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

ROBERTO SCHMIDT/AFP/Getty Images
Show Hide image

Unlikely sisters in the Gaza Strip

A former Jewish settler in Gaza recalls her childhood friendship with a young Palestinian.

It was well after midnight, one summer night in 1995, when Inbar Rozy, a 13-year-old living in the former Israeli settlement of Alei Sinai in the northern Gaza Strip, heard her parents answer the phone. Sitting up in bed, surrounded by potted plants, candles and fairy dolls lit by shafts of light from a nearby security outpost, Inbar listened closely.

“I could hear everyone talking around me, making calls,” Inbar said when we met recently in Nitzan, southern Israel. When she got up to find out what was happening, her parents told her to make up a second mattress. As dawn broke, they led into the room a young woman carrying a small bag and wearing a black shirt and jeans. “She had shoulder-length dark hair dyed with red henna and beautiful eyes – big, black with thick eyelashes,” Inbar told me, smiling. “[She was] quiet. She looked scared.”

The woman was Rina (her surname cannot be given for security reasons), a talented artist in her early twenties studying at a local art college, where she had fallen in love with a Christian boy. For Rina, coming from a traditional family, marrying a non-Muslim would be strictly forbidden.

When her parents found out, they were furious and forbade her from seeing her boyfriend. But her male cousins felt this wasn’t enough. Earlier on the day the girls first met, Rina’s cousins had attempted to kill her in retribution for her perceived “honour crime”. Seeing that another attempt on her life was likely, Rina’s father called a relative, who in turn called Inbar’s father, Yossef, a friend of many years. There was no doubt she had to leave. Ironically, a Jewish settlement protected by the Israel Defence Forces was the safest place in Gaza for her to be.

In 1967, Israel seized the Gaza Strip from Egypt during the Six Day War. In time, it settled 21 communities on a third of the land, with a population of 8,000 by 2005. Soldiers guarded the settlements from 1.5 million displaced Palestinians, tens of thousands of whom were displaced in 1967 and moved to live in nearby refugee camps. In Gaza, before Israel’s ultimate withdrawal from the Strip in 2005, relationships between Israeli settlers and Palestinians were fraught. True, many Palestinians worked in Israeli settlements, earning wages higher than elsewhere in the Strip, but the two communities lived largely separate lives.

In the mid-1990s, even after the Oslo Accords, violence was simmering. Israeli military incursions increased with the outbreak of the Second Intifada in 2000. Thousands of home-made Qassam rockets were launched by Palestinian militants at settlers and those living in southern Israel. Security measures hardened. The veteran Israeli journalist Amira Hass, who spent several years living in Gaza, describes neighbourhoods that were “turned into jails behind barbed-wire fences, closed gates, IDF surveillance, tanks and entry-permit red tape”.

And yet, in spite of the forced segregation, Inbar’s family enjoyed close links with their Palestinian neighbours. Inbar’s father worked as an ambulance driver, and on several occasions he helped transport those who lived nearby for emergency medical treatment in Israel. “Every Tuesday, my father’s Jewish and Arab friends would come to our house and we’d eat lunch together,” Inbar remembered.

Given the gravity of Rina’s situation, she couldn’t leave the house. Secrecy was paramount. The girls spent weeks together indoors, Inbar said, chatting, watching TV and drawing. “I’m not sure that as a child I actually understood it for real,” she said. “She taught me how to paint and sketch a face from sight.”

Almost as soon as Rina arrived, Inbar’s family began receiving anonymous phone calls asking about her. “My dad told me, ‘Don’t mention anything about Rina. Say you don’t know what they’re talking about – because otherwise they’ll come and kill us,’” Inbar said.

While the girls got to know each other, Inbar’s mother, Brigitte, found a women’s shelter in East Jerusalem for Rina. Whereas today Gaza is closed off by a military border under heavy surveillance, at that time it was porous. Brigitte drove Rina in to the capital, where she was given a new name and identity that would enable her to begin a new life, on condition that she contact no one in Gaza.

Today Inbar, who is 33, works at the Gush Katif centre in Nitzan – a museum dedicated to the memory of the Israeli settlements in Gaza. Despite her parents’ objections, the family was evacuated in 2005. Unlike most settlers in Gaza, some residents of Alei Sinai were determined to stay on, even if that meant forfeiting their Israeli citizenship. “I have no problem with living as a minority in a Palestinian state,” one of Alei Sinai’s inhabitants, Avi Farhan, told the Israeli daily Haaretz at the time.

Inbar now lives in Ashkelon, a city of 140,000 in southern Israel, and finds the big city alienating, especially when she recalls the warm relationships that once existed in Gaza. “I’ve never felt less secure,” she told me.

Years later, she learned that Rina had developed cancer and died. “The day before Rina left . . . she drew a portrait of me,” she said, describing how her friend had outlined, in charcoal strokes, the features of the teenager. Her parents packed the portrait with all their belongings in a shipping container the day they left Gaza. Soon after, the container was destroyed in a fire.

“I think if people had given it a chance . . . they would have had these kinds of friendships,” Inbar said, looking back. “We’d get along fairly well if we didn’t look at others as the monsters over the wall.” 

This article first appeared in the 27 August 2015 issue of the New Statesman, Isis and the new barbarism