With justification, the First Minister has described the integration of health and social care as one of the most significant reforms affecting the National Health Service in Scotland since its founding. High hopes and sheer necessity are combined in a laudable ambition.

Nicola Sturgeon has promised, furthermore, that if her party is returned to government next year it will “begin to increase Carer’s Allowance so that it is paid at the same level as Jobseeker’s Allowance”. This too is praiseworthy. Those who shoulder the burden of care for family or friends too often pay a very high price.

Reality is thrawn in the face of rhetoric, however. Fine plans are shredded when budgets shrink, or when those making the decisions fail to grasp what integration is supposed to mean. Finance might decree that the daytime care provided for a brain-injured man with dementia should be cut from 41 hours to 14. Common sense – and the principles advocated by the First Minister – says otherwise.

Is Lorraine Allan’s predicament the fault of her council or the Scottish Government? The former is responsible for the care package at stake; the latter, ultimately, for its funding. The local authority is hard-pressed for money; the government, sticking with its council tax freeze, claims to be protecting services while its own budget is cut. Between them, providing a priceless service yet left with nowhere to turn, is one carer.

Ms Allan is no enemy of Ms Sturgeon. Raising her case with the First Minister at a Health and Social Care Alliance event, the carer praised the government’s promised legislation. But Ms Allan’s point, though personal, is acute: integration is a matter of funding and of organisational reform, but also of logic. Responsibility (or blame) cannot be passed back and forth like a parcel when vulnerable people are being failed by all concerned.

A great deal of work is being done in Scotland to integrate health and social care for a great many very good reasons. The pressure on institutions could be eased; scarce money could be saved; and, above all, care in the home could at last be seen as a key part of the service. Nevertheless, the case raised by Ms Allan exposes two obstacles.

One is institutional inertia. Bureaucratic buck-passing from council to government and back again makes a bad situation worse. It is the enemy of progress. Secondly, if integration is to work, the role of carers such as Ms Allan must be recognised. Whether the politicians and the professional yet realise it or not, these individuals are at the heart of the system. Financial help is just part of the help they need. Without them, the grand plans will fail.

So much for theory. Ms Allan deserves a better answer than she has had from her cash-strapped council and her government. If the person in her care needed 41 hours how on earth can 14 suffice? Her problem needs a solution. As a test for the principle of integrated care in a healthier Scotland, the case could not be bettered.