Nigel Morris: After the political capital comes only pain for the PM

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The furore over Celyn Vincent's care will cause deep pain for David Cameron both personally and politically. There was no doubting his sincerity yesterday when he expressed his deep sympathy for Riven Vincent and her "crumbling" family. Less than two years ago the Camerons suffered the death of their six-year-old-son Ivan, who had cerebral palsy and epilepsy.

But, for all the private anguish, the experience of bringing up a profoundly disabled child also assumed a highly political dimension for the Tory leader. He repeatedly referred to his long hours at Ivan's hospital bedside as proof that the NHS was safe in his hands – a key message to voters unconvinced by his party's commitment to public services.

It was no coincidence that he visited the Riven family home during the election campaign. As recently as this week, senior Tories privately pointed to his background as proof there was no sinister motive in the Government's plans to overhaul the NHS.

In office, though, Mr Cameron has taken decisions that mean there will be many, many more instances of Coalition policies being blamed for increasing the anguish of the most vulnerable.

Ministers have embarked on the heaviest cuts in public services in a generation, and combined that with delegating responsibility to council chiefs for detailed spending decisions – the principle of so-called "localism". Although the amount of cash allocated to councils for respite care has increased, the rules ring-fencing it for that purpose have been canned. Grants for local authorities are being slashed by more than a quarter over the next four years, meaning that many cherished services will be axed. Ministers hope their arms-length distance from the cuts will insulate them from anger. They are being optimistic.

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