AMID all the headline-grabbing scandal of late about various MPs’ donations and family-friendly employment practices, let’s not forget the real flesh-and-bones issues doing the rounds. A case in point – last week’s hard-hitting report by the UK’s social care watchdog, the Commission for Social Care Inspection.
There was bleakness to the CSCI’s findings on care for the elderly. It pointed to a massive and growing gap between demand for personal and residential care and provision by local government. Many needy people being denied help now by councils would have received it only several years ago. A full-fledged postcode lottery exists – while some local authorities help those assessed at ‘moderate’ risk and above, a hardcore of particularly strapped councils only extend a hand to those in ‘critical’ need. Ivan Lewis, minister for social care, responded by taking councils to task. He claimed that a “no help here� attitude is creeping into the system and demanded a probe into the “inconsistencies� in services.
Sefton provides a good microcosm for the challenges facing social care. It is one of the 73% of councils that imposes a criterion of ‘substantial’ risk for providing personal care, and has done for a number of years. Yet it is bordered by Knowsley, Liverpool and Lancashire which help the ‘moderately’ afflicted – including people who need help with everyday tasks such as washing and shopping.
Social care minister Ivan Lewis: says he wants answers
When this was put to Sefton’s social care cabinet member, Cllr Vin Platt, he was adamant that the vagaries of government grants to councils explained the limits to what the borough can offer. A press release from Labour-run Lancs County Council made clear it was a higher than expected grant settlement that allowed them to keep ‘moderate’ as their threshold despite proposals to raise it being on the table. Sefton also has a higher than average elderly population.
So there is finger pointing between national government and some councils over the situation. The conclusions of the independent CSCI report into the postcode lottery, commissioned by Mr Lewis, should make for interesting reading. But ultimately there are more fundamental questions of political economy at stake – what level of state provision for care do we want as a society? Who should pay for it? What premium should be placed on equity?
The situation has now become more fluid. This week we learned that the Scottish Government’s much vaunted policy of free elderly personal care is face a funding black hole. Its introduction was a Lib-Dem condition for coalition with Labour, which ended last year at the hands of the Scottish Nationalists. The policy is expensive and the position of Labour in Westminster was that it would divert too much revenue to help well-off pensioners. New leader Nick Clegg last month dropped a longstanding national Lib Dem commitment to free personal care for over 65s. Instead he embraced a model of co-funding – free basic provision and match-funding for optional personal top-ups – proposed by thinktank the King’s Fund and banker turned national headscratcher Sir Derek Wanless. Conservatives also back co-funding, as do Age Concern. The government in London is due to consult on reforming social care this year.
Cheap it will not be. The Wanless proposals would need an estimated trebling of the social care budget to £30bn. Faced with policy conundrums such as this, no wonder everyone is getting in such a lather about some MPs’ wonky accounting.
Speaking last week with the director of Sefton Pensioners Advocacy Centre, Andrew Booth, he suggested an eminently sensible route to taking the political sting from council tax rises. If, say, a 0.5 per cent rise is needed to help provide a decent service for our elderly, why not ringfence this revenue (or hypothecate it to use the jargon). Were that to happen, it might certainly take the sting from some of the political sniping we are seeing in Sefton. Already local Lib Dems have been publicly noting areas of strain in the council budget and pointing to five or even six-figure sums they say could have been saved by following their path in the imbroglio over top management jobs…
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