i Editor's Letter: The future of the NHS has become the elephant in the ward

A conspiracy of silence. That’s the verdict of Britain’s most respected independent health body. Not one of the Westminster political parties has revealed their plans for how we should pay for NHS and social care after May’s general election. It’s the elephant in the ward. How are we going to pay for all this in 10 years, let alone 50?

We all know about our ageing population, that people with chronic conditions are living for much longer (hooray!) and that treatment is unfair because of the separation of health from care services. (If you or I have a heart problem or cancer we will be treated for free. Dementia, though? Cough up tens of thousands of pounds for your care.)

The radical plan today from the respected King’s Fund is that social care for the elderly and long-term ill becomes free at the point of use. They estimate the cost in England at £9bn a year – a 50 per cent increase in its budget. (Devolved health services could decide for themselves.)

To pay for this, and the other challenges I mention, the controversial proposal is for over-40s and high-earners to pay more tax; for the Government to end fuel payments, free bus passes and TV licences to better- off pensioners; and to stop the National Insurance exemption for people who work past pension age.

Would you be willing to pay more to protect the NHS? The strategy’s author, Dame Kate Barker, the former Bank of England economist, says: “We have to afford it. We can’t let people with dementia wander the streets.” But the plans will invite fury from some of those who would be affected, particularly where incomes are tight or retirements already planned.

Ed Miliband is determined to make a grand NHS policy the centrepiece of Labour’s election campaign. His problem is how to get us to pay for it when Labour has lobbied so hard on the cost of living. Expect more in three weeks when his party gathers in Manchester.

i@independent.co.uk

Twitter.com: @olyduff