The NHS and social care providers are close to all out war, and it is a war where politicians have already decided that the NHS will win.
Politicians of all stripes view the NHS as untouchable. No matter how badly it behaves, and how much money it wastes, you will never hear a minister go any further than blame trade unions such as the British Medical Association for being unreasonable.
Meanwhile charities like Age UK, or associations like Care England, do their best to put the case for social care providers that are viewed by the NHS and its unions as capitalist scum.
The animosity cuts both ways. I once heard an HR consultant to the social care sector (who obviously has a penchant for Star Wars analogies) describe the NHS as the Death Star.
This is the toxic backdrop against which to view the latest outrageous assault from the BMA, which has persuaded its members to vote for GPs to withdraw visits to frail and elderly residents at their care homes.
Independent experts agree that better integration between NHS and social care will improve outcomes for patients and almost certainly reduce costs to tax payers.
However, as Professor Martin Green, chief executive of Care England told Care Home Professional this month, the NHS shows little intention of cooperating with care homes. They want control of them.
The process is already starting. According to a recent presentation by the Care Quality Commission chief executive David Behan, at least 20 NHS provider organisations are preparing to deliver social care.
Imagine how that will turn out – rather than privately run care homes providing high dependency care for as little as £2.31 an hour, the NHS will find a way of providing worse care for ten times more, and then demanding a huge funding boost from tax payers to cover its profligacy.
There is no doubt that all elements of health and social care are under financial strain. But it is only the NHS and its unions that have a loaded gun to the Government’s head. If peace doesn’t break out between leaders of the NHS and social care, the NHS military machine will continue to grab territory. This will lead to worse outcomes for the elderly, the tax payers and care home operators.