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At the beginning of the week of the Conservative Party conference, a report to mark the 40th anniversary of charity Turning Point told us that a lack of joined-up services in health and social care is costing Britain more than £7bn a year.

It said people with a mixture of needs, including mental health problems, drug and alcohol misuse and learning difficulties, can rarely find help to tackle them in a concerted way.

Failure to help exacts a cost on the individual - and on society too. Lord Adebowale, Turning Point's chief executive, said: "Too often, for people with complex needs we are providing services that are like an ambulance at the bottom of the cliff, rather than trying to stop them from falling in the first place."


At the end of the week, Tory leader Michael Howard made a pledge. "I'll give you a government you can trust," he said. Even if we give Mr Howard the benefit of a very large doubt and accept his offer of honesty and accountability, the next fraught question is about his ambition to lead "a government you can trust". Which is: to do what, exactly? Ensure that there is even less support for the most vulnerable? Axe the ambulance at the foot of Lord Adebowale's cliff?

The Tories have yet to realise that the electorate has become more knowledgeable about the connections between deprivation and discord. Today, unlike in periods of past Tory rule, we have families who have been without work not for one or two generations but for three and four.

For all its flaws, the Labour government has recognised that finding a long-term solution involves more than jobs and money - although both help. It's also about vision. As a result "social exclusion" - a phrase which points to systemic failure rather than simply the behaviour of the allegedly feckless individual - is now part of the modern political lexicon.


Action to revitalise the poorest and most vulnerable is not only an issue of social justice, it makes economic sense. A society which has a widening chasm between rich and poor can never achieve prosperity. Research from around the world tells us so. The most effective economies have the narrowest of gaps. So, when the Tories talk of tax cuts, not only do their focus groups reveal that nobody believes them, it also exposes their inability to face up to what is required to govern in the 21st century.