Pantomime politics: how ministers are failing us on social care | David Brindle

Piggy bank
More than £6bn has been taken out of adult social care budgets in England since 2010. Photograph: Umkehrer/Getty/iStockphoto

We seem to be living through an era of pantomime politics, so it should come as no surprise to find yourself screaming at the government: “It’s behind you!”

It took an unconscionable amount of time for ministers to wake up to the importance of social care. Having done so at last, they now insist on looking only at the bit that offers support for older people. Equally critical issues are creeping up on them, stage left.

As Barbara Gelb, chief executive of the charity Together for Short Lives, has argued, children’s services risk marginalisation, and worse. Services for young adults are getting short shrift too and may be in most trouble.

For the first time, the annual budget survey of members of the Association of Directors of Adult Social Services (Adass) shows that cost pressures are being driven more by growing demand for care and support for young adults than for that for older people.

Of a total 2.8% annual rise in needs found by the survey – which is estimated to require an extra £400m in services in 2017-18 – rising demand from older people accounts for 1.1%, while 1.7% stems from younger people with disabilities or mental health problems.

This makes a nonsense of the government’s approach. It was clear before the general election that work on the promised green paper on social care reform was concentrating too narrowly on older people and, more than that, on cost rather than care quality.

Desperate cost-cutting is hitting the very services that prevent people becoming highly dependent in older age

The Conservatives’ ill-fated manifesto dwelt on “care for the elderly” and background notes for last week’s Queen’s speech, which reaffirmed their intent to publish the green paper, couched it in the context of an ageing population and growing numbers of over-75s.

Adass’s survey exposes the short-sightedness of this. More worrying still, it shows how desperate cost-cutting is hitting the very services that prevent people becoming highly dependent in older age.

Spending on preventive services is down 6.7% this year, to £890m. This is just 6.3% of total adult social care budgets. In 2016-17, it was £954m or 7.1%. That points unerringly to more people hitting crisis point and requiring costly hospital and/or residential care. Talk about a false economy.

The survey, completed by 95% of all councils in England with significant social care responsibilities, reveals that further cuts of 8% will be made in social care budgets this year despite the government’s double cash boost before the election.

By the first injection of funds, councils were allowed to increase the special social care “precept” or levy council tax. That raised £380m, according to Adass, but the cost of paying the “national living wage” in social care this year amounts to an extra £612m.

The second injection was an emergency £2bn over this year and next, which Adass welcomes. But the cash has proved insufficient to avoid £824m more in cuts during 2017-18.

These further cuts will mean that a total of £6.3bn has been taken out of adult social care budgets in England since 2010. Little wonder that barely one in three care directors feels confident of being able to meet all their statutory duties.

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