Social care for the elderly will be the first to go in the council cuts

What could replace it? "Adopt-a-granny" schemes, or a National Care Service, maybe.

Recent weeks have seen social security cuts ignite passions and viscerally polarise politics. Benefits reform lit the touch paper for disputes on the future affordability of the welfare state. But pensioner benefits, over half of the total welfare spend, are curiously off the table for discussion.

Yet if anything it is elderly care, rather than jobseekers payments, which will bankrupt the public finances. Constructive debate on the future of adult social services is more urgent than political wrangling on strivers vs. scroungers. Without it we risk sleep walking into a care crisis. 

The looming crisis hasn’t gone unnoticed by government over the past decade, yet no minister has yet arrived at a conclusive response. The latest attempt to grasp the nettle was made in Budget 2013, when the Chancellor agreed to fast track reform to social care funding. The government’s proposals are designed to make the system fairer, by protecting housing assets, but don’t tackle current spending pressure. 

Simply put, through capping individual payments at £72,000 from 2016, the government is addressing the balance of payments between the state and individuals. But the totality of funding will not change.

In response, a prominent Lords Select Committee has declared that the country is still “woefully underprepared for ageing.” Radical changes to the way that health and social care is delivered are needed to provide appropriate care and to address future demand.

Over the next two decades, England will see a 51 per cent rise in those aged 65+ and a doubling of those aged 85+. Many elderly people will be increasingly dependent on the care system. The Local Government Association estimates that this will see an increase in the care bill of £7bn - or about 15 per cent - over the decade. Worryingly, this is a "modest" estimate.

At the same time, until the social care system is reformed, money will continually be sucked out of other local services, such as roads, street cleaning and education support. This reality became apparent during research for NLGN’s latest report Gaming the Cuts, which is launched today. 

To inform the research we conducted a "budget war game" with senior council officers thinking through the implications of the cuts on an imaginary council called AnyBorough. Both teams quickly latched onto integrating health and social care, thinking that substantial savings could be made.

Back in the real world, many local authorities are already looking to bring clinical and public health commissioning together. Essex County Council is pioneering a new joint approach to tackle the £1bn elderly budget it shares with the NHS.

It is estimated that Essex’s new approach could save the public purse £348m by 2017/18. A study commissioned by the Local Government Association suggests that if such approaches were scaled up there could be a 5-year net benefit to the public sector of £5.8-£12bn. 

However, the budget war game made clear that savings from new models would likely flow to the acute sector. As a result, councils may look to the community to provide more social support. 

In England and Wales the informal care economy already accounts for approximately 3.4m working days every week, this is a substantial increase from 10 years ago. During our research it was therefore mooted that the public may have to be paid to deliver social services.

Currently, advocates for increased community involvement in adult social care point to the success of time dollar banking approaches first developed in Japan. Elderly people are befriended in order to combat loneliness and people account for the time spent in such schemes as a currency. They can then trade time to ensure that their own elderly relatives, who often live too far away to visit regularly, are supported.

But what if such Adopt-a-Granny schemes were based on a monetary transaction? Could support for elderly independent living be based on a similar financial footing to the fostering of children, with allowances paid to accredited carers?

Although seemingly radical the principle behind such an approach makes sense. For many people social relations are as important to physical and mental health as social services.

Yet, considerable risk would be transferred onto the community and more money saved would only be a drop in the ocean of the health and adult social care bill. But most importantly, monetisation could have unforeseen consequences on the sense of community and mutual relations that is at the heart of caring. 

With health integration and community care likely to be insufficient we are left with a seemingly intractable situation. Councils are even beginning to raise the possibility of social care spend being taken away from them, through a National Care Service for example, so that they can focus on making investments for local prosperity and growth. Just two years ago this would have been unthinkable, but such is the pressure now facing councils that such heresies are increasingly to be heard whispered around local government.

Photograph: Getty Images

Joe is a senior researcher at the New Local Government Network

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Find the EU renegotiation demands dull? Me too – but they are important

It's an old trick: smother anything in enough jargon and you can avoid being held accountable for it.

I don’t know about you, but I found the details of Britain’s European Union renegotiation demands quite hard to read. Literally. My eye kept gliding past them, in an endless quest for something more interesting in the paragraph ahead. It was as if the word “subsidiarity” had been smeared in grease. I haven’t felt tedium quite like this since I read The Lord of the Rings and found I slid straight past anything written in italics, reasoning that it was probably another interminable Elvish poem. (“The wind was in his flowing hair/The foam about him shone;/Afar they saw him strong and fair/Go riding like a swan.”)

