On Thursday 19 November I was able to attend The King's Fund Annual Conference. It was a timely event, a chance to look at the current state of health and social care ahead of the Comprehensive Spending Review on 25 November.
There was no shortage of opinions, but I did see broad agreement amongst panellists that NHS funding is in danger while social care is in crisis.
Serious financial trouble ahead
There's no denying that the NHS is in serious financial trouble, even if the Government has pledged £8bn by 2020.
Simon Stevens, chief executive of the NHS, wants this 'frontloaded' so the health service sees investment sooner rather than later to help pay off mounting deficits.
This investment presumes £22bn in efficiency savings, however there are very real questions about whether these savings are even possible.
Services for people with multiple sclerosis are already patchy at best and we don't want to see them get worse as the NHS starts to cut back.
Why is social care not on the agenda?
Social care, meanwhile, is in an even worse state but remains frustratingly absent from the political agenda. This crucial service- which helps with the basics of everyday living - is in crisis yet politicians are turning their faces away from the problem.
Social care is provided by local councils that have already seen their central government funding reduced by 40% since 2010. Councils are now forecasting a £4.3bn shortfall in social care funding in England by 2020.
Further cuts on the horizon
Recently it has been reported that The Department for Communities and Local Government has agreed with the Treasury to cut a further 30% off its budget.
On top of this the new pressures of paying the living wage will cost councils an extra £1 billion by 2021. This all adds up to a growing financial black hole.
A crisis in social care will be felt by the most vulnerable people in society, including the people with MS who rely on care to help them eat, wash and live their day to day lives with dignity.
Access to care is already poor and could get worse, with fewer people able to receive the support that they need. The quality of care provided could also suffer, with fewer, shorter care visits and reduced packages of support.
Putting the NHS under increased pressure
Without a care system well equipped to support people, increased pressures will be felt in the NHS. When care support is lacking it is the NHS that deals with the expensive consequences such as inappropriate hospital admissions.
The Government cannot continue to view these services entirely separately. It cannot fund one and cut the other, this is a completely false economy.
What happened to the social care cap?
Earlier this year the social care cap was delayed. The cap was designed to limit the amount one individual can spend on their care and was very welcome.
The Government ended up 'saving' £6bn by delaying the cap. We did not support this delay, but now it's done the money needs to be reinvested in social care not spent somewhere else. We desperately need a commitment on this in the Comprehensive Spending Review.
The Government urgently needs to prioritise social care before we find the system in a crisis that cannot be ignored.