On twitter yesterday Ivan White wrote:
“Softening us up for NHS charges – first make foreigners pay, then maybe rich pensioners, the obese and smokers….everyone in due course.”
Scary to think that this might be the way things are edging. But I wonder if future changes to social care might be the way the coalition are telling us that government healthcare provision is no longer our friend.
They nearly had it half-right with the care bill during the spending review. George Osborne confirmed that £3bn had been added to the £16bn pot for social care in 2015-16 after increased integration of health and social care services.
Furthermore, with the recent draft care eligibility criteria, the government are planning to end the ‘postcode lottery’ of social care, making sure all councils submit to a national threshold.
So far, so good. However the reality is that councils have cut spending on social care by around £2.7 billion – or 20 percent – since 2010, and a further 10 percent cut was announced to local government spending – which will impact upon social care – by Osborne last Wednesday.
Worse still is that most councils (around 86 per cent) have raised their care criteria to ‘substantial’ in the last year, meaning that the eligibility threshold for where people can access state social care has been increased to a very high level.
The draft care eligibility criteria will ensure that all councils set their threshold to substantial, which drastically increases the risk of people losing out on the services they need.
Compare this to 2005 when half of councils in the UK were funding care for people at a moderate or higher level needs and you can see how short social care has been sold even with the extra funding.
Money matters of course, but so do people who access support services. The Personal Social Services Research Unit found earlier this year that introducing a national threshold at ‘moderate’ would have provided state-funded support to an additional 260,000 people at a cost of £2bn a year if introduced in 2010-11.
That this group of people will now fall under the radar has made many in the third sector, for example, very unhappy.
Mark Lever, chief executive of The National Autistic Society, recently told the press:
“People with [autism] often require support with everyday activities like getting washed and dressed, but the draft criteria restrict eligibility to those with a physical or mental impairment, which could mean that those who don’t have a formal diagnosis miss out on support altogether.”
Michelle Mitchell, charity director general of Age UK, said:
“We believe the equivalent of ‘substantial’ sets the bar too high: ‘moderate’ would be much more in tune with the spirit of the government’s new Care legislation, and with what the public has been led to expect.”
So what can be done? Firstly the government needs to halt plans to see every council raise their criteria level to substantial. Instead it should call for that level to be moderate, to ensure needs are met.
Disability charities and those for older people have said that some people who most require care services will not always qualify for substantial needs, and they risk having unmet needs.
Secondly, sensible spending in social care will mean there is no reason to save money through cutting people out the system. Sinéad Brophy who is chief executive of MySupportBroker, a social enterprise that works with local councils and trains local ‘peers’ to help people find the care support services they need, said:
“It is hugely important to make sure people have the care services they require while cost savings are being made to council budgets at these times. Peers working with MySupportBroker have a very strong and beneficial presence in the local authorities they live in, showing empathy with customers through their own personal experience, and saving councils money.”
Thirdly, there needs to be more dialogue between commissioners and providers make it easier for local councils to maintain quality services in times of budget constraint.
Clearly budgets are tight for local councils, but it is still apparent that they are not making the best use of local knowledge. Indeed in Localis’ recent report, it is recommended that councils give greater focus to how communities and providers can be involved in the commissioning process and priority setting.
More focus on outcomes and locally-deemed priorities is better than targets that cut off support for around 260,000 people.
Leaving people without the correct care services might be a way to save money but it is highly unethical. Charity representatives have all warned of how dangerous it would be for government to cut people out of the care services they require. Here’s hoping it listens before it is too late.
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