The social care crisis in England is getting worse every week, yet there is no sign that the Government understands the scale of the pressures on local authorities, and the knock on impact this is having on our NHS.
Earlier this month the independent regulator, the Care Quality Commission, said that the social care sector has now reached a “tipping point”. Between 2009 and 2014, the number of people in England receiving local authority funded social care services fell by 26 per cent, from 1.1m to approximately 850,000. Age UK estimate that there are now more than one million adults with unmet care needs.
The social care crisis is also increasing the pressure on the NHS. David Behan, the CQC’s chief executive recently said, “what’s happening, we think, is that where people aren’t getting access to [social] care, and we are not preventing people’s needs developing through adult social care, is that they are presenting at A&E.” The number of days patients spend in a hospital bed because the social care they need is not available but are otherwise fit to be discharged – so-called bed-blocking – increased by 70 per cent between 2012 and 2015.
Beyond the raw statistics, there are thousands of stories of mainly frail and elderly people being left without the help they need for basic needs, like dressing, washing and cooking. Too many then end up in hospital as a result of a painful fall or malnourishment. Meanwhile, some carers have not been paid the minimum wage as care providers spread resources as thinly as possible.
The immediate priority is to provide additional resources to local authorities to help bridge the alarming funding gap that opened up. The Association of Directors of Adult Services have estimated that this gap now stands at £1bn per year.
At the spending review last year, George Osborne did belatedly acknowledge the growing pressure on local government and private care providers, announcing a Better Care Fund, and allowing local council’s to increase council tax by two per cent to pay for social care. But much of the additional funding pledged is backloaded to 2019/20 and, even when this is factored in, the Kings Fund has estimated that the funding gap between needs and resources will rise to £3.5bn by 2019.
The social care crisis is indicative of the larger difficulties local government has faced in Osborne’s era of austerity. Councils have been hit by cuts of around 40 per cent, with many having to cut services back towards the statutory minimum. One local authority representative told the Kings Fund last year they believed the cuts they were targeting would breach the council’s duties under the Care Act 2014. The cross-party Local Government Association estimate that there will be a funding gap of £5.8bn by 2020 when other services, such as children’s social care and homelessness services are also considered.
Labour-run local authorities have led the way in finding innovative solutions to tackle the social care crisis, such as a time bank initiative in Southwark that brings neighbours together to lend a helping hand. Devolving responsibility for health and social care in Greater Manchester also offers opportunities to integrate services.
A key test for Philip Hammond, the chancellor, as he delivers his first autumn statement next month will be whether he tackles the growing social care funding gap, and whether he will trust local government to develop innovative responses to the demands of an ageing population, or whether he will continue Osborne’s strategy of simply devolving responsibility for cuts.
The demand for adult social care is only going to increase as the number of people over the age of 85 is set to double in the next decade. It’s time to push power out of Whitehall, and allow local government to find ways to tackle this crisis and build sustainable social care services for the future.
Gareth Thomas MP is Shadow Minister for Local Government