The government’s plans for reforming social care are gathering pace, with the recent publication of the Law Commission’s review report on adult social care law.
While some of the headline recommendations from the Commission contained the usual PR-speak fluff – such as ‘putting the individual’s wellbeing at the heart of decision-making’ – others pointed to real and positive change ahead.
For example, building a single, streamlined assessment and eligibility framework could help to ensure greater fairness in decision making and less of a postcode lottery in services provided.
It could also help to avoid ugly situations such as that of Birmingham City Council, which recently lost its legal battle against four service users, some of whom had learning disabilities. The council had planned to cut its service provision to people with ‘critical’ needs only, which would have seen the claimants lose out on their services. But the claimants argued successfully that it was against disability discrimination laws. Birmingham City Council is now reconsidering its plans.
It will be interesting to see the fallout from that decision in the coming months – especially whether it sparks a slew of legal cases against other councils trying to make similar cuts.
Other measures, designed to protect service users from abuse and neglect, with a new legal framework, and to give carers legal rights to services also auger well for the future.
Of course, this is only one part of the government’s plans to reform social care. The Dilnot Commission on the funding of social care and support, is set to report in July. Members of the commission have also indicated that they back a new national set of eligibility criteria, including an overhaul of the fair access to care services framework. A national definition of continuing care – the system of NHS-funded social care for people with serious health conditions – is also on the cards, as is the retention of attendance allowance.
But the key part of Dilnot’s review will be the system of funding that is recommended for social care. Currently, a partnership approach – where individuals pay a proportion of their care costs along with the state – seems to be the favoured solution.
Meanwhile, the Health and Social Care Bill, with its radical proposals for health service reform, is currently on ‘pause’ for a listening exercise. The government is seeking to make it more palatable to professionals and service users who have been up in arms about it ever since health secretary Andrew Lansley introduced it in ‘Equity and Excellence: Liberating the NHS’ in August 2010.
How much change this listening exercise will bring about is unclear – senior Conservatives are on record as saying the major tenets of the plan, such as transferring commissioning of services to GPs, will not be changed.
Taken together, the effects of the Law Commission proposals, the Dilnot Review and the planned changes to the NHS are likely to bring about the biggest shake-up of social care in 60 years. The current system has been creaking for decades and undoubtedly needs reform. Hopefully the government will create a system that will be fit for purpose for years to come.
But the biggest hope is that the necessary funding is there for change – and that the agenda is not hijacked by the current drive to cut costs. If it is, then reforms will be on the back foot from the start.