I totally accept that the position is not entirely rosy. I said many times in the Chamber before the hon. Lady entered the House that we face the same challenges. Those challenges are increased demand, workforce needs—they will be made significantly worse by Brexit—and the fact that money is tight. We face exactly the same challenges. Some of the patients she refers to will have had particularly complex needs that it was a struggle to meet. We are talking about the fact that we are funding free personal care—it is not based on means-testing—and we are working towards providing it for under-65s.
Everything happening in England at the moment will seemingly be solved by the sustainability and transformation plans, yet they have been set backside forwards, with designers having to work backwards from the budget line, which is made the predominant thing. That will not produce the desired result, and it must be recognised that supporting people at home and in the community is desirable in its own right. None of us wants to be stuck in a hospital or in a care home if we could be looked after in our own home; that is the choice we would all make. That will not necessarily cut the money required by a hospital. The nurses will still be there, the lights will still be on. What it might mean is that that bed can be more effectively used and waiting times for surgery or other treatments can be achieved, and they are not at the moment.
On the news yesterday, there was talk about the inefficiency of operating lists, and the former president of the Royal College of Surgeons clearly said that this comes down to beds. The number of beds in England has been cut in half over recent decades, and the problem is that if a patient cannot be put in a bed before or after the operation, the operation cannot be done. That is often discovered only the day before, and we cannot just drum up another bed.
All sorts of things, not just delayed discharges, are driving inefficiencies within the system. The thing generating the biggest pressure on the NHS has been the cuts in funding to social care that mean that by 2020 in England a funding gap of more than £2 billion will have to be met. We all want to look forward to a dignified older
age. We hope that we will be independent and healthy. We need to invest in that, yet public health spending has gone down 5%. Should we need care, we will also want care that is dignified and decent. That has to be funded.
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