Scrapping means testing would prevent some elderly people from facing care home bills of more than £100,000.

It would bring the social care system into line with the NHS, where care is free at the point of need.

And it would reduce pressure on hospitals where people who are fi t to be discharged cannot be sent home because they need help with daily tasks such as dressing, washing and eating.

One of the report’s authors, Labour peer Lord Darzi, a former surgeon, said: “My patients don’t recognise the difference between the NHS and social care.

“Social care capacity shortages are crippling NHS services.”

He and Conservative colleague Lord Prior propose a number of radical reforms to the health service.

They set out a 10-point plan for funding and organisational changes and a 10-point “offer to citizens” outlining what effect these changes would have for patients, including shorter waiting times and the end of the postcode lottery of care.

Prime Minister Theresa May is expected to make an announcement soon on extra funding for the NHS to mark its 70th anniversary.

But money alone will not solve the crisis, the two former health ministers say. 

Their plan, compiled with the Institute for Public Policy Research, calls for annual spending on social care to double, from around £17billion to £36billion by 2030. 

The report recommends funding this by putting a penny on National Insurance Contributions for employers, employees and the selfemployed.

This was backed up by a YouGov poll yesterday which showed two thirds of voters would be willing to pay 1p more on income tax to provide more money for the NHS.

Lord Darzi pointed out that cuts in social care funding over the past decade have led to an average fall of five per cent a year in the number of people receiving state-funded care.

“The NHS and social care have done well to improve or maintain quality over the last decade. But the cracks are now showing,” he said.

“We need bold action to ensure that the NHS is fit for the 21st century. This will mean caring as much about social care and public health as the NHS and embracing reform as much as additional funding.

“The gift the NHS needs on its 70th birthday is a pragmatic plan to secure it for future generations.”

The peers put forward the case for a long-term settlement which guarantees NHS funding will increase at an annual rate of 1.5 per cent above the overall rate of economic growth.

Their plan also suggests a radical streamlining of the NHS by replacing 244 commissioning bodies and other organisations with up to 10 new Health and Care Authorities.

The number of national NHS leadership bodies would be cut from six to three, by merging NHS Improvement, Health Education England and Public Health England with NHS England.

Chris Askew, chief executive of Diabetes UK, and chairman of the Richmond Group of Charities, said: “We all know the NHS is grossly underfunded but, unless we also fill the funding gaps in social care and public health, pumping money into one aspect of our health and social care system won’t make a sustainable difference.

“Failure to keep up with demand in one part has massive impacts for the whole system. It’s a case of sink or swim together.”

It is believed Mrs May’s announcement of a funding boost for health and social care services to help address the rising costs associated with the ageing population could come as soon as tomorrow.

A spokesman for the Department of Health and Social Care rejected the peers’ report, saying: “This Government is committed to ensuring that everyone has access to the care and support they need but we are clear that people should continue to expect to contribute to their care.”

They also suggest the obligation to tender competitively for services – internally or externally – should be scrapped, arguing that the constant changes generated by this process are costly and disruptive to care, with limited evidence that it has improved quality or efficiency.

Lord Prior said: “Simply putting more money into the NHS and hoping for the best will not work. With funding must come radical reform. We need a shift from ‘diagnose and treat’ to ‘predict and prevent’. Care must be joined up around – and tailored to – the patient. A universal service should be there for everyone, not the same for everyone.

“At the heart of our plan for reform is a radical simplification of the NHS and a properly funded social care system to make this happen.”

Commenting on the report, Dr Anna Dixon, chief executive of the Centre for Ageing Better, said: “Ultimately, there is no point living for longer if those extra years are spent suffering a poor quality of life in ill health and without access to decent care.”

The YouGov survey for pressure group 38 Degrees found that 73 per cent of those questioned did not believe politicians were prepared to make difficult decisions about how to fund the NHS.

Some 66 per cent said that they would be ready to pay an additional 1p in income tax.

This could raise £5.5billion a year, according to the Centre for Economics and Business Research.

David Babbs, executive director of 38 Degrees, said: “The Government knows the NHS needs more sustainable funding but the last few days proves they haven’t worked out how. “They now have a clear mandate from the people, who are willing to pay a bit more in tax to give our NHS the proper funding boost it needs, not a sticking plaster solution.”

Case study: Trapped by a cross-border dispute

Roger Whitting, 61, from Oswestry, Shropshire, was trapped in a hospital bed for three days after a mix-up between English and Welsh ambulance services.

After a night in the Wrexham Maelor Hospital on May 20 Mr Whitting was discharged.

But, having been left disabled in an accident in 2013, he needed an ambulance to get him home.

He was then left to bed-block because of a mix-up over NHS rules on who pays for cross-border ambulances at weekends. 

