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New report points to huge regional variations in social care spending

Blog post 22 May 2017

 I’m not normally a follower of the financial Press, but I note with interest the Financial Times has seen worthy to turn its attention to social care spending by councils.

In real-terms local authority spending on social care per adult between 2009–10 and 2015–16 fell by 11 per cent.

The fact comes from a media release from the Institute for Fiscal Studies (IFS), a piece of work funded by the Health Foundation, a charitable body that aims “to bring about better health and health care for people in the UK.”

The FT reports a West Midlands reduction in social care spending by 17 per cent.  Although I don’t doubt the figures and indeed, they are scary, I’m not sure whether they fully reflect just how bad thing are.

Plenty has been written on the state of social care and doubles with the launch of the Conservative manifesto on radical socal care funding, much more will be.

For decades I’ve said geographical differences in the delivery and funding of care are diverse and it’s a point the FT has brought to our attention.

Here we go – and this is from the PR put out by the Institute: 

  • There remains significant variation in councils’ social care spending across the country: spending was less than about £325 per adult resident in a tenth of council areas, while it was more than about £445 per adult resident in another tenth of council areas in 2015–16. That’s a difference of more than a third.
  • Councils where there are relatively more people over pension age (particularly those entitled to means-tested benefits), and where levels of disability benefit claims and deprivation are higher, tended to spend more on social care. Higher local earnings levels are also associated with higher levels of social care spending.
  •  Even so, these ‘spending needs factors’ explain only a small proportion of the variation in spending across councils. Indeed, councils’ ‘scores’ in the last official needs assessment in 2013–14 can only explain around 13 per cent of the variation in what they actually spent on social care per person in 2015–16.
  • In part, this may reflect inaccuracies in that needs assessment, and the fact that by 2015–16, the assessment was two years out of date. But it will also reflect that given similar needs, different councils are likely to make different trade-offs between spending on adult social care and spending on other services. And they have different overall budgets (from council tax, business rates, and grants) from which to fund their service spending.
  • In addition to council spending, care recipients often contribute towards the cost of their care through fees and charges. These raise an average of £63 per adult resident, but the amount varies widely: one-in-ten councils raise less than £35 per adult resident, while a further one-in-ten raise £95 or more.
  • However, there is no clear relationship between local authorities’ own spending and fee income. It is not the case that all high spenders charge lower fees, nor that all low spenders rely on high income from co-payments to meet costs. 

I’m reminded of a quote from George Orwell’s Animal Farm, essential reading for English lessons of my generation: “All animals are equal, but some animals are more equal than others.”

Orwell’s comment was on the hypocrisy of governments that proclaim equality of their citizens but give power and privileges to a small elite. Not quite the same premis, but the facts state that in varying degrees, some have, some don't.

Devolved power allows local authorities to spend budgets mostly as they see fit – a good thing, I believe.

But the figures presented clearly show big differences in spending per adult on social care among councils assessed to have very similar spending needs by the government. Some, indeed are ‘more equal’ and are worthy of better funding.

Our media guy knows of a West Midlands family who are moving to Wales because they fear massive care cuts in local authority provision for their severely disabled daughter would make life unbearable.

Wales, they say, is “a safe refuge because social care is being preserved.”

An extra £10 million a year of new funding will help ensure the social care sector is strong and sustainable for the future, Welsh Government Minister for Social Services and Public Health Rebecca Evans announced in January.

As supporters of the providers of social care, my West Midlands Care Association, it would be fascinating to know how the IFFS spending cuts map translates to business wellbeing (or the lack of it).

Such a study would be fraught with regional demography complexities and it’s not one I’d wish to undertake.

The data does, however, provide another raft of evidence that social care has at best been financially neglected, or (depending on my levels of paranoia) positively persecuted.

 

2009–10 and 2015–16 (both in 2016–17 prices), and changes between these years by region

and council type

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