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
Show Hide image

The Prevent strategy needs a rethink, not a rebrand

A bad policy by any other name is still a bad policy.

Yesterday the Home Affairs Select Committee published its report on radicalization in the UK. While the focus of the coverage has been on its claim that social media companies like Facebook, Twitter and YouTube are “consciously failing” to combat the promotion of terrorism and extremism, it also reported on Prevent. The report rightly engages with criticism of Prevent, acknowledging how it has affected the Muslim community and calling for it to become more transparent:

“The concerns about Prevent amongst the communities most affected by it must be addressed. Otherwise it will continue to be viewed with suspicion by many, and by some as “toxic”… The government must be more transparent about what it is doing on the Prevent strategy, including by publicising its engagement activities, and providing updates on outcomes, through an easily accessible online portal.”

While this acknowledgement is good news, it is hard to see how real change will occur. As I have written previously, as Prevent has become more entrenched in British society, it has also become more secretive. For example, in August 2013, I lodged FOI requests to designated Prevent priority areas, asking for the most up-to-date Prevent funding information, including what projects received funding and details of any project engaging specifically with far-right extremism. I lodged almost identical requests between 2008 and 2009, all of which were successful. All but one of the 2013 requests were denied.

This denial is significant. Before the 2011 review, the Prevent strategy distributed money to help local authorities fight violent extremism and in doing so identified priority areas based solely on demographics. Any local authority with a Muslim population of at least five per cent was automatically given Prevent funding. The 2011 review pledged to end this. It further promised to expand Prevent to include far-right extremism and stop its use in community cohesion projects. Through these FOI requests I was trying to find out whether or not the 2011 pledges had been met. But with the blanket denial of information, I was left in the dark.

It is telling that the report’s concerns with Prevent are not new and have in fact been highlighted in several reports by the same Home Affairs Select Committee, as well as numerous reports by NGOs. But nothing has changed. In fact, the only change proposed by the report is to give Prevent a new name: Engage. But the problem was never the name. Prevent relies on the premise that terrorism and extremism are inherently connected with Islam, and until this is changed, it will continue to be at best counter-productive, and at worst, deeply discriminatory.

In his evidence to the committee, David Anderson, the independent ombudsman of terrorism legislation, has called for an independent review of the Prevent strategy. This would be a start. However, more is required. What is needed is a radical new approach to counter-terrorism and counter-extremism, one that targets all forms of extremism and that does not stigmatise or stereotype those affected.

Such an approach has been pioneered in the Danish town of Aarhus. Faced with increased numbers of youngsters leaving Aarhus for Syria, police officers made it clear that those who had travelled to Syria were welcome to come home, where they would receive help with going back to school, finding a place to live and whatever else was necessary for them to find their way back to Danish society.  Known as the ‘Aarhus model’, this approach focuses on inclusion, mentorship and non-criminalisation. It is the opposite of Prevent, which has from its very start framed British Muslims as a particularly deviant suspect community.

We need to change the narrative of counter-terrorism in the UK, but a narrative is not changed by a new title. Just as a rose by any other name would smell as sweet, a bad policy by any other name is still a bad policy. While the Home Affairs Select Committee concern about Prevent is welcomed, real action is needed. This will involve actually engaging with the Muslim community, listening to their concerns and not dismissing them as misunderstandings. It will require serious investigation of the damages caused by new Prevent statutory duty, something which the report does acknowledge as a concern.  Finally, real action on Prevent in particular, but extremism in general, will require developing a wide-ranging counter-extremism strategy that directly engages with far-right extremism. This has been notably absent from today’s report, even though far-right extremism is on the rise. After all, far-right extremists make up half of all counter-radicalization referrals in Yorkshire, and 30 per cent of the caseload in the east Midlands.

It will also require changing the way we think about those who are radicalized. The Aarhus model proves that such a change is possible. Radicalization is indeed a real problem, one imagines it will be even more so considering the country’s flagship counter-radicalization strategy remains problematic and ineffective. In the end, Prevent may be renamed a thousand times, but unless real effort is put in actually changing the strategy, it will remain toxic. 

Dr Maria Norris works at London School of Economics and Political Science. She tweets as @MariaWNorris.