When you cut councils, it’s the NHS that bleeds

Even before the cold weather hits, the NHS is on the brink of another winter crisis. Figures released yesterday show that many hospitals, having barely recovered from last winter’s crisis, are facing another which promises to be worse still.

A significant contributing factor is our creaking adult social care system. Elderly people are increasingly ending up in A&E as a result of insufficient care at home, and hospitals are struggling to discharge them  for the same reason. In October there were 160,000 bed days lost by hospitals due to patients who should not be there, up 10% on last year.

The root cause of this is the savage cuts to council funding. Austerity has hit local government hardest. Since 2010, government funding for local authorities reduced by 40% in real terms. The Comprehensive Spending Review announced a further 24% cut. The Tories are slowly choking local government.

Councils have done their best to protect the most vulnerable. Universal services such as libraries have taken a greater proportionate cut in order to protect adult social care. But with care making up a significant proportion of total spending – and with the sheer scale of the cuts forced on councils – protecting this area has proved impossible. The Nuffield Trust found that between 2009/10 and 2013/14, there was a 16% real terms reduction in adult social care spending on older people, equivalent to almost £1.3bn. This means that 300,000 fewer older people were receiving care – a drop of 30% at a time when the elderly population is soaring.

Perhaps more than any other area, this demonstrates the false economy of Tory austerity. As social care is cheaper than hospital care, cuts to councils just increase pressure elsewhere, like squeezing a baloon. A recent Respublica report showed that a funding gap for residential care of £1bn by 2020/21 could lead to the loss of around 37,000 beds, and an annual cost-shunt to the NHS of £3bn. The Government has promised extra funding for the NHS, but without sustainable funding for social care, this will not be enough. We are seeing this already with NHS trusts heading for record deficits this year projected to top £2bn.  By slashing council funding, the government is pushing the NHS to breaking point.

But beyond the numbers, this shows too the human tragedy of austerity. Elderly people in hospital unnecessarily are often called ‘bed blockers’, a term that paints them only as a burden on the NHS. But these are frail, elderly  and often lonely people, unable to get the care that they need in their own homes. They are deeply vulnerable and they are being let down by society.

The Tories have so far been able to get away with savage cuts to local government with relative impunity. They’ve distracted attention with talk of devolution and health and social care integration. Both are welcome, but neither will make up for the scale of the cuts. The Chancellor allowed some extra flexibility on council tax last month, but this will not come close to plugging the growing funding gap. Awareness of the situation facing councils is pretty low. In fact, the Prime Minister himself doesn’t have the foggiest; he recently wrote to his own council expressing his shock and surprise at the need to cut services.

To be frank, Labour didn’t do a good enough job in the last Parliament to make the case for local government and oppose cuts to councils. This has allowed the Tories to get away with this with relative political impunity. It is welcome to see Jeremy Corbyn and John McDonnell focusing on the danger of cuts to local authorities. In London, Labour Councils and opposition groups have come together to form Red Lines and push this issue up the agenda. This winter we’ll be highlighting the impact of Tory cuts to councils on care services and the NHS in the capital.

We need urgently to up our game, get our message across, and fight back. These savage cuts to local government cannot continue on this scale without undermining social care and destabilising the NHS. When you cut councils, it’s the NHS that bleeds.

Joe Dromey is a councillor and Cabinet Member for Policy and Performance in the London Borough of Lewisham