Tag Archives: comprehensive spending review

Comprehensive spending review: little for social care

The months of rumours, leaks and speculation are over; the Comprehensive Spending Review has finally been announced. As expected, for social care, it does not make for fun reading.

Here are some of my immediate thoughts, based on Chancellor George Osborne’s speech and a (very) swift look at the spending review document. While the review obviously affects everyone in some way, I’m going to try to focus on the impact it could have on people with mental health issues and/or learning disabilities.

Firstly, it should be noted that there is very little geared specifically to people with learning disabilities and/or mental health issues. For instance, specific mentions of ‘learning disability’ (or disabilities) does not get one mention and ‘mental health’ only 2. I didn’t expect there to be; today is the day for grand statements, with the detail to come at a later date.

In terms of what was said, while Osborne promised an extra £2 billion for social care in the next five years, including £1 billion to aid joint working between health and social care, he mentioned that this would help older people – no mention of adults with disabilities.

Also, BBC health reporter Nick Triggle worries this could be more or less cancelled out by the increasing demand of the aging population.

Meanwhile, benefit reform will ensure that it “always pay to work”, according to Osborne. Benefits are to be capped at no more than the average net wage from 2013 – which will work out to about £500 per week for couple/lone parent household and £350 per week for single adult households – although people receiving Disability Living Allowance are exempt from this.

However, this may well hit people on incapacity benefit/Employment and Support Allowance and other benefits, especially those who are moved onto Jobseeker’s Allowance from ESA. The focus of the welfare reform is evidently on people getting jobs, with benefits cut to make it more of an incentive to work.

There is also a new 12-month time limit proposed for the one million people on ESA in the Work Related Activity Group to find work or face having their benefits cut.

But surely this will be dependent on the jobs being out there for people to take? Many people on ESA would like to take up jobs – part or full-time – but with many businesses not looking to take on employees, and the public sector set to shed 490,000 jobs, there are precious few available and competition for them will be fierce.

The reforms to housing benefit will also hit many people with learning disabilities and/or mental health issues, especially those living in London and the southeast, where property prices are generally higher than in the rest of the UK.

Potentially, the adverse impact of money worries on people with mental health issues or learning disabilities could be immense, as could the upheaval of having to move, if they now cannot afford the rent on their homes. For someone to have to move away from an area they know – including a network of informal support – to somewhere new could have a disastrous effect on a person.

Not all bad news

But the CSR wasn’t all bad for social care; there were a couple of positive notes from the Chancellor.

Firstly, personal budgets are to be extended to people with long-term health conditions, children with disabilities and special educational needs and adult social care. The commitment to personalisation is welcome and, for some people, personal budgets have made a tangible positive difference to their lives. Giving more people the option to do this is a good thing. Whether their budget will be enough to do this is another matter.

Likewise, the commitment to increase talking therapies for people with mental health issues is also to be welcomed.

The government is also going to take forward proposals to invest nationally in mental health liaison services at police stations and courts to intervene at an early stage, diverting mentally ill offenders away from the justice system and into treatment. However, it does carry the caveat ‘subject to business case approval’.

Nevertheless, this is a good move. Far too many people with mental health problems get stuck in the justice system and opportunities for them to access treatment are often lost.

Conclusion

From an initial assessment, people with learning disabilities and/or mental health issues do not fare well out of the CSR, especially in terms of welfare and housing reform. However, I don’t think anyone – regardless of who they are – fares well out of this review.

But there are some crumbs of comfort, especially with expanding personal budgets and talking therapies, although they are probably outweighed by the cuts.

However, to paraphrase Winston Churchill, this is not the end, it is not the beginning of the end, it is the end of the beginning. Next month, government departments will set out business plans to outline how they will implement cuts. This is where the real detailed information about cuts will come at a local level, and we will all find out which departments, services, projects, charities etc will retain funding, be closed, or face hard times.

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Paying for social care

There are an increasing number of local news reports coming through of cuts being made to social care provision and charges for it being put up. Unfortunately, this is going to be repeated across the UK in the coming months.

 In the past day or so, 2 stories have come across my radar, both of which detail aspects of social care cuts in local authority areas.

