Cutting the budget for social care is a false economy

Social care is higher on the political agenda than at any time during the last few Parliaments, and yet disabled and older people now face a worse situation than when it was a low-profile issue.

The Care Bill is in Parliament for its second reading today and although in principle it seems to be a turning point for the current ineffective social care system, if the right amount of funding isn’t released from central Government, the laudable aspirations of the Bill will never be realised. Chronic underfunding has left many disabled people without the support they need and MPs must take this golden opportunity to improve social care for some of the most disadvantaged people in society.

Social care is higher on the political agenda than at any time during the last few Parliaments, and yet disabled and older people now face a worse situation. Successive attempts to improve the system – community care, direct payments, personalisation – have been implemented to varying degrees in different areas, creating a post code lottery. Underpinning it all is the ever tightening financial pressures under which local authorities struggle to deliver. Social care isn’t an issue that will ever go away. People with disabilities and older people will always need support and inevitably funding and adequate provision will always be a big political issue. As the population ages, the number of people needing social care is set to rise, and as a society we desperately need this latest piece of legislation to work for everyone, disabled and older people and their families.

Over the past year there have been unprecedented cuts to the amount of social care disabled people receive. The numbers receiving support are dropping while the numbers needing support rise year on year. Just today LSE research has shown half a million older and disabled people have fallen out of social care in the last five years. And the group seeing the biggest drop are people with sight loss, including deafblind people.

But cutting the budget for social care is a false economy. As people reach crisis point they can become more susceptible to falls or require hospital treatment, or drop out of employment and claim benefits, because they didn’t get the support they needed from social care. Not to mention the human cost, as people experience intense loneliness and isolation if they are unable to leave the house without support and can result in them needing counseling or mental health support.

The new buzzword in social care is integration. Currently, social care is paid for by local authorities and health care is provided for centrally. This means that many people with long term needs end up being shunted from one to the other as both try and avoid the cost or view one problem as health and another problem as social care. Proposals to integrate the two have been around for years, but finally they seem to be gathering momentum with a new integration fund.

Integration offers significant opportunities, both to improve things for the individual and to make more efficient use of resources by investing in preventative care. If people with disabilities are provided with adequate levels of social care they require less expensive treatment from the NHS in the long term. But we shouldn’t underestimate how politically difficult it will be to make the shift from acute services to community services.

All political parties see integration of health and social care as critical to the necessary transformation of services to address the funding crisis. Labour would perhaps go further than the current government, but all agree on the principles. Rarely do we have such consensus from the political parties on the issue so perhaps this is a positive sign.

Over the past year many disabled people, including the deafblind people that Sense supports, have been pushed to breaking point. They have been hit by the bedroom tax, struggled with changes to the benefit system and many have faced huge cuts to their social care, leaving them without the support they desperately need to live full and active lives. When we talk about social care, we aren’t just talking personal care and help getting washed and dressed. We’re also talking about ensuring that people can exercise, get to medical appointments and have a life outside of the home. One of the welcome features of the Bill is that it focuses social care on a broad concept of well-being. But this is also the part of the Bill most likely to fail if the funding is not there to deliver. We desperately need MPs to put our money where their mouths are and make sure that this materialises.

Sue Brown is head of public policy and campaigns at Sense


Older people will always need support and inevitably funding and adequate provision will always be a big political issue. Photo: Getty

Sue Brown is head of public policy and campaigns at Sense

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America’s domestic terrorists: why there’s no such thing as a “lone wolf”

After the latest attack on Planned Parenthood in Colorado Springs, America must confront the violence escalating at its heart.

First things first: let’s not pretend this is about life.

Three people have died and nine were injured on Friday in the latest attack on a women’s health clinic in the United States. Planned Parenthood in Colorado Springs was besieged by a gunman whose motives remain unclear, but right-to-lifers—who should really be called “forced birth advocates”—have already taken up their keyboards to defend his actions, claiming that women seeking an abortion, or doctors providing them, are never “innocent”. 

This was not unexpected. Abortion providers have been shot and killed before in the United States. The recent book Living in the Crosshairs by David S Cohen and Krysten Connon describes in sanguine detail the extent of domestic terrorism against women’s healthcare facilities, which is increasing as the American right-wing goes into meltdown over women’s continued insistence on having some measure of control over their own damn bodies. As Slate reports

In July, employees at a clinic in the Chicago suburb of Aurora, Illinois, reported an attempted arson. In August, firefighters found half a burning car at the construction site of a future clinic in New Orleans. On Sept. 4, a clinic in Pullman, Washington, was set ablaze at 3:30 a.m., and on Sept. 30, someone broke a window at a Thousand Oaks, California, clinic and threw a makeshift bomb inside.

