Tag Archives: Social care funding

Social care funding commission has 2 options

This blog was originally going to be about how unhelpful the newspapers’ focus on the Commission on the Funding of Care and Support’s decision to not automatically discount bringing in a “Death Tax” was, but since I started writing, the government has ruled it out completely, according to Community Care.

This isn’t a surprise, to be honest. Firstly, the government would want to defuse criticism from the newspapers that saw this as the Conservatives back-tracking on their stance from the election campaign.

But in any case, since it was christened the “Death Tax”, that idea – a compulsory levy on estates after death – would have been impossible to implement because of the backlash from the press it would get and the image it has in the public’s eye. Whether or not it was the best option is a moot point.

But on the upside this should help bring about a more reasoned debate in the media on what the funding options are – no more tub-thumping headlines screaming about the injustice of the “Death Tax”, for instance.

Many people do not understand the social care or benefits systems currently, so a clear setting out of the current regimes, along with an explanation of all the options being considered and their relative merits/downsides would be good.

Not that there is that much to cover now. Currently, there would seem to be 2 options realistically on the table; a voluntary insurance scheme and a partnership of state finance and service user finance. A system completely funded by users or by the state was ruled out by the last government and has hardly been mentioned by this one, so I think we can assume those ideas aren’t really being considered.

So, it seems as if the commission’s job is to decide which of the 2 options – or slight variations on – is better.

Considering when this last went out to consultation there was no consensus on which option was best, they have a tough job ahead.

So how does the commission decide? Perhaps they should get Harry Hill in – “There’s only one way to find out…”

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Social care providers worry about maintaining service quality

These are worrying times for service users, carers and families involved in social care; with the uncertainty over service provision, eligibility criteria, benefit cuts and future policy all causing stress. Now, care providers are adding to that by saying that services may get worse.

A survey published last week by accountants PricewaterhouseCoopers (PwC), Fair care crisis? An independent survey of social care providers for the elderly,  found that many care home and domiciliary care providers are worried about the effects of cutbacks on service users, and have warned that some have ‘unrealistic expectations’ of the services they receive and ought to revise their expectations downwards.

Providers said a key challenge is maintaining the quality of services against a background of rising costs and downward pressure on fees. Indeed, 80% worry that quality of care services will suffer due to cost reduction measures.

While it has to be remembered that these are the views of care providers, who are always going to say they need more money – the majority want a fair fees policy for local authority commissioners, for instance – this survey nonetheless highlights some of the current concerns among the sector.

Respondents also fear that smaller providers may go out of business because of cost pressures, which could lead to reduced choice for service users – so much for the increased choice and control promised by the personalisation, it seems.

OK, that’s the scary part over with. The survey also had some positive messages; 97% feel they are equipped to meet current or future challenges and 94% are already taking action to address market challenges.

Of those taking action, 83% are increasing skills and capacity – meaning better-trained staff – but 78% are controlling costs, which can be a double-edged sword, depending on where the cuts come.

This survey provides an interesting snapshot of the mood of social care providers. While there is optimism about meeting the future challenges, it is worrying that some say that service users should not expect so much of them.

While this may be realistic talk from providers – if you know how to do more with less please tell me – it does not augur well for service users; it seems they will face increased eligibility criteria, fewer services, less choice and less care.

The uncertainty in the sector is also not helping. The survey notes that 79% of providers want the government to outline its vision for the future of elderly social care, but they are likely to be disappointed. While there may be some measures outlined in the plans for the NHS today, for the definitive standpoint I imagine we will have to wait until the independent commission on the future of adult social care reports back sometime in the next year.

Only when policy is confirmed, along with budgets – we’ll find out what local authorities have to spend in October when the comprehensive spending review is announced – will providers be able to plan with certainty, and therefore give service users a better picture of what services will be provided – or not, as the case may be.

While PwC’s report closes on an optimistic note from a business point of view – many expect to cope with the future challenges and see opportunities in an expanding marketplace – I can’t help feeling that the outlook for service users, their families and carers is much more pessimistic.

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Would increasing NHS spending cut social care services?

Interesting stuff from shadow health secretary Andy Burnham today, as reported in the Guardian, who claims that increasing NHS spending could adversely affect social care provision.

Burnham objects to the government’s commitment to increase NHS spending in real terms year on year; “If they persist with this councils will tighten their eligibility criteria even further for social care. There will be barely nothing left in some parts of the country, and individuals will be digging ever deeper into their own pockets for social care support,” the Guardian reports him as saying.

As a cynical journo, my instant reaction is this is just a way of scoring a few cheap political points before the emergency Budget next Tuesday. And it probably is – but he does make a couple of salient points nevertheless.

It has struck me as odd that the only department with a guarantee of an increase in spending – amid swingeing cuts for everyone else – is health, especially at a time when the NHS is performing relatively well – if you take meeting the majority of targets as ‘well’. It smacked of a sop to the electorate – increasing health spending is always a vote winner.

Also, while there is nothing to say that the increase in NHS spending will come from the social care budget, there is nevertheless an element of robbing Peter to pay Paul with the Conservative commitment too – its reasonable to assume that increases in one department will mean that others gets cut. There are no spending commitments for social care (that I know of), so cuts in this area would seem inevitable.