 These are just taken at random and happen to be the ones that appeared in my inbox. There have been others over the past few weeks and there will be more to come, these are just to illustrate my point.

 Firstly, www.getwokingham.co.uk reported that Wokingham Borough Council has confirmed that it will no longer offer free services to people with savings of more than £23,250 and will introduce a £16.30-a-day charge for day care services.

Meanwhile, Community Care carried a story about Derbyshire County Council’s plans to save about £4 million a year by ramping up its eligibility threshold for social care services.

I suspect that many more councils will follow suit as budget cuts really begin to bite. The oft-quoted figure of 25% savings having to be found still haunts managers and commissioners in local authorities who will have to make some very uncomfortable decisions in the coming months.

I don’t wish to be the harbinger of doom, but, well, I’m going to be; these cuts could get deeper too. The comprehensive spending review, which sets local authority spending budgets for the next 3 years, is in October, and with cutting the UK’s deficit at the top of the government’s priority list, there are likely to be more cuts to come.

While many politicians claim that cuts won’t affect frontline services, it seems to me to be political flannel. Cuts of that magnitude will inevitably affect frontline services, as the 2 reports above show.

Currently 72% of council have their eligibility criteria set at ‘substantial’. Meanwhile, 24% will cater for people with ‘moderate’ needs and only 1% provide services for people with ‘critical’ needs, according to the Local Government Association and the Association of Directors of Adults Social Services.

I reckon that the percentage of councils catering only for ‘substantial’ or ‘critical’ needs will rise in the next year, which will mean that increasing numbers of people with moderate needs will be left out of the care system, unless they can pay for it themselves.

The government has talked about a focus on early intervention and prevention – which is to be applauded – and will help to keep people independent for longer. There is also a focus on those with the highest needs, as there should be.

But this leaves an enormous hole in the middle of people with moderate to quite complex needs who, unless they are lucky enough to live in an area that isn’t scrabbling around for every penny it can find, won’t be getting any services.

To me, there are inevitable knock-ons from this. For instance, without any care services, more people will end up with higher – and more expensive – needs faster than if they had got support earlier. It also puts more of a strain on carers, many of whom undertake the role without any financial support, or just for the Carers Allowance, which is still only £53.90 a week.

Not only this but services such as day care and meals on wheels, which are often vital lifelines, will also be cut back on.

I apologise if this makes for grim reading – I take no pleasure in writing it – but I can only see hard times ahead for everyone associated with social care. I doubt I’m saying anything revelatory, either.

But, to end on a positive note, if there is one thing the sector is good at, it is being resourceful. Social services, charities, third sector organisations and carers will always find ways to provide services that make a difference. This won’t stop because of local authority cuts.

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Reflections on the Budget’s impact on social care

As usual, Tuesday’s Budget was a mixed bag; some gains, some losses for the majority of people, including those in social care. Here is a brief summary of what I have spotted.

Firstly, the downsides; public sector pay has been frozen for 2 years, except for those earning less than £21,000 per year. As many people in social care work in the public sector, this could have an impact on service users down the line.

For instance, it could demotivate workers, but some may decide to leave the sector entirely if they see the chance of better pay in the private sector – however, losing experienced staff is something that can be ill-afforded.

Also, the government will introduce a medical assessment for Disability Living Allowance from 2013 for new and existing claimants. Interestingly, the wording in the Budget says that this measure is to “ensure support is targeted on those with the highest medical need”.

I assume this will be some form of capacity for work assessment, which is the prevailing trend in disability benefits. It also seems to indicate that the criteria for eligibility may be raised. This could see some claimants moved onto other benefits that do not pay as much, or off them entirely.

Also, and a little oddly, the document also says that the medical assessment will “ensure payments are only made for as long as a claimant needs them”. As DLA is paid to people with a disability – generally an ongoing thing that doesn’t get better – this makes me wonder if the government really understand what it is and what it is for.

DLA has never been a form of unemployment benefit; it is there to help people with disabilities – physical or mental – pay for items they need to live, such as care services, which the general population do not need. To take this away could make life very difficult for some disabled people.

Elsewhere, VAT will rise to 20% from January 2011, which is a move that will hit everyone in the pocket, but for people on benefits or low incomes, the effect could be magnified.