The real horror here is not just that a forced-birth fanatic attacked a clinic, but that abortion providers across America are obliged to work as if they might, at any time, be attacked by forced-birth fanatics whose right to own a small arsenal of firearms is protected by Congress. 

The United States is bristling with heavily armed right-wingers who believe the law applies to everyone but them. This is the second act of domestic terrorism in America in a week. On Monday, racists shouting the n-word opened fire at a Black Lives Matter protest in Minneapolis, injuring three. This time, the killer is a white man in his 50s. Most American domestic terrorists are white men, which may explain why they are not treated as political agents, and instead dismissed as “lone wolves” and “madmen”.

Terrorism is violence against civilians in the service of ideology. By anyone’s sights, these killers are terrorists, and by the numbers, these terrorists pose substantially more of a threat to American citizens than foreign terrorism—but nobody is calling for background checks on white men, or for members of the republican party to wear ID tags. In America, like many other western nations, people only get to be “terrorists” when they are “outsiders” who go against the political consensus. And there is a significant political consensus behind this bigotry, including within Washington itself. That consensus plays out every time a Republican candidate or Fox news hatebot expresses sorrow for the victims of murder whilst supporting both the motives and the methods of the murderers. If that sounds extreme, let’s remind ourselves that the same politicians who declare that abortion is murder are also telling their constituents that any attempt to prevent them owning and using firearms is an attack on their human rights. 

Take Planned Parenthood. For months now, systematic attempts in Washington to defund the organisation have swamped the nation with anti-choice, anti-woman rhetoric. Donald Trump, the tangerine-tanned tycoon who has managed to become the frontrunner in the republican presidential race not in spite of his swivel-eyed, stage-managed, tub-thumping bigotry but because of it, recently called Planned Parenthood an “abortion factory” and demanded that it be stripped of all state support. Trump, in fact, held a pro-choice position not long ago, but like many US republicans, he is far smarter than he plays. Trump understands that what works for the American public right now, in an absence of real hope, is fanaticism. 

Donald Trump, like many republican candidates, is happy to play the anti-woman, anti-immigrant, racist fanatic in order to pander to white, fundamentalist Christian voters who just want to hear someone tell it like it is. Who just want to hear someone say that all Muslims should be made to wear ID cards, that Black protesters deserve to be “roughed up”, that water-boarding is acceptable even if it doesn’t work because “they deserve it”. Who just want something to believe in, and when the future is a terrifying blank space, the only voice that makes sense anymore is the ugly, violent whisper in the part of your heart that hates humanity, and goddamn but it’s a relief to hear someone speaking that way in a legitimate political forum. Otherwise you might be crazy.

American domestic terrorists are not “lone wolves”. They are entrepreneurial. They may work alone or in small groups, but they are merely the extreme expression of a political system in meltdown. Republican politicians are careful not to alienate voters who might think these shooters had the right idea when they condemn the violence, which they occasionally forget to do right away. In August, a homeless Hispanic man was allegedly beaten to a pulp by two Bostonians, one of whom told the police that he was inspired by Donald Trump’s call for the deportation of “illegals”. Trump responded to the incident by explaining that “people who are following me are very passionate. They love this country and they want this country to be great again.”

But that’s not even the real problem with Donald Trump. The real problem with Donald Trump is that he makes everyone standing just to the left of him look sane. All but one republican governor has declared that refugees from Syria are unwelcome in their states. Across the nation, red states are voting in laws preventing women from accessing abortion, contraception and reproductive healthcare. Earlier this year, as congressmen discussed defunding Planned Parenthood, 300 ‘pro-life’ protesters demonstrated outside the same Colorado clinic where three people died this weekend. On a daily basis, the women who seek treatment at the clinic are apparently forced to face down cohorts of shouting fanatics just to get in the door. To refuse any connection between these daily threats and the gunman who took the violence to its logical extreme is not merely illogical—it is dangerous.

If terrorism is the murder of civilians in the service of a political ideology, the United States is a nation in the grip of a wave of domestic terrorism. It cannot properly be named as such because its logic draws directly from the political consensus of the popular right. If the killers were not white American men, we would be able to call them what they are—and politicians might be obligated to come up with a response beyond “these things happen.”

These things don’t just “happen”. These things happen with escalating, terrifying frequency, and for a reason. The reason is that America is a nation descending into political chaos, unwilling to confront the violent bigotry at its heart, stoked to frenzy by politicians all too willing to feed the violence if it consolidates their own power. It is a political choice, and it demands a political response.

Laurie Penny is a contributing editor to the New Statesman. She is the author of five books, most recently Unspeakable Things.