals to place a limit on the care costs individuals face. Details will be set out when it is published.”