I had a visitor the other day – a resident who was her husband’s carer. Neither was elderly and she was coping remarkably well. I am honestly not sure I could perform her role. I suspect many of us couldn’t.
She had no complaint to make but instead wanted me to understand – for the purposes of local and national policy – what caring looked like in terms of costs. The simple point is that the care she provides comes cheap. She does most of the work so the local authority delivers only respite care at some thousands a year. But were she older, frailer or even simply smaller in stature this would not be possible. And then the cost of care would escalate as it fell to the state to provide it. Ultimately it would reach a six figure sum. Per annum.
We all know this, of course, and are grateful as taxpayers. But when it comes to policy-making the value to society of social care is usually forgotten about.
More money on the NHS? Naturally. What is the NHS? It’s doctors and nurses and hospitals, of course.
But that isn’t the case. The NHS is anyway much more about primary care: 90% of patient interactions are outside the hospital sector, with GPs and other general practice professionals.
And beyond that, there is the care provided by local authorities and carers. The significance of local government in looking after people (as opposed to ‘place-shaping’) is overlooked even sometimes by those elected to it.
Councils (or at least ‘upper tier’ councils) are more social care authorities than they are anything else. And they are facing a total funding gap of £12.4bn per annum by 2020, of which social care is about a third.
The Government has indeed put in extra money – £7.2bn over the past three years – and has introduced the Better Care Fund and the Care Act.
But this is still the Cinderella sector: it delivers very low cost care and saves us all a small fortune for each and every client who is kept out of hospital, either directly or because of the services of a carer. To do this, however, it pays poor wages to a largely female sector who are anyway only rewarded for the time they are with a client (sometimes as little as 15 minutes) and not paid for travelling. Small wonder that many try to find work in the NHS or switch to stacking shelves.
ALDC and the Lib Dem LGA group out down an amendment to the pre-manifesto motion in Glasgow proposing that social care spending be given the same level of fiscal protection as the NHS. The movers of the motion appeared not to understand the significance of this problem and the amendment was lost.
So we need to keep trying. The alternative is that we waste the extra funding we now promise for the NHS.
* Chris White is a former Leader of the Liberal Democrats on St Albans Council, Councillor for Hertfordshire County Council and Regional Chair: East of England
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7 Comments
It was a very important amendment and I was disappointed to see it voted down.
Well said Chris. It is incoherent to propose the slashing of the local government budget including social care at the same time as its integration with the NHS. I supported the amendment which could have done with a greater push from the local government wing of the party. I hope the battle isn’t lost.
There seems to be a problem that neither NHS or social services work together with families. My Mother had been in hospital for several months when I was called to a discharge meeting. No not to be sent home but moved to a private care home with 24×7 nursing care, presumably to un block a bed. The Social Service person was only interested in the fact Mum was self funding, no discussion if she was mentally competent to accept a contract or set up a direct debit and no question if I had power of attorney. At no time was it mentioned if the NHS had any obligation to pay any part of the nursing care. Mum understood enough to understand that after changes of wards (4) and hospitals (2) she had had enough and either the increasing morphine dose or her wish to die happened before we even had decided which home she should go to.
Spot on Chris. Just yesterday, our very own Norman Lamb remarked that local authorities delivering social care have been more innovative and have delivered far greater change than the NHS in the face of year on year reduction of budgets.
Of course we must protect the NHS budget but we must also protect the Social Care budget too. The Better Care Fund is a great leap forward to creating a new system which combines the care and health systems into one which focuses on the individual. However, in my opinion, in order to bring two systems together, each having their own unique contribution and culture, both need to feel empowered to do so. We as a party seek to empower to allow positive change; by protecting the social care budget we can affect larger wholesale change faster to create a system which puts people at the centre; whether they be the carer, the cared for, the doctor, the nurse, the care worker or the social worker.
Good to see the issue being highlighted.
Even better to see a comment from Gareth Epps the only Lib Dem in Reading to genuinely want to take up and campaign on adult social care in Reading.
Of course the problem for the ‘leadership’ in this town was that they had held the cabinet post dealing with care in a council coalition with the Tories and made cuts that affected vulnerable people.
Hopefully the future of adult social care will be hotly debated as we approach a General Election.
The only party in Reading who have so far shown a willingness to engage in this debate in my area are the Greens.
@ Dave. I know what you mean and I know that you are personally and intimately acquainted with the serious underfunding of social care.
What you describe was some years ago. It was a cock-up and acknowledged as such, and the people responsible is no longer councillors. The Greens aren’t in power and, in Reading, are not likely to be. They can afford to make all the right-sounding promises knowing that they’ll probably never be in a position to do anything, to take responsibility and be accountable for making difficult and unpleasant choices.
@Chris. Appreciate the comment Chris.
The fact is that the Lib Dems in Reading were in power and made bad decisions on adult social care.
As you know I tried to get this discussed to avoid a repetition but got nowhere.
I have tried to get dialogue on the overall issue with all four parties in the town and the only one to respond positively are the Greens.
That doesn’t mean I support them but I do give them credit for not running away from talking to someone who knows a bit about adult social care and wants a non partisan debate.
The cuts in Reading hurt vulnerable people.
I remember when the Lib Dems used to speak out against that.