A North East MP has accused Government ministers of ignoring the region’s “first class” healthcare when dishing out emergency cash awards.
This week, Westminster approved a £25m injection into social care for older people in areas where hospitals are facing the biggest problems over delayed patient discharges.
But of the 65 local authorities in England to receive the money, which must be spent by the end of March to ease pressure on wards by moving patients into care in the community, none are in the North East.
Ronnie Campbell, Labour member for Blyth Valley, claims the funding is “almost all southern based where local authorities haven’t been on the receiving end of same level of ConDem cuts as Northern authorities” which have still managed to provide “a first class service”.
And he accused the Government of bailing out councils who are failing to organise their discharges from hospitals properly, while not rewarding Northumberland, North and South Tyneside, Sunderland, Durham and Newcastle councils who are facing up to the challenges.
“I’m very worried that local authorities like Northumberland are having their budgets hacked to bits and yet they’re coping with the transfer from NHS care to local authority care.
“They’re under enormous pressure to deliver other services to the general public yet Eric Pickles and Jeremy Hunt are rewarding councils which happen to have marginal constituencies in them.
“This doesn’t seem to be the ‘fair deal for Northumberland’ local Tories are trumpeting – in fact, this ranks up there with the 20% cut to transport funding and £3m further cuts to the council budget as an example of how the ConDems are targeting the North for purely party political reasons.”
The Department of Health emergency fund was authorised by a special ministerial committee, which has met weekly to help the NHS cope with winter pressures.
According to NHS England, one in five hospital beds was occupied over the Christmas period by someone ready for discharge but unable to move on because of blockages in the system. About a third of these blockages were attributed to lack of social care services.
The average cash boost for each of the 65 councils is £380,000, with money to be spent on extra support for people in their homes and short-term places in residential homes.
Responding to Mr Campbell, Coun Peter Jackson, Tory leader on Northumberland County Council, said:
“The truth is that this Government has fully protected NHS funding from day one.
“Rather than acknowledge this or the indication that our local health care services are performing much better than others across the country, Labour are once again resorting to scaremongering tactics and displaying financial illiteracy.
“Mr Campbell appears to be deliberately misleading the public by confusing local government and health care funding.”
Meanwhile, a spokesman for the Department of Health added:
“We planned for winter earlier than ever this year. We constantly review what additional measures we can take to ease the pressure on services.
“In preparation for the Better Care Fund, the NHS and local authorities are already preparing joint plans to work together better, keep people well and avoid hospital admissions. This money helps speed up that work for this winter.”
Source – Newcastle Evening Chronicle, 23 Jan 2015
Oxfordshire county council has for the past four years pulled out all the stops to avoid passing on a 38% cut in its grant for services for homeless people. But now the authority says it has nowhere left to turn and is reluctantly planning to phase in the reduction, including stopping all funding for dedicated support for those with substance misuse problems.
“It’s not something I like to do, but we’re not unusual in doing it,” says John Jackson, the council’s director for social and community services. “The reality is that I have to protect services for people I have a statutory responsibility for.”
According to new research published today, Oxfordshire’s decision is emblematic of the state of adult social care services across England. Findings from a survey of adult social care directors reveal that half say that fewer people are getting services; barely one in three says they are protecting the size of the personal budgets older people and disabled adults receive to pay for their care and support, and six in 10 directors are braced for more legal challenges.
The Association of Directors of Adult Social Services (Adass), which conducted the survey, has hitherto been notably measured – critics might say overly so – in its response to cuts ordered by the coalition government since 2010. But now it warns that the social care system is on the brink of becoming unsustainable. Its president, David Pearson, calls on wider society to say how far it is prepared to protect “countless vulnerable people who will fail to receive, or not be able to afford, the social care services they need and deserve”.
Recalling that earlier this year the National Audit Office (NAO) questioned whether councils were approaching the limits of their capacity to absorb pressures on social care budgets, Pearson says: “Our survey shows beyond doubt that we have reached the point where we are unable to absorb the pressures they, and our survey, have identified.”
The survey adds to the sense of financial crisis. Demands for extra cash for the NHS are mounting and this week the Local Government Association (LGA) warns that councils in England face a £5.8bn funding gap by March 2016 due to further cuts in grant – forcing 12.5% savings in 2014-15 alone – and escalating demand for services, particularly for older people.