Shropshire Clinical Commissioning Group said Welsh Ambulance Service should have taken Mr Whitting home.

But the Welsh Ambulance Service does not transfer patients to England on Sundays – while the English ambulance said it was not able to cross to Wales.

Mr Whitting said: “It seemed no-one was prepared to foot the bill to get me home.

“Everyone talks about bed blocking yet for the price of the fuel for a few miles I was using a bed that someone else should have been able to have.

“At home I had my carers on standby to come in and look after me. I also have a state-of-the-art bed that turns me every 30 minutes to prevent pressure sores and infections.

“The care I have from the paramedics, ambulance staff and everyone at the hospital was first class. I am on lots of medication that luckily I took with me.

“At home I would self administer this, or my carers would help. In hospital nurses had to go through their protocol and give up a lot of their time to give me my tablets.

“The hospital found me an air mattress because of my disability but the NHS cost of handling me and having me in hospital must have been enormous.”

How a radical shake-up of NHS would ensure it is fighting fit for 21st century

Ten point plan for reform

1. Invest in health, not just health care. This means embracing a “health in all policies” approach across government and getting serious about tackling obesity, smoking and alcohol consumption.

2. Invest in the digital infrastructure the NHS needs, enabling data sharing across the system and embracing “full automation” to release more time to care.

3. Deliver a significant increase in research and development spending.

4. Make social care free at the point of need. This means extending the NHS’s “need, not ability to pay” principle to social care and fully funding the service as part of new social contract between the citizen and the state.

5. Establish a New Deal for general practice, mental health and community services. This means creating a new option of integrated care trusts for all out-of-hospital care and shifting power and funding away from the acute sector.

6. A radical simplifi cation of the system with a single structure – Health and Care Authorities – at regional level.

7. A coherent strategy to improve quality across the board.

8. Ensure health and care are properly staffed by creating an integrated skills and immigration policy and providing fair pay for staff.

9. A transformation fund to allow for changes and provide the building blocks for a 21st century NHS.

10. Set out a long-term funding settlement to end the “feast and famine” cycle.

10 benefits of the proposals 

1. Free personal and nursing care for everyone who needs it, regardless of your ability to pay – just like the NHS. Growing old shouldn’t mean getting poor.

2. Fast and convenient access to primary care for working families, open during the evenings and over the weekend.

3. A digital NHS. An ability to access your medical records, order your prescription and have your consultation with the GP online.

4. A single named GP, a joint care plan, a personal budget and regular check-ups for people with long-term conditions.

5. Shorter waiting times and better access to care. No waiting on trolleys. No delays in hospital beds. No cancelled operations.

6. Quality of care in England for people with poor mental health and cancer on a par with best practice abroad.

7. Never knowingly understaffed. Enough nurses and doctors in every hospital and GP practice across the country, with time to care and not just to treat.

8. Elimination of the postcode lottery in treatment. Access to the best treatments, approved by Nice, no matter where you live.

9. A reduction in health inequalities. Where you live should not determine how long you live.

10. An NHS that helps to create good jobs at home and increase our earnings from exports abroad – generating prosperity that’s good for everyone.

COMMENT – IZZI SECCOMBE: Community Wellbeing Board chair, Local Government Association

THERE is an irrefutable crisis in adult social care.

With rising demand, people living longer, care providers closing and contracts being handed back to councils, there is less choice and availability for people needing care.

Properly funding social care not only helps councils with overly-stretched budgets protect care services, it also helps to prevent crises in the NHS by reducing the numbers of people who are admitted to hospital in the first place.

Most council services, including housing, leisure and libraries, help to save the NHS a fortune. Without essential council services, we will almost certainly see further rises in demand and the A&E crisis spiral to an unresolvable, year-round problem.

But the lack of funding – especially for public health and adult social care – makes it ever harder to keep people out of hospital and to help those who have to be admitted to return home safely and without delay.

Councils are the most efficient, transparent and trusted part of the public sector and are effectively managing ever tighter budgets to maintain their track record of delivering quality services.

The fact that councils have reduced delayed transfers of care from hospital due to social care by 33 per cent since July 2017, and at a faster rate than the NHS, should help to persuade Government to fully fund our social care system.

The Government needs to give urgent funding to councils to invest in community based early intervention and prevention measures.

This is the most effective use of local government and NHS resources, and will help to reduce costs to public purse.

Fundamental changes to the way we fund adult social care are needed if we are to deliver a system that works for everyone in society.

Otherwise vital council services will not be there when residents, and the NHS, need them.

All funding options should be up for discussion. It is critical the care and support green paper is published in the summer and incorporates solutions to plug the funding gap facing adult social care which is set to exceed £2billion by 2020.

Time for bold decision making is long overdue because these issues cannot be ignored any longer.

