Is social care the latest casualty of austerity?

Is social care the latest casualty of austerity?

As the problems in social care continue to grow, the head of the Local Government Association has called for an extra £1.1bn funding to allow councils to maintain a “civilised level of care”

It is no secret that many public services are suffering as a result of austerity measures. For weeks the NHS has been crying out for assistance, waving its hands frantically as it steadily drowns in overwhelming patient numbers. From staff to working for free, to accident units shutting the doors to ambulance drivers, the horror stories keep mounting as the winter progresses.

Much of the pressure within the NHS stems from cuts to social care. People are living longer and require complex levels of care. Both health and social services are struggling with the demand to do more with less.

Social care, which is run and funded via local authorities, is starting to buckle under the pressure. Key services are being cut because of austerity and it is people like the elderly who are suffering as a result.

David Sparks, leader of the Local Government Association (LGA), said social care funding in England and Wales is in a “ridiculous situation”, and isn’t it just?

The LGA, which represents councils, said around £900m has been pulled from other services in a bid to plug the funding black hole facing elderly care. Sparks said an additional £1.1bn funding is needed for local authorities to maintain a “civilised level of care”.

He added: “Our councils are telling us that they have had to switch £900m from other services to plug the gap on elderly care.

“It’s basic arithmetic. If you freeze local council spending and the population is increasing all the time and the demand for services is increasing, it means other people will suffer.”

Austerity has to happen, but the scale of the campaign instilled by the coalition seems to be bringing its own issues. Cutting other services to pay for social care feels a little bit like robbing Peter to pay Paul. There needs to be a more sustainable approach to the budget.

Sparks said: “We need at least £1.1bn to match what we view as the likely demand for next year based on the trends. Every year it’s going up, it’s now 35% of local government expenditure [that] just goes on adult social care.

“If you go in, like I do, to see my father in a care home, and you listen to the bell ringing, you know that bell rings longer before people are seen because money is being spread out, and there’s an inadequate amount of funding going in for a civilised level of care in the 21st century. It is just a ridiculous situation.”

Sparks’ statement comes on the heels of research carried out by Age UK last week, which found that between 2010-11 and 2013-14 the number of older people receiving home help for tasks such as washing and dressing fell by a third to just over 370,000.

Additionally, the research also found there had been a two-thirds drop in day care places to just under 60,000, as well as a decline of 64 per cent in the number of people receiving meals on wheels.

Speaking last week, Director of Age UK Caroline Abrahams said: “Our state-funded social care system is in calamitous, quite rapid decline.

“The more preventive services like meals on wheels and day care are being especially hard hit, leaving the system increasingly the preserve of older people in the most acute need, storing up big problems for the future.

“Hundreds of thousands of older people who need social care are being left high and dry.

“The lucky ones have sufficient funds to buy in some support, or can rely on the goodwill of family, neighbours and friends. But there are many who are being left to struggle on entirely alone.”

Abrahams continued: “Until recently the impact of the decline in social care has been relatively hidden, but social care is a crucial pressure valve for the NHS and the evidence of what happens when it is too weak to fulfil that function is clear for us all to see.”

The Commons Public Accounts Committee also published a report that examined the financial sustainability of local authorities. It is not really surprising, but the report found that cuts to local authority budgets are hitting the poorest areas the hardest.

Chair of the committee, Margaret Hodge, said that between 2010-11 and 2015-16 some council had faced funding reductions of 37 per cent, which, when you think about it, is a staggering amount. It is no wonder some councils are in trouble.

“These cuts have not hit all local authorities equally, with reductions ranging between 5 per cent and 40 per cent,” she continued.

“Councils with the greatest spending needs – the most deprived authorities – have been receiving the largest reductions.

“Further cuts could not just undermine the entire viability of most optional services, but might threaten some statutory services in these areas.”

The report also highlighted the fact that the Department for Communities and Local Government (DCLG) had adopted a hands-off approach, despite lacking understanding of the impact of funding reductions on services.

Hodge said: “[The DCLG] looks only at data on spending and has little information on service levels, service quality, and financial sustainability.

“Without at least an idea of the amount of funding required to maintain statutory services to a minimum standard, it is hard to see how the department could ensure that local authorities are able to fulfil their statutory duties.”

And as if all that wasn’t enough, an analysis carried out by the BBC yesterday also revealed that the average amount spent on care for people aged 65 and over had fallen by a fifth in England over the last decade. Using official data, the research found that in 2003-4, a total of £1,188 was being spent per person. In 2013-14, this figure dropped by 20 per cent to £951. Given we are facing an increasingly ageing population this reduction seems ludicrous.

Acknowledging that councils have had a “tough budget settlement”, Care Minister Norman Lamb said “[councils] have had to play their part in getting the public finances under control.”

He also noted that attempts were being made to ensure community services played a greater role in the care sector and that schemes such as the Better Care Fund would help alleviate pressure on the health service.

However, critics have warned that Better Care will not be the answer to the problems facing health and social care. In fact, Better Care has done little to appease the minds of health or social care sector.

In a recent report, the National Audit Office said plans for amalgamating health and social care were not adequate and were based on “optimism rather than evidence”.

The report said: “There is limited evidence that integrated care is cost-effective in sustainably reducing unplanned hospital admissions.”

The NAO also said that assumptions that admissions would fall from 47 per cent by 3.5 per cent a year was “highly ambitious”.

Margaret Hodge also recently criticised the plans, stating that: “Planning for the Better Care Fund has been a shambles.

“The fund is a complex and challenging initiative that clearly requires strong leadership and effective cross-government working, both of which have been lacking.

“It is hard to believe that until recently there was no central management team or programme director, and there were only limited attempts to identify and manage risks to successful delivery.

“Such incompetence from departments is unacceptable at a time when the number of people most likely to need care is rising, and overall funding is falling.”

Councils face monumental hurdles ahead—particularly councils from less affluent regions—but what is clear is that the system cannot continue as it is. We cannot ignore the needs of older people, people with mental health problems, or children at risk, and it would be criminal to do so, but councils are not magicians. They can only do what the money will allow them to do, and what is apparent is the money does not allow them to do what they need to.


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