Also, capping Housing Benefit at £280 a week for a one-bedroom property and £400 a week for a four-bedroom family home could also adversely impact on service users and carers, especially in London and the south of England.

On the plus side, from April 2011, disabled people who require an extra room to support a resident carer will be able to claim Housing Benefit. This again supports the government’s ongoing commitment to the personalisation agenda.

Also, the changes to tax thresholds could see some people on low incomes – which often include carers – taken out of the tax system.

Likewise, the move to link pensions with earnings from April 2011, meaning that it is guaranteed to rise in line with earnings, prices or 2.5%, whichever is the greater, will help older people.  

Chancellor George Osborne added that proposals on welfare reform will be announced by October this year, before the government announces its comprehensive spending review (CSR), which will set out the plans for public expenditure for the next 3 years. It is good to see that – finally – there may be some movement on this much-needed measure.

So there are plusses and minuses to this Budget – possibly more of the latter than the former. However, benefit cuts have not come directly, which had been rumoured, but other measures will impact adversely nonetheless.

But there is also still much that is still to be decided; local authority budgets, which will be announced in the CSR, and that could yet have more impact on social care.

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Budget – little for social care

As predicted in my earlier blog, the last Budget from this government had very little in it for social care – either professionals or service users.

In terms of service users, as expected, little was said; so no real gains or losses, other than for those who enjoy cider and cigarettes.

In regards to care funding, the Chancellor merely said that the health secretary would soon outline further proposals, which tells us nothing we didn’t already know.

The only other impacts on the social care industry came from the announcements that government departments would be saving £11 billion this year – reinforcing that the next Comprehensive Spending Review in 2011 will be the toughest for decades – and public sector pay settlements would be at a maximum of 1% in 2011-12.

Again, nothing that wasn’t already know. The details for where the cuts will come will be announced by the individual departments shortly.

My initial assessment is that this Budget is a bit of a damp squib, with few surprises and obviously geared to the forthcoming election – there are some cheap wins for the government contained in it, such as removing stamp duty for first time buyers of properties under £250,000.

Despite social care being touted as one of the primary battlegrounds for the election, the amount of coverage it got in the Budget perhaps suggests otherwise. Or maybe it is just a bit too controversial a subject for a Budget designed not to rock the boat and potentially alienate any voters.

Another theory is that any potential solution to care funding may not involve any new money – such as an inheritance tax scheme (or ‘Death Tax’).

Nevertheless, the real Budget to pay attention to will be the first one after the election; that will be when the real hard funding decisions will be announced and we will really know whether a new age of austerity will be upon us.

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Alastair Darling to make budget cuts public

For months now, talks of budget cuts have been rife among council departments, especially social care. Many councils are already tightening their belts in anticipation of big cuts in 2011, when the next comprehensive spending review is scheduled for.

However, all the talk has thus far been based on guesswork. At the National Commissioning Conference in June, there was talk of public sector cuts of up to 10%, which was met with sage nods rather than gasps of shock, but it was emphasised that this was only a guess.

Meanwhile, the Institute of Fiscal Studies says that total departmental spending will have to fall by 3.2 % a year for 3 years if the government’s target of halving the budget deficit within 4 years is to be met.

The only certainties given by the government so far are that police, education and health budgets will be protected. There is no such guarantee for social care, and the lack of new money made available – thus far – to help drive the recommendations in the recent Social Care Task Force report seem to indicate the prevailing wind.

However, the guesswork is set to end, according to the Guardian. It carries a report saying that Chancellor Alastair Darling has committed to publish more internal estimates about range of departmental spending cuts the Treasury expects to make in the next 3-4 years after a grilling from the Treasury select committee yesterday. This may extend to being more open with the public about spending assumptions for the years post 2010-11 as well.

Anything that gives people – inside local councils and outside – a clearer picture of what is, or will be, happening is to be welcomed. People are more accepting of cuts when they are given the facts of why it is happening, rather than just being told that it is.

Everyone knows that cuts are coming, but knowing how much will be an advantage. It can inform public debate and ensure councils have a better idea of just how swingeing the cuts will be.

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