As the UK continues the battle with Covid, even the charismatic Sunak would find the setting of a budget a real challenge.

When he spoke, Rishi’s sing-song voice rehearsed the items that his PR team had already trailed. But, in two areas, there was near total silence.

Yes, the Covid rescue package would continue until April 2022, but nothing substantial was offered for the NHS’s exhausted workforce: nothing to tackle the staffing crisis and beds shortage, nothing to offer hope to the millions on waiting lists or head-off the ballooning looming mental and public health crises.

However, the silence was broken the next day with the Government’s cynical recommendation of a 1% pay deal for NHS workers. This, with the £17bn planned cuts to public spending and some inflation, means that medics and care workers will wind up with a reduction in real wages.

Far from funding an integrated health and care service that would learn the lessons of the epidemic, Sunak has managed to alienate the entire workforce.

Three weeks earlier Matt Hancock’s NHS white paper also ignored social care and didn’t even hint at the plan that Johnson (on his first day in No10) promised would “…fix the crisis in social care once and for all”.

Ham & High: David WinskillDavid Winskill (Image: David Winskill)

Days before Rishi spoke, the UK’s largest care home operator announced the closure of 52 of its homes and a refocusing of the business towards high-dependency care. Who ultimately picks up the responsibility for those displaced? Local government and the NHS.

The white paper also signalled a move to more centrist control as well as firming up governance arrangements for the integrated care systems (ICSs) that have gradually been taking over from Lansley’s unlamented clinical commissioning groups (CCGs).

A rather cynical commentator asked whether the answer to the NHS’s problems really is more Hancock? Following North Central London’s decision to continue with a GP contract that has passed into American ownership, we could also ask if Hancock really believes that co-operation will be the driver of the NHS.

We desperately need a properly funded plan to fix our broken care sector but not one that allows important decisions about the welfare of the most vulnerable to be taken by financiers and solely in the interest of shareholders.

Perhaps a little less clapping for heroes and a bit more taxing for health and care?

  • David Winskill is a Crouch End-based campaigner.