ePolitix.com Stakeholders comment on the government's social care green paper.
It is estimated that 1.7 million more adults will need care and support by 2026. The green paper sets out the creation of a National Care Service where a "minimum care entitlement" would be introduced to end the postcode lottery, giving everyone in the country a basic entitlement to care, regardless of where they live.
Speaking before the launch of the paper, health secretary Andy Burnham said the proposed new National Care Service will be created using "existing resources".
Stakeholder response: Jenny Hirst, co-chairwoman of the Insulin Dependent Diabetes Trust
In the discussions about the green paper, 'Shaping the Future of Care Together', emphasis is being given to the funding of residential and home-based social care in the future. However, little attention is being given to the proposals to hand over attendance allowance and "disability benefits" to social services which is causing health and disability charities and their members great concern.
I am writing in behalf of the Insulin Dependent Diabetes Trust (IDDT) to express our concerns about the proposals contained in the green paper, 'Shaping the Future of Care Together'. We are concerned that these proposals will curtail the flexibility that the current system of payments gives recipients to choose what care they purchase and will effectively reduce their independence and freedom of choice.
For example, in specific relation to people with diabetes in receipt of benefits, these people may choose to spend a higher proportion of their income on healthy foods, as they are advised to do by their diabetes healthcare teams. If their income is reduced then their choice of diet is curtailed. If the green paper proposals to hand over benefits to social services come about, we are unable to see how they will ensure the provision of a healthy diet for people with diabetes.
We are also concerned by the vagueness of the term "disability benefits". The green paper only mentions attendance allowance specifically but does not clarify which other "disability benefits" will be affected.
These proposals would have a huge negative impact on a relatively small but significant number of people within the diabetes community, those who are the most vulnerable. It is also worth remembering that with the soaring numbers of people being diagnosed with the condition and that the long-term complications of diabetes can lead to disabling conditions, then the number of people with diabetes affected by the green paper proposals can only increase.
Stakeholder Response: Local Government Association
The LGA has long called for reform of our adult social care and support system. Councils do an incredible job to ensure the vulnerable members of our society get the services they need but the system is notfit for the challenges of the twenty first century. The combination of insufficient funding, increased demand from an ageing society and escalating costs is already placing an immeasurable strain on adult care.
We recognise the perceived and real unfairness that has resulted from the way the current system is funded and therefore suppor a nationally consistent system of assessment alongside a commitment for the state to fund an agreed minimum portion of each inividuals care package.
Councils know all too well, as the government acknowledges in the paper, that there is a need for society to pay more for care and support in the future if we are to meet the needs of all those who rquire care. We accept therefore the need to consider options such as insurance schemes. This must be done alongside a wider debate on the total funding for health and social care, to ensure scarce resources are used effectively and focused on prevention, particularly after a decade that has seen funding for health increase in real terms by more than 6 times the increase in fundig to local government to deliver services like social care. We do not believe it is right to conclude that there is not enough money in the system before having this debate.
Local government already contributes a significant amount to total local adult social care expenditure through council tax. We estimate that local government contributes 39 per cent, or more than £5.3bn to total adult care spend of over £13bn. In some areas councils fund more than 80 per cent of their adult care expenditure through council tax.
The green paper presents two system options: a part local/part national model and a fully national model. We want to see a part-national, part-local system with a single, transferable assessment of needs and means being applicable anywhere in the country but the services to meet need and the amout to pay for them decided locally.
The LGA would strongly reject any attempt to 'nationalise' the care service. We do not support the option for a National Care Service that is fully nationally funded. This would:
- undermine councils' flexibility in commissioning and designing care services around the needs of the user, which is clearly at odds with the commitment to personalisation;
- hamper the ability of councils to join-up social care, health, housing and other systems to provide better outcome for local people;
- be less responsive than a locally-funded and locally-managed system;
- lessen accountability by removing overall decision-making from democratically elected local councillors. Local people would effectively lose their voice on a service area that will affect everyone; and
- change the nature local government funding which could reduce local flexibility.
Balancing national consistency and local flexibility is key to the future of a successful, reformed system of adult care and support. Democratically elected local government must be able to decide with individuals what form support should take, within a national framework and an adequately funded system. This means adequate resources being allocated at a local level to take account of local need, local markets, and the local range of statutory and non-statutory organisations that are involved in care and support, which are unique to each area.
Reform will take time but the difficult decisions that need to be made must not allow this crucial issue to slip down the agend nor can the real funding pressures that are facing councils today be ignored. We are pleased that social care is finally getting the recognition it deserves and no longer being seen as the Cinderella servce alongside health and education.
The LGA set out detailed proposals for a reformed system in A Fairer Future.
Stakeholder response: Su Sayer, chief executive of United Response
This green paper is an attempt to tackle one of our society's greatest challenges – the future funding of social care – and is to be welcomed, particularly the proposals for a national care service. The green paper provides an important opportunity for everyone involved in social care - including central government, local authorities, care providers and the general public - to think not only about how to fund growing demand for care and support but also how to use the money available more effectively and creatively. If it also helps wider society think more about the essential role of social care, so often ignored, so much the better.
However, we would like to see more detail on what the proposals would mean for working age disabled people, and especially those with a learning disability. At the moment the lack of clarity in the proposals makes it difficult for disabled people to engage in the debate. We consider that the Government should set out the kind of essential services that people with learning disabilities should be entitled to receive irrespective of where they live. It is vital that these include support for people with moderate needs, for whom just a few hours a week of specialist help - with tasks like budgeting, maintaining a tenancy or looking for work - can be sufficient to enable them to lead an independent life in the community.
Failing to invest in low level support can not only damage quality of life, but can lead to deterioration in both mental and physical health, costing the health service and taxpayer more in the long run. This is a false economy at a time when we can least afford one, and yet many local authorities are currently withdrawing support from people with moderate needs.
In 2007, Ivan Lewis – the then care services minister – called the way we used to treat people with learning disabilities "a scandal which disfigured our society." Abandoning the progress made and going backwards would be even more scandalous, which is why we must continue to make our arguments for a strong, properly funded and efficient social care system.
United Response case study - Alice's story
Alice is in her forties and has Down's Syndrome. She lives at home with her mother, who has recently been diagnosed with dementia. She is assessed as having moderate needs, and as such falls below the threshold where many local authorities provide support. Until recently, she received three days of support through a day service, but this recently closed.
Alice cannot travel independently and needs support with daily living activities such as cooking, managing money and travelling. Without support, she is at risk of increasing social isolation and deteriorating mental and physical health. Timely intervention now, to help her develop independent living skills, could prevent her needing far more intensive and expensive care in the future.
