There was no mention of social care in the Autumn Statement. No recognition by the Tory Chancellor that £4.6bn of cuts to budgets for adult social care had brought care services to the point of crisis - or "a tipping point" as the Care Quality Commission describes it.
An ever-growing coalition of organisations working in health and social care had pleaded with the Government to bring forward funding to address the current crisis. Those pleading the case for more funding range from NHS Chief Executive Simon Stevens to current leaders of 11 Medical Royal Colleges. And from the King's Fund to the Local Government Association. From Unison to the Care and Support Alliance. And Labour in our recent Opposition Day debate.
We all share a belief that the Government must act on social care funding.
Without extra funding for social care this promises to be a long hard winter for our health and social care systems. The most visible manifestation of the pressures caused by cuts to social care budgets is the rapid growth in delayed transfers of care from hospital. The September figure of over 196,000 delayed days was a record. A record in delayed discharges not in winter, but at the end of summer.
That means people "stuck" in hospital waiting for a care package or a care or nursing home place. Long stays in hospital can affect patients' morale and mobility. They also increase the risk of hospital-acquired infections.
Outside of hospital, there are 400,000 fewer people receiving publicly-funded support than there were in 2009-10. Age UK report that the number of older people with unmet care needs is now at a record 1.2 million.
Cuts in social care support, happening in the context of an ageing population with increasing needs, have made a profound impact on the family carers who are now stepping in to provide more care than ever before.
The increase in the numbers of unpaid carers providing care and the increased number of hours they are providing comes at a huge personal cost to those carers if they are not well supported. And too many family carers are not well supported by overstretched local councils and overstretched GPs.
So, nothing from the Tory Chancellor on social care which is in crisis due to a lack of funding. A silence that Philip Hammond and many Tory MPs may find themselves regretting, during a winter which may see our social care system experience the collapse so many have predicted.
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