Anyone who writes about politics encounters this; I call it Subclause Syndrome. Smother anything in enough jargon, whirr enough footnotes into the air, and you have a very effective shield for protecting yourself from accountability – better even than gutting the Freedom of Information laws, although the government seems quite keen on that, too. No wonder so much of our political conversation ends up being about personality: if we can’t hope to master all the technicalities, the next best thing is to trust the person to whom we have delegated that job.

Anyway, after 15 cups of coffee, three ice-bucket challenges and a bottle of poppers I borrowed from a Tory MP, I finally made it through. I didn’t feel much more enlightened, though, because there were notable omissions – no mention, thankfully, of rolling back employment protections – and elsewhere there was a touching faith in the power of adding “language” to official documents.

One thing did stand out, however. For months, we have been told that it is a terrible problem that migrants from Europe are sending child benefit to their families back home. In future, the amount that can be claimed will start at zero and it will reach full whack only after four years of working in Britain. Even better, to reduce the alleged “pull factor” of our generous in-work benefits regime, the child benefit rate will be paid on a ratio calculated according to average wages in the home country.

What a waste of time. At the moment, only £30m in child benefit is sent out of the country each year: quite a large sum if you’re doing a whip round for a retirement gift for a colleague, but basically a rounding error in the Department for Work and Pensions budget.

Only 20,000 workers, and 34,000 children, are involved. And yet, apparently, this makes it worth introducing 28 different rates of child benefit to be administered by the DWP. We are given to understand that Iain Duncan Smith thinks this is barmy – and this is a man optimistic enough about his department’s computer systems to predict in 2013 that 4.46 million people would be claiming Universal Credit by now*.

David Cameron’s renegotiation package was comprised exclusively of what Doctor Who fans call handwavium – a magic substance with no obvious physical attributes, which nonetheless helpfully advances the plot. In this case, the renegotiation covers up the fact that the Prime Minister always wanted to argue to stay in Europe, but needed a handy fig leaf to do so.

Brace yourself for a sentence you might not read again in the New Statesman, but this makes me feel sorry for Chris Grayling. He and other Outers in the cabinet have to wait at least two weeks for Cameron to get the demands signed off; all the while, Cameron can subtly make the case for staying in Europe, while they are bound to keep quiet because of collective responsibility.

When that stricture lifts, the high-ranking Eurosceptics will at last be free to make the case they have been sitting on for years. I have three strong beliefs about what will happen next. First, that everyone confidently predicting a paralysing civil war in the Tory ranks is doing so more in hope than expectation. Some on the left feel that if Labour is going to be divided over Trident, it is only fair that the Tories be split down the middle, too. They forget that power, and patronage, are strong solvents: there has already been much muttering about low-level blackmail from the high command, with MPs warned about the dire influence of disloyalty on their career prospects.

Second, the Europe campaign will feature large doses of both sides solemnly advising the other that they need to make “a positive case”. This will be roundly ignored. The Remain team will run a fear campaign based on job losses, access to the single market and “losing our seat at the table”; Leave will run a fear campaign based on the steady advance of whatever collective noun for migrants sounds just the right side of racist. (Current favourite: “hordes”.)

Third, the number of Britons making a decision based on a complete understanding of the renegotiation, and the future terms of our membership, will be vanishingly small. It is simply impossible to read about subsidiarity for more than an hour without lapsing into a coma.

Yet, funnily enough, this isn’t necessarily a bad thing. Just as the absurd complexity of policy frees us to talk instead about character, so the onset of Subclause Syndrome in the EU debate will allow us to ask ourselves a more profound, defining question: what kind of country do we want Britain to be? Polling suggests that very few of us see ourselves as “European” rather than Scottish, or British, but are we a country that feels open and looks outwards, or one that thinks this is the best it’s going to get, and we need to protect what we have? That’s more vital than any subclause. l

* For those of you keeping score at home, Universal Credit is now allegedly going to be implemented by 2021. Incidentally, George Osborne has recently discovered that it’s a great source of handwavium; tax credit cuts have been postponed because UC will render such huge savings that they aren’t needed.

Helen Lewis is deputy editor of the New Statesman. She has presented BBC Radio 4’s Week in Westminster and is a regular panellist on BBC1’s Sunday Politics.

This article first appeared in the 11 February 2016 issue of the New Statesman, The legacy of Europe's worst battle