Hunt hunting

Jeremy Hunt stays as health secretary with added responsibilities for social care. Source: Guardian

Photograph: Daniel Leal-Olivas/AFP/Getty Images

It has been reported that Prime Minister Theresa May has "dropped a manifesto pledge" to hold a vote on the fox-hunting ban during this parliament.

It is a peculiarity of the British people that many appear to care more for animals than they do for people. Large legacies left to animal charities emphasise the point.

Some readers may recallBrumas, a baby Polar bear from the 1950s. An endearing ball of fluff to be hugged and cuddled. All changes when Polar bears mature into adulthood. Then a hug is likely to prove fatal. The 'Brumas complex' was applied to opponents of fox hunting who could identify only with the little balls of fluff, apparently oblivious to a carnivorous adulthood. Little has changed as 'pro' and 'anti' continue to square up over the issue.

There is no such contention over social care, only that HM government gets on with it. Jeremy Hunt has, according to reports, convinced the Prime Minister that he should remain in post as Secretary of State for Health with added responsibility for Social Care. The Sun says "Jeremy Hunt?S refusal to leave Health Secretary shows his dedication to NHS. Jeremy Hunt has shown he is hell-bent on improving the NHS despite the endless flak and financial woes,"

The Telegraph takes a different view: "Jeremy Hunt, the Health Secretary, successfully faced down the Prime Minister when she asked him to become business secretary, forcing Mrs May to tear up her plans to promote or move other ministers who were already penciled in."

Whatever one's views, despite the endless flak and financial woes as the Sun puts, Hunt appears to want to do something about it rather then take the easy option and move.

That the two areas of responsibility, health and social care, should be joined up has been obvious to most for some time. In the current system each service is fouling the other creating blockages which cause misery and waste. Simplistically, the health system needs to get more patients out and fewer in.

Some of us have been through the hoop already, trying to arrive at a sustainable solution for parents, relatives and friends who are no longer able to care for themselves. Often they have been admitted to hospital out of medical necessity but when that has been dealt with they remain in hospital, bed blocking because of administrative procedures such as a social worker has not reviewed the case.

Even when appropriate care arrangements have been made because there is no alternative, the official stamp of approval is needed from someone who seems to work according to their own timescale even if it takes weeks.

That is not to say that the solution is always easy. Some patients will be able to return home only if appropriate domiciliary care is available. Others will prefer to move into a care home while others will need the more specialised care provided in nursing homes. Many people who could be cared for at home do not have sufficient private means to pay for their care. Inadequate Local Authority funding forces them to remain in hospital for no valid medical reason while they await suitable accommodation in care homes causing further blockages.

Carers do amazing work for little financial reward. Without their dedicated hard work the system would be in an even worse mess but local Authorities continue to undervalue carers. Last year it was reported that thousands of disabled and older people were receiving 15 minute homecare visits in England because almost a quarter of councils (22 per cent) – 34 - were ignoring Care Act guidance to stop the practice. That is unfair to both. If animals were treated the same there would be an outcry.

At the opposite end of the system too many people are using hospital Accident and Emergency units as primary care facilities. Millions of patients have been putting unnecessary strain on the NHS by seeking medical help for minor complaints such as colds, insect bites and dandruff, according to a report.

The crisis in general practice is said to be unprecedented: "Anyone who has visited their GP recently will be aware of the pressures: the struggle to get an appointment, the difficulty of seeing the same GP more than once, the rush to get you out of the door for the next patient."

The system is not working as it should. While there are individual pockets of excellence there are constant crises. Jeremy Hunt must not be tempted to kick the duduk perkara into the long grass with another inquiry. It is identified in his new title, Secretary of State for Health and Social Care - a joined up system with proper funding.

His smooth talk will not get Hunt out of this one. Delivery will prove Mrs May right. Failure will make them both the quarry.