Scrapping means testing would prevent some elderly people from facing care home bills of more than £100,000.

It would bring the social care system into line with the NHS, where care is free at the point of need.

And it would reduce pressure on hospitals where people who are fi t to be discharged cannot be sent home because they need help with daily tasks such as dressing, washing and eating.

One of the report’s authors, Labour peer Lord Darzi, a former surgeon, said: “My patients don’t recognise the difference between the NHS and social care.

“Social care capacity shortages are crippling NHS services.”

He and Conservative colleague Lord Prior propose a number of radical reforms to the health service.

They set out a 10-point plan for funding and organisational changes and a 10-point “offer to citizens” outlining what effect these changes would have for patients, including shorter waiting times and the end of the postcode lottery of care.

Prime Minister Theresa May is expected to make an announcement soon on extra funding for the NHS to mark its 70th anniversary.

But money alone will not solve the crisis, the two former health ministers say. 

Their plan, compiled with the Institute for Public Policy Research, calls for annual spending on social care to double, from around £17billion to £36billion by 2030. 

The report recommends funding this by putting a penny on National Insurance Contributions for employers, employees and the selfemployed.

This was backed up by a YouGov poll yesterday which showed two thirds of voters would be willing to pay 1p more on income tax to provide more money for the NHS.

Lord Darzi pointed out that cuts in social care funding over the past decade have led to an average fall of five per cent a year in the number of people receiving state-funded care.

“The NHS and social care have done well to improve or maintain quality over the last decade. But the cracks are now showing,” he said.

“We need bold action to ensure that the NHS is fit for the 21st century. This will mean caring as much about social care and public health as the NHS and embracing reform as much as additional funding.

“The gift the NHS needs on its 70th birthday is a pragmatic plan to secure it for future generations.”

The peers put forward the case for a long-term settlement which guarantees NHS funding will increase at an annual rate of 1.5 per cent above the overall rate of economic growth.

Their plan also suggests a radical streamlining of the NHS by replacing 244 commissioning bodies and other organisations with up to 10 new Health and Care Authorities.

The number of national NHS leadership bodies would be cut from six to three, by merging NHS Improvement, Health Education England and Public Health England with NHS England.

Chris Askew, chief executive of Diabetes UK, and chairman of the Richmond Group of Charities, said: “We all know the NHS is grossly underfunded but, unless we also fill the funding gaps in social care and public health, pumping money into one aspect of our health and social care system won’t make a sustainable difference.

“Failure to keep up with demand in one part has massive impacts for the whole system. It’s a case of sink or swim together.”

It is believed Mrs May’s announcement of a funding boost for health and social care services to help address the rising costs associated with the ageing population could come as soon as tomorrow.

A spokesman for the Department of Health and Social Care rejected the peers’ report, saying: “This Government is committed to ensuring that everyone has access to the care and support they need but we are clear that people should continue to expect to contribute to their care.”

They also suggest the obligation to tender competitively for services – internally or externally – should be scrapped, arguing that the constant changes generated by this process are costly and disruptive to care, with limited evidence that it has improved quality or efficiency.

Lord Prior said: “Simply putting more money into the NHS and hoping for the best will not work. With funding must come radical reform. We need a shift from ‘diagnose and treat’ to ‘predict and prevent’. Care must be joined up around – and tailored to – the patient. A universal service should be there for everyone, not the same for everyone.

“At the heart of our plan for reform is a radical simplification of the NHS and a properly funded social care system to make this happen.”

Commenting on the report, Dr Anna Dixon, chief executive of the Centre for Ageing Better, said: “Ultimately, there is no point living for longer if those extra years are spent suffering a poor quality of life in ill health and without access to decent care.”

The YouGov survey for pressure group 38 Degrees found that 73 per cent of those questioned did not believe politicians were prepared to make difficult decisions about how to fund the NHS.

Some 66 per cent said that they would be ready to pay an additional 1p in income tax.

This could raise £5.5billion a year, according to the Centre for Economics and Business Research.

David Babbs, executive director of 38 Degrees, said: “The Government knows the NHS needs more sustainable funding but the last few days proves they haven’t worked out how. “They now have a clear mandate from the people, who are willing to pay a bit more in tax to give our NHS the proper funding boost it needs, not a sticking plaster solution.”

Case study: Trapped by a cross-border dispute

Roger Whitting, 61, from Oswestry, Shropshire, was trapped in a hospital bed for three days after a mix-up between English and Welsh ambulance services.

After a night in the Wrexham Maelor Hospital on May 20 Mr Whitting was discharged.

But, having been left disabled in an accident in 2013, he needed an ambulance to get him home.

He was then left to bed-block because of a mix-up over NHS rules on who pays for cross-border ambulances at weekends. 

