Chancellor Philip Hammond’s recent Autumn Statement omitted social care entirely, and this snub to a sector that is already pointing to a funding gap of more than £1 billion is only going to create more problems for service users and providers in the future, says editor Dan Parton.
While Philip Hammond’s first – and, as he is abolishing them, last – Autumn Statement inevitably focused on Brexit and its effect on, well, everything, one thing was conspicuous by its absence: social care.
Ahead of the statement, many had been hopeful that the Chancellor would be able to find some extra cash for the sector, but as he delivered his speech, those hopes were dashed. It is now clear the sector will have to make do with what it has for the foreseeable future, at least.
What the sector has, in one pithy soundbite, is not enough money. Local authority budgets have been slashed by 25% over the past 6 years thanks to former Chancellor George Osborne’s austerity policy, and this has seen spending on social care – traditionally one of the biggest expenses – similarly squeezed.
Inevitably, this has affected frontline services. While administration and back-office functions have experienced swingeing cuts, there were only so many ‘efficiency savings’ that could be made before frontline services started to take a hit. And take a hit they have: many councils now only provide services to those who satisfy the most stringent criteria, and some services have either been cut back or discontinued altogether.
An added problem for the sector is the National Living Wage (NLW), which was introduced in April. While many do not argue against the principle of paying their employees more, the practicalities of doing it in such straightened times is adding to the pressure on services. Hft have been vocal on this, for instance.
Already, we have heard that some contracts for services are being handed back because the provider cannot viably provide them. Other councils are struggling to find providers for services for this reason.
The lack of funding will only exacerbate these problems. Cases such as in Rochdale, where the council is considering moving back to a model based on residential care, are likely to increase in number in the coming years.
The sector responded to the Autumn Statement with dismay and concern, as you would expect. For instance, Lord Porter, chairman of the Local Government Association, said: “The government must take urgent action to properly fund social care if councils are to stand any chance of protecting the services which care for the elderly and vulnerable. Extra council tax-raising powers will not bring in enough money to alleviate the pressure on social care and councils will not receive the vast majority of new funding in the Better Care Fund until the end of the decade. Services supporting our elderly and vulnerable are at breaking point now.”
Meanwhile, Tim Cooper, chief executive of United Response, said that it was a “deeply worrying” statement, adding: “It is hypocritical for the government to continue to advocate for adequate care, without providing the necessary funding. The immense gulf between the aspirations of the Care Act, and the reality as experienced by millions of older and disabled people has just been added to by this staggering omission from the Chancellor.
“Our most conservative calculation of additional funding needed for social care by 2020 is £1.166 billion, with £926 million required for learning disability support services alone.”
These are huge figures, and tally with the £940 million figure the Association of Directors of Adult Social Services calculated earlier in the year. It is no wonder then that talk of crisis is mounting within the sector. With no new money forthcoming, that talk will only increase.
Of course, you also have to factor in that the number of people requiring social care is going to rise. We live in an ageing population, and people are living longer with more – and more complex – conditions. Likewise, people with disabilities are living longer. In addition, the number of people seeking mental health services has been steadily increasing for years now. So this isn’t a problem that is going to solve itself.
Quite why social care was ignored is a mystery. It isn’t like this is an unknown situation – and it has been getting progressively worse for years. Perhaps it is an indicator of where it stands in the political pecking order. With Brexit now set to dominate political thinking for the next couple of years, sectors such as this – which aren’t regarded as a vote-winner – will be largely ignored.
Add in forthcoming cuts to specialist employment support – about 75% will be slashed when the new Work and Health Programme comes in next year, according to the Employment Related Services Association – and it is hard to find any positives in this situation.
Whether a service will fail completely remains to be seen. I suspect not, but that would be down to the dedication of the professionals working in the team more than anything else.
Optimists (or political spin doctors – delete as applicable) may say that necessity is the mother of invention, and with limited budgets, some innovative services will be created. But these will be in a minority. In general, to provide a good service to people, a service needs to be adequately funded. It’s obvious, really.
Hammond’s failure to grasp what is, admittedly, a very thorny nettle is only storing up problems for the future. Firstly, failing to address social care funding will also add to pressure on other services, notably the NHS, which is also struggling to deal with increased numbers of people requiring its services – as the figures on the length of time people have to wait for a bed after emergency admission show.
In addition, the funding gap mentioned earlier is also only going to grow, so it will take even more resources to sort it out when – or if – the government decides to tackle it.
But, more importantly, we will see more people in need of social care – be they older people, or people with physical or learning disabilities or mental ill health – going without, and their quality of life will suffer as a result. These could be the services they need to live effectively in the community, stay safe in their own homes, or avoid a crisis that could see them end up in the health service.
Of course, if this happens, it will be far costlier to the public purse, which highlights the short-sightedness of the policy.
The government may still pay lip service to the personalisation agenda, and increasing choice and control for service users, but how much choice and control do you have when there are few services to choose from, and ones that are available don’t fit your needs?
After years of steady progress in providing better, more personalised services that are focused on outcomes for people, it seems that we could be standing at a tipping point where services move away from the progressive model advocated in policies like Valuing People and back to a more institutional model.
This cannot be allowed to happen. We should not go back to models of care that have been shown not to work and which deliver poor outcomes. The Chancellor has to listen to these calls and in next year’s Budget put right this glaring omission, and ensure that the sector can be pulled back from the brink. Without that, many lives are going to be adversely affected.