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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Five things Hillary Clinton’s released emails reveal about UK politics

The latest batch of the presidential hopeful’s emails provide insight into the 2010 Labour leadership contest, and the dying days of the Labour government.

The US State Department has released thousands of Hillary Clinton’s emails. This is part of an ongoing controversy regarding the presidential hopeful’s use of a private, non-governmental server and personal email account when conducting official business as Secretary of State.

More than a quarter of Clinton’s work emails have now been released, in monthly instalments under a Freedom of Information ruling, after she handed over 30,000 pages of documents last year. So what does this most recent batch – which consists of 4,368 emails (totalling 7,121 pages) – reveal?
 

David Miliband’s pain

There’s a lot of insight into the last Labour leadership election in Clinton’s correspondence. One email from September 2010 reveals David Miliband’s pain at being defeated by his brother. He writes: “Losing is tough. When you win the party members and MPs doubly so. (When it's your brother...).”


Reaction to Ed Miliband becoming Labour leader

Clinton’s reply to the above email isn’t available in the cache, but a message from an aide about Ed Miliband’s victory in the leadership election suggests they were taken aback – or at least intrigued – by the result. Forwarding the news of Ed’s win to Clinton, it simply reads: “Wow”.


Clinton’s take on it, written in an email to her long-time adviser, Sidney Blumenthal, is: “Clearly more about Tony that [sic] David or Ed”.

Blumenthal expresses regret about the “regression” Ed’s win suggests about the Labour party. He writes to Clinton: “David Miliband lost by less than 2 percent to his brother Ed. Ed is the new leader. David was marginally hurt by Tony's book but more by Mandelson's endorsement coupled with his harsh statements about the left. This is something of a regression.”
 

Peter Mandelson is “mad”

In fact, team Clinton is less than enthusiastic about the influence Mandelson has over British politics. One item in a long email from Blumenthal to Clinton, labelled “Mandelson Watch”, gives her the low-down on the former Business Secretary’s machinations, in scathing language. It refers to him as being “in a snit” for missing out on the EU Commissioner position, and claims those in Europe think of him as “mad”. In another email from Blumenthal – about Labour’s “halted” coup against Gordon Brown – he says of Mandelson: “No one trusts him, yet he's indispensable.”

That whole passage about the coup is worth reading – for the clear disappointment in David Miliband, and description of his brother as a “sterling fellow”:


Obsession with “Tudor” Labour plotting

Clinton appears to have been kept in the loop on every detail of Labour party infighting. While Mandelson is a constant source of suspicion among her aides, Clinton herself clearly has a lot of time for David Miliband, replying “very sorry to read this confirmation” to an email about his rumoured demotion.

A May 2009 email from Blumenthal to Clinton, which describes Labour politicians’ plots as “like the Tudors”, details Ed Balls’ role in continuing Tony Blair and Gordon Brown’s “bitter rivalry”:


“Disingenuous” Tories “offending” Europe

The Tories don’t get off lightly either. There is intense suspicion of David Cameron’s activities in Europe, even before he is Prime Minister. Blumenthal – whose email about a prospective Cameron government being “aristocratic” and “narrowly Etonian” was released in a previous batch of Clinton’s correspondence – writes:

Without passing "Go," David Cameron has seriously damaged his relations. with the European leaders. Sending a letter to Czech leader Vaclay Klaus encouraging him not to sign the Lisbon Treaty, as though Cameron were already Prime Minister, he has offended Sarkozy., Merkel and Zapatero.

He also accuses him of a “tilt to the Tory right on Europe”.

In the same email, Blumenthal tells Clinton that William Hague (then shadow foreign secretary), “has arduously pressured for an anti-EU stance, despite his assurances to you that Tory policy toward Europe would be marked by continuity”.

In the aftermath of the 2010 UK election, Blumenthal is apprehensive about Hague’s future as Foreign Secretary, emailing Clinton: “I would doubt you’ll see David again as foreign secretary. Prepare for hauge [sic, William Hague], who is deeply anti-European and will be disingenuous with you.”

Anoosh Chakelian is deputy web editor at the New Statesman.