Blog post 10 May 2017
The electioneering has begun as we trundle towards a premature General Election.
Promises will be made and no doubt and for ‘good reason’ fail to materialise. It’s just the way it is as the parties contend for votes.
Perhaps the spin doctors, advisers, strategists and wordsmiths involved in the election machine could take counsel from my jottings of what needs to be addressed with social care policy. But first let me make it clear that West Midlands Care Association is non-political and would work with any party to advance the care of our most vulnerable and those who deliver this valuable service.
It would be foolish for anyone to claim something has not gone wrong over the last decade; the problem being so complex successive Budgets and Government policies have failed to secure a resolve.
Mrs May has pledged fairness and serious consideration of the social care issues.
Perhaps in her musings she could consider the following, though I suspect former Government health minister Paul Burstow, who inspired this piece, will have already delivered a comprehensive document on this matter to No 10.
- Spending on social care by local authorities and Government has effectively stopped.
Recent tax levies are a drop in the ocean and a massive injection of finance is required to stabilise the sector as businesses close almost weekly – especially in the geographically less wealthy regions.
Mrs May’s ‘fairness’ pledge is well placed as some social care expressions are affected more than others. Social care covers everything from children's social workers and fostering through to services for disabled adults and the care provided to people in their old age.
- Spending by care providers continues to escalate and the demand is ever increasing.
Growth in the population, people living longer and those with long-term medical conditions living longer add to the challenges.
Swaging cuts in recent times from central Government to local authorities have meant smart thinking on the part of providers as they struggle to survive. But the financial headaches can effectively be raced back to 2008 and the final crash. From that point the economic brakes were being applied and social care very much became the Cinderella service while the NHS continued to get funding.
BBC analysis of social care spending suggests that more than half of council budgets are swallowed up by these services.
- Spare a thought for the local authorities.
The majority of oouncils have tried to protect social care as cuts have been made to other services – libraries, leisure centres and refuse collection etc. But for many with whom I work, their ‘smart thinking’ is at an end. They need funding and need it now.
- The health of social care has a direct impact on the NHS as patients get stranded.
According the to Beeb, in 2015/16 some £900m less was handed to the NHS than in 2009/10. In itself that’s a massive problem, but add to it those 150,000 days of discharge delays in 2016 and the bed blocking earlier this year we continue to write all the wrong things into our history.
There’s cycle that’s emerged: Discharge officers can’t find care packages quick enough as the social care supply diminishes. Investment in care provision is only for the brave – and then in areas where self-funders are in the majority. When beds are occupied by patients who cannot leave, it gets more difficult to admit new patients.
The number of delays of this sort has nearly doubled in five years and we’ve all seen the news on worsening waiting times in accident and emergency departments.
- Like it or not, care is on ration.
Fewer people aged 65 or over in England are receiving social care as councils try to prioritise who gets what. That also means fewer old people are getting council funding for care home placements. And when they are funded, the funding is unrealistic – not fair, Mrs May.
- Spare a thought for the elderly and frail who are left to fend for themselves.
Figures from Age UK, Laing Buisson, NHS Digital and Carers UK estimate 30 per cent of older people get no help, 12.5 percent pay for help, 37.5 per cent get help from family and friends, and 21 per cent get council funding for care. Age UK estimates there are 1.2 million with substantial needs who are left to fend for themselves.
- Self-funders subsidising councils and Government.
There’s an argument that self-funded care subsides local authorities and the Government. Prices councils are paying are squeezed so much that many care providers are now making a loss in areas devoid of private payers.
Is this fair, Mrs May? I really don’t think so. It has been called a "hidden care tax" but sadly, unless funds are forthcoming from Government it looks like it will remain.
- The bigger picture
As the care market is pressured the inevitable will emerge . . . In areas where self-funders can be found the sector will survive, but in regions like mine (the West Midlands) where there is a shortage of council-funded places, market forces will dictate a decline of a crucial service that relies principally on council-funded clients.
My concern is the destabilising effect on the care industry for both those needing care and the care providers, an issue that has been raised by the Care Quality Commission.
I simply don’t believe the sticking plaster council tax precept will fix the problem.
Finally, a note to our politicians regarding social care: Please, please don’t make promises you cannot keep.