Brexit means "only major crisis will focus ministers on to NHS"

The NHS and social care are at risk of being downgraded as a priority by a government distracted by Brexit unless there is a major public health crisis, the former chief executive of the NHS has warned.

Nigel Crisp, who ran the NHS and Department of Health for six years, said the government’s need to concentrate on the economics of leaving the EU would be one of the three biggest risks to health and social care posed by the referendum vote, along with loss of staff who are EU citizens and a brain drain from medical research.

The crossbench peer issued the warning in evidence to the House of Commons health committee inquiry into the impact of Brexit on health and social care, at a time when senior politicians and medical leaders have been sounding the alarm that care for the elderly is close to collapse.

Last week, Philip Hammond, the chancellor, refused to bow to pressure to give more funding to social care or NHS at the autumn statement, prompting anger from Labour MPs and even some Conservatives.

In his evidence to the new inquiry, Crisp said the NHS and social care were already “dealing with major problems and facing an uncertain future” but the uncertainty of Brexit only makes it even more important that the government sets out a clear direction and strategy.

Listing the possible risks of Brexit in his evidence, he said: “Pressures on the economy will bring pressures on all public services, adding to existing ones. Moreover, the emphasis in government policy will of necessity be on addressing economic rather than social issues with the result that health and social care will become a lower priority – unless, of course, there is a major public crisis.”

He added: “My most immediate concern is that we haven’t yet seen any adequate mitigating strategy or actions being taken by the government. NHS England and local employers have attempted to reassure staff but we need to see a government-led comprehensive and well supported risk mitigation approach adopted and publicised.”

Whitehall sources have told the Guardian that Downing Street is well aware of the funding difficulties in the NHS and social care but believes the government’s position on funding can hold at least until after the major hurdle of triggering article 50 is out of the way at the end of March.

However, there are already warnings about the risk of a winter crisis in the NHS as cuts to social care places mean many elderly people are not being discharged from their hospital beds.

Senior figures in the medical profession, together with Tory, Labour and Liberal Democrat leaders in local government, wrote to the Observer this weekend demanding a reversal of Philip Hammond’s decision not to offer more funding for social care in last week’s autumn statement.

They argued that the safety of millions of elderly people was at risk because of an acute financial shortfall in adult social care, which is in turn putting pressure on the NHS.

On Sunday, Stephen Dorrell, the former Conservative health secretary and chair of the NHS Confederation, also said that Hammond made a mistake in failing to give more funding to social care in the autumn statement.

His voice adds to other senior Tories, including fellow former health secretary Andrew Lansley and Sarah Wollaston, the chair of the Commons health select committee, in expressing fears that social care cuts are having a worrying effect on the NHS.

Responding to the warnings, a Treasury spokeswoman said: “The government has committed to increase NHS funding by £10bn above inflation by 2020/21, going beyond what the NHS requested.

“In addition, we have given local councils £3.5bn extra funding by 2020 for social care. Many councils are already providing high-quality social care services within existing budgets.”

Labour MPs expressed anger after Hammond did not mention social care once during his autumn statement speech to the Commons.

It prompted Jeremy Corbyn, the Labour leader, to launch a national “Care for the NHS” campaign on Saturday.

Brexit means "only major crisis will focus ministers on to NHS"