Shropshire Clinical Commissioning Group said Welsh Ambulance Service should have taken Mr Whitting home.

But the Welsh Ambulance Service does not transfer patients to England on Sundays – while the English ambulance said it was not able to cross to Wales.

Mr Whitting said: “It seemed no-one was prepared to foot the bill to get me home.

“Everyone talks about bed blocking yet for the price of the fuel for a few miles I was using a bed that someone else should have been able to have.

“At home I had my carers on standby to come in and look after me. I also have a state-of-the-art bed that turns me every 30 minutes to prevent pressure sores and infections.

“The care I have from the paramedics, ambulance staff and everyone at the hospital was first class. I am on lots of medication that luckily I took with me.

“At home I would self administer this, or my carers would help. In hospital nurses had to go through their protocol and give up a lot of their time to give me my tablets.

“The hospital found me an air mattress because of my disability but the NHS cost of handling me and having me in hospital must have been enormous.”

How a radical shake-up of NHS would ensure it is fighting fit for 21st century

Ten point plan for reform

1. Invest in health, not just health care. This means embracing a “health in all policies” approach across government and getting serious about tackling obesity, smoking and alcohol consumption.

2. Invest in the digital infrastructure the NHS needs, enabling data sharing across the system and embracing “full automation” to release more time to care.

3. Deliver a significant increase in research and development spending.

4. Make social care free at the point of need. This means extending the NHS’s “need, not ability to pay” principle to social care and fully funding the service as part of new social contract between the citizen and the state.

5. Establish a New Deal for general practice, mental health and community services. This means creating a new option of integrated care trusts for all out-of-hospital care and shifting power and funding away from the acute sector.

6. A radical simplifi cation of the system with a single structure – Health and Care Authorities – at regional level.

7. A coherent strategy to improve quality across the board.

8. Ensure health and care are properly staffed by creating an integrated skills and immigration policy and providing fair pay for staff.

9. A transformation fund to allow for changes and provide the building blocks for a 21st century NHS.

10. Set out a long-term funding settlement to end the “feast and famine” cycle.

10 benefits of the proposals 

1. Free personal and nursing care for everyone who needs it, regardless of your ability to pay – just like the NHS. Growing old shouldn’t mean getting poor.

2. Fast and convenient access to primary care for working families, open during the evenings and over the weekend.

3. A digital NHS. An ability to access your medical records, order your prescription and have your consultation with the GP online.

4. A single named GP, a joint care plan, a personal budget and regular check-ups for people with long-term conditions.

5. Shorter waiting times and better access to care. No waiting on trolleys. No delays in hospital beds. No cancelled operations.

6. Quality of care in England for people with poor mental health and cancer on a par with best practice abroad.

7. Never knowingly understaffed. Enough nurses and doctors in every hospital and GP practice across the country, with time to care and not just to treat.

8. Elimination of the postcode lottery in treatment. Access to the best treatments, approved by Nice, no matter where you live.

9. A reduction in health inequalities. Where you live should not determine how long you live.

10. An NHS that helps to create good jobs at home and increase our earnings from exports abroad – generating prosperity that’s good for everyone.

COMMENT – IZZI SECCOMBE: Community Wellbeing Board chair, Local Government Association

THERE is an irrefutable crisis in adult social care.

With rising demand, people living longer, care providers closing and contracts being handed back to councils, there is less choice and availability for people needing care.

Properly funding social care not only helps councils with overly-stretched budgets protect care services, it also helps to prevent crises in the NHS by reducing the numbers of people who are admitted to hospital in the first place.

Most council services, including housing, leisure and libraries, help to save the NHS a fortune. Without essential council services, we will almost certainly see further rises in demand and the A&E crisis spiral to an unresolvable, year-round problem.

But the lack of funding – especially for public health and adult social care – makes it ever harder to keep people out of hospital and to help those who have to be admitted to return home safely and without delay.

Councils are the most efficient, transparent and trusted part of the public sector and are effectively managing ever tighter budgets to maintain their track record of delivering quality services.

The fact that councils have reduced delayed transfers of care from hospital due to social care by 33 per cent since July 2017, and at a faster rate than the NHS, should help to persuade Government to fully fund our social care system.

The Government needs to give urgent funding to councils to invest in community based early intervention and prevention measures.

This is the most effective use of local government and NHS resources, and will help to reduce costs to public purse.

Fundamental changes to the way we fund adult social care are needed if we are to deliver a system that works for everyone in society.

Otherwise vital council services will not be there when residents, and the NHS, need them.

All funding options should be up for discussion. It is critical the care and support green paper is published in the summer and incorporates solutions to plug the funding gap facing adult social care which is set to exceed £2billion by 2020.

Time for bold decision making is long overdue because these issues cannot be ignored any longer.