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

Photo: Getty
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Who will win in Stoke-on-Trent?

Labour are the favourites, but they could fall victim to a shock in the Midlands constituency.  

The resignation of Tristram Hunt as MP for Stoke-on-Central has triggered a by-election in the safe Labour seat of Stoke on Trent Central. That had Westminster speculating about the possibility of a victory for Ukip, which only intensified once Paul Nuttall, the party’s leader, was installed as the candidate.

If Nuttall’s message that the Labour Party has lost touch with its small-town and post-industrial heartlands is going to pay dividends at the ballot box, there can hardly be a better set of circumstances than this: the sitting MP has quit to take up a well-paid job in London, and although  the overwhelming majority of Labour MPs voted to block Brexit, the well-advertised divisions in that party over the vote should help Ukip.

But Labour started with a solid lead – it is always more useful to talk about percentages, not raw vote totals – of 16 points in 2015, with the two parties of the right effectively tied in second and third place. Just 33 votes separated Ukip in second from the third-placed Conservatives.

There was a possible – but narrow – path to victory for Ukip that involved swallowing up the Conservative vote, while Labour shed votes in three directions: to the Liberal Democrats, to Ukip, and to abstention.

But as I wrote at the start of the contest, Ukip were, in my view, overwritten in their chances of winning the seat. We talk a lot about Labour’s problem appealing to “aspirational” voters in Westminster, but less covered, and equally important, is Ukip’s aspiration problem.

For some people, a vote for Ukip is effectively a declaration that you live in a dump. You can have an interesting debate about whether it was particularly sympathetic of Ken Clarke to brand that party’s voters as “elderly male people who have had disappointing lives”, but that view is not just confined to pro-European Conservatives. A great number of people, in Stoke and elsewhere, who are sympathetic to Ukip’s positions on immigration, international development and the European Union also think that voting Ukip is for losers.

That always made making inroads into the Conservative vote harder than it looks. At the risk of looking very, very foolish in six days time, I found it difficult to imagine why Tory voters in Hanley would take the risk of voting Ukip. As I wrote when Nuttall announced his candidacy, the Conservatives were, in my view, a bigger threat to Labour than Ukip.

Under Theresa May, almost every move the party has made has been designed around making inroads into the Ukip vote and that part of the Labour vote that is sympathetic to Ukip. If the polls are to be believed, she’s succeeding nationally, though even on current polling, the Conservatives wouldn’t have enough to take Stoke on Trent Central.

Now Theresa May has made a visit to the constituency. Well, seeing as the government has a comfortable majority in the House of Commons, it’s not as if the Prime Minister needs to find time to visit the seat, particularly when there is another, easier battle down the road in the shape of the West Midlands mayoral election.

But one thing is certain: the Conservatives wouldn’t be sending May down if they thought that they were going to do worse than they did in 2015.

Parties can be wrong of course. The Conservatives knew that they had found a vulnerable spot in the last election as far as a Labour deal with the SNP was concerned. They thought that vulnerable spot was worth 15 to 20 seats. They gained 27 from the Liberal Democrats and a further eight from Labour.  Labour knew they would underperform public expectations and thought they’d end up with around 260 to 280 seats. They ended up with 232.

Nevertheless, Theresa May wouldn’t be coming down to Stoke if CCHQ thought that four days later, her party was going to finish fourth. And if the Conservatives don’t collapse, anyone betting on Ukip is liable to lose their shirt. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.