Burnham also notes that putting the NHS in a stronger financial position to social care would make joint working – the current prevailing trend – harder to achieve.

Also, cutting social care could increase the burden on the NHS if more people end up in hospital due to falls etc due to struggling without care services they need because they cannot afford them. They could stay there longer if there is not the social care provision – meals on wheels, housing, care services etc – to support them in the community on release.

But whatever happens in next week’s Budget, it would seem the future for social care is an austere one; at a local level, there are already news stories of cutbacks in services, or charges for them increasing. To pick one example at random, here is a story from the online version of the Northampton Chronicle & Echo about county council proposals – currently out to public consultation – to raise £600,000 by increasing the cost of social care services.

Northampton County Council justifies this plan by saying that without the increase in charges, services would have to be cut.

This is a situation repeated across the country. It would seem that social care providers and service users are going to have to do more with less. How the government – and local authorities – will deal with this will be interesting to see. All should become clear in the coming weeks.

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Social care possible victim of government cuts

Chancellor George Osborne announced the first wave of cuts to public spending yesterday, but it is still unclear what this will mean for social care – yet.

Most of the announcement dealt in headline terms – talking about millions of pounds worth of cuts to government departments, but not saying exactly where they will be made.

For instance, councils have been told that they will have to cut £500 million worth of services in the next 10 months. In the absence of concrete details, there is lots of speculation about where these cuts could come – such as in residential and home care for the elderly, according to a report in today’s Times.

This would seem likely – a recent poll for the BBC’s Panorama said that more than half of councils were considering making cuts to adult social care provision.

In practice, it may mean that eligibility criteria gets ramped up again, so that only those with ‘substantial’ or ‘critical’ needs will get services – which already happens in many council areas. Also, services such as day centres may be targeted for cuts, as will any service that struggles to demonstrate it provides value for money.

With budgets needing to be slashed other areas, such as the roll-out of the personalisation agenda, may be hit. There is the £237 million Social Care Reform grant scheduled for this year, and there is speculation that might be cut, according to a report in Community Care.

Meanwhile, children’s services were largely protected from the cuts, except for the abandonment of the Child Trust Fund, which wasn’t that popular anyway.

But this is just educated speculation. I assume the details of the cuts will gradually come out in the next few days and weeks, which should shed more light on what will happen and then councils – and service users – can start to plan for the future.

But what is certain is that these are only the first cuts – and not necessarily the deepest. June’s emergency Budget is expected to announce further spending cuts, while with the Comprehensive Spending Review – which sets out council budgets for the next 3 years – there are fears that council funding could fall off a cliff.

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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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Blown consensus = blown chances?

So near. And yet, so far. 

In my previous blog, I wrote about how any chance of serious debate about social care and how it is funded has gone, since the Conservatives launched its “Death Tax” poster campaign.

But since then, more has emerged about what was happening behind the scenes before that, and it makes for interesting reading.

I’ve blogged before about how consensus is needed on the future direction and funding of social care and for a while it seems as if the health secretaries of the 3 main political parties had had the same idea.

Apparently, Andy Burnham, Andrew Lansley and Norman Lamb had put party politics to one side and begun working together – in secret, without their superiors’ knowledge – for the good of the country in trying to find consensus on the future for adult social care funding, and had made some progress towards this, according to The Times.

It sounded too good to be true and, ultimately, was.

But the fact that they tried has to be applauded. Social care is such a big issue that it will require support from all 3 sides if a solution to a growing problem is to be found.

It is a shame that this progress was, apparently, sacrificed on the election altar. Whether after this breach of trust the parties will come back together again after the election is a question that will need to be asked.

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Little honesty in social care debate

So, the political mud-slinging has begun in earnest. As the Conservatives, Labour and Liberal Democrats all strive to tell you how bad the others are (or would be), reasoned debate goes out of the window.

The Tories have landed the first blow, accusing Labour of planning a £20,000 “Death Tax” to be levied on all estates after death.

To ram the point home, a new poster was revealed depicting a gravestone engraved with ‘RIP Off’ (see what they did there?) and the slogan: ‘Now Gordon wants £20,000 when you die.’

Health secretary Andy Burnham has rejected this accusation (or hinted that the party is planning it, depending on which paper you read), saying that “firm proposals” will be set out before the election – one assumes he means the White Paper on adult social care funding, which is still being promised, although time is fast running out if it is to appear before the election.

Currently, Labour is sticking to its line that it is considering the outcomes of the Big Care Debate, which took place last autumn after the release of the green paper on the future of adult social care funding.

The Conservatives have said even less, apart from their £8,000 voluntary insurance scheme.

Responding to this, another other related stories, Stephen Burke, chief executive of Counsel and Care, a charity that works with older people, their families and carers, has appealed for an “honest and serious” debate that recognises that better care will cost more, and that radical reform and proper funding is required.

While many people in the social care sector will agree wholeheartedly with that call, the chances of such a debate happening are virtually nil.

Also, any hopes of a cross-party consensus on the future of social care – something various social care commentators have called for – now appear dead and buried.

With the parties now getting into the swing of electioneering, everything they say will be geared to getting your vote. So a reasoned debate on the future of care funding will not happen, because it will require some tough – i.e. not popular – decisions to be made, if a crisis of care is to be averted. No politician is going to say anything that might lose them votes.

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