No government in my lifetime has been dealt a worse hand than Keir Starmer’s. Austerity-broken public services, an empty Treasury, a jittery bond market freaked out by Liz Truss and then stricken by the arrival of Trump 2.0 with his bully-tariffs. Now Britain’s ally is setting the Middle East on fire in a murderous war, exploding oil and gas prices. This needs repeating regularly, lest anyone forgets the obstacles blocking this government’s best intentions for change.

One of those good intentions in the Labour manifesto was the creation of a national care service. Louise Casey, respected troubleshooter, was given a commission to review adult social care and solve its impossible dilemmas. She showed her thinking in a blistering speech last week.

With her trademark brutal honesty, she laid bare the chaos in ramshackle care services on the verge of collapse, as near-bankrupted councils fail to cope with the “seismic challenge” of soaring dementia cases. With all the wars and crises around the world, it was practically overlooked. It shouldn’t be.

Later this year comes Casey’s first report on creating a national care service out of the 18,000 mostly private providers in England, ranging from tiny family businesses to chains owned by profiteering private-equity firms. A new service will try (yet again) to bond with the NHS, ending warfare over shifting expensive responsibilities from one to the other: the NHS says that about 12,000 beds are occupied by patients fit for discharge, while councils complain that those with clear medical needs are being shunted out of the NHS and into social care.

In her letter to the health secretary, Casey says dementia should be regarded not as “an inevitable part of ageing” but as “a clinical........

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