The funding gap for adult social care on its own will be £1.9bn by March 2016, the LGA estimated. Next year, 2015, is “make or break” for social care with the introduction of the government’s Better Care Fund, expected to pool more than £5bn of existing funds from councils and the NHS to spend on integrated services that are designed to keep people out of hospital. Current government funding for social care is £14bn.
Pearson, however, says the scale of the challenge far outstrips any benefit that may come from integration. “It is not the directors’ job, but that of the country as a whole and its politicians, to debate how much, in times of the most severe adversity, vulnerable people should be protected from the consequences of that adversity by the introduction of new money into social care.”
Norfolk gives a flavour of the challenge. The county’s population is projected to rise 25% by 2033, but numbers of those aged 65-74 will increase 54% and numbers aged 75 or over will soar by 97%. Much of this growth will be in isolated rural communities in the north of the county.
Norfolk’s adult social services department already reports growth of 53% in referrals over the past five years, together with a near-tripling of demand for intensive homecare support of 10 hours a week or more, at the same time as it has been making £72m savings, which includes cutting the numbers of social work posts and paring back preventive services. Nevertheless, it says spending on frontline care has been protected.
With further cuts of £59m in Norfolk social services planned over the next three years, however, continuing to protect care is no longer realistic. Some £14m is coming out of people’s personal budgets, £6m from support for people with learning or physical disabilities and £4.5m from the contract with the council’s own residential care company.
Asked what the future holds, Sue Whitaker, Labour chair of Norfolk’s adult social services committee, says: “I have a feeling that trying to provide anything on top of what is required statutorily is going to be exceptionally difficult, if not impossible.”
This reflects the national picture painted by the Adass survey. Based on returns from directors in 144 councils with adult social care responsibilities, 95% of the total, Adass calculates that another £266m (1.9%) is being taken out of services in 2014-15, making a total 12% real-terms cut in spending since 2010 while demand for services has risen 14%. The net effect, therefore, is said to represent total savings since 2010 of 26% or £3.5bn.
Questioned about the likely impact over the next two years, 47% of directors say people who used services would get smaller personal budgets for their care and support; 48% say fewer people would be able to get services; 50% forecast greater pressure on the NHS; 55% expect care providers to face financial difficulty; and 59% anticipate receiving more legal challenges to cuts.
With most provision of care these days outsourced, 19% of directors admit not knowing if all their contractors paid the national minimum wage and only 3% are confident that all paid the higher, unofficial living wage. As many as 75% say they commission some homecare visits of just 15 minutes, although 90% of them say such visits were simply to check on an individual’s wellbeing or medication.
Richard Humphries, assistant director of policy at the King’s Fund thinktank, says the survey rings painfully true. “This is the consequence of the 2010 spending settlement that supposedly protected the NHS but left the social care system totally exposed,” he says. “It was all entirely predictable.
“What we are seeing now is a double whammy with both the NHS and social care simultaneously facing a crunch year next year. Most people cannot see how to get beyond this without extra money – not just money for more of the same, but for transformation of services. The Better Care Fund is OK, but it’s a very small step towards much bigger measures that are needed.”
Back in Oxfordshire, Jackson thinks the county council has a sustainable – if unpalatable – four-year plan for social care. His political boss, Conservative cabinet member Judith Heathcoat, has told the Oxford Mail she is “as comfortable as I can be” with the planned 38% cuts in housing-related support, which are part of a £64m savings package across the authority over four years.
Other savings will come through cheaper support for people with learning disabilities, moving them either out of residential care or perhaps from two-person flats to shared accommodation for five. Older people will also be hit: those attending health and wellbeing centres may next year be charged £20 a day.
Jackson’s fear is that growing numbers of legal challenges will be incurred over people’s statutory rights to care. “In the end we cannot not meet people’s care needs” he says. “We would want to do that morally anyway, but the law is very clear about it. We don’t need the courts to tell us that.”
This article was written by David Brindle, for The Guardian on Wednesday 2nd July 2014
Source – Welfare News Service, 02 July 2014