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

Getty
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Martin McGuinness's long game: why a united Ireland is now increasingly likely

McGuinness died with his ultimate goal of a united Ireland arguably closer to realisation than at any other time since the island’s partition in 1921.

In late 2011 Martin McGuinness stood as Sinn Fein’s candidate in Ireland’s presidential election, raising all sorts of intriguing possibilities.

Raised in a tiny terraced house in the Bogside, Derry, he would have ended up living in a 92-room presidential mansion in Dublin had he won. A former IRA commander, he would have become supreme commander of Ireland’s defence forces. Once banned from Britain under the Prevention of Terrorism Acts, he would have received the credentials of the next British ambassador to Dublin. Were he invited to pay a state visit to London, a man who had spent much of his youth shooting or bombing British soldiers would have found himself inspecting a guard of honour at Buckingham Palace.

McGuinness would certainly have shaken the hands of the English team before the Ireland-England rugby match at the Aviva Stadium in Dublin every other year. “I’d have no problem with that,” he told me, grinning, as he campaigned in the border county of Cavan one day that autumn. Though a staunch republican, he enjoyed the “Protestant” sports of rugby and cricket, just as he supported Manchester United and enjoyed BBC nature programmes and Last of the Summer Wine. He wrote poetry and loved fly-fishing, too. Unlike Gerry Adams, the coldest of cold fish, McGuinness was hard to dislike – provided you overlooked his brutal past.

In the event, McGuinness, weighed down by IRA baggage, came a distant third in that election but his story was astonishing enough in any case. He was the 15-year-old butcher’s assistant who rose to become the IRA chief of staff, responsible for numerous atrocities including Lord Mountbatten’s assassination and the Warrenpoint slaughter of 18 British soldiers in 1979.

Then, in 1981, an IRA prisoner named Bobby Sands won a parliamentary by-election while starving himself to death in the Maze Prison. McGuinness and Adams saw the mileage in pursuing a united Ireland via the ballot box as well as the bullet. Their long and tortuous conversion to democratic politics led to the Good Friday accord of 1998, with McGuinness using his stature and “street cred” to keep the provisional’s hard men on board. He became Northern Ireland’s improbable new education minister, and later served as its deputy first minister for a decade.

His journey from paramilitary pariah to peacemaker was punctuated by any number of astounding tableaux – visits to Downing Street and Chequers; the forging of a relationship with Ian Paisley, his erstwhile arch-enemy, so strong that they were dubbed the “Chuckle Brothers”; his denunciation of dissident republican militants as “traitors to the island of Ireland”; talks at the White House with Presidents Clinton, George W Bush and Obama; and, most remarkable of all, two meetings with the Queen as well as a state banquet at Windsor Castle at which he joined in the toast to the British head of state.

Following his death on 21 March, McGuinness received tributes from London that would have been unthinkable 20 years ago. Tony Blair said peace would not have happened “without Martin’s leadership, courage and quiet insistence that the past should not define the future”. Theresa May praised his “essential and historic contribution to the extraordinary journey of Northern Ireland from conflict to peace”.

What few noted was that McGuinness died with his ultimate goal of a united Ireland arguably closer to realisation – albeit by peaceful methods – than at any other time since the island’s partition in 1921.

The Brexit vote last June has changed political dynamics in Northern Ireland. The province voted by 56 per cent to 44 in favour of remaining in the European Union, and may suffer badly when Britain leaves. It fears the return of a “hard border” with the Republic of Ireland, and could lose £330m in EU subsidies.

Dismay at the Brexit vote helped to boost Sinn Fein’s performance in this month’s Stormont Assembly elections. The party came within 1,200 votes of overtaking the Democratic Unionist Party, which not only campaigned for Leave but used a legal loophole to funnel £425,000 in undeclared funds to the broader UK campaign. For the first time in Northern Ireland’s history, the combined unionist parties no longer have an overall majority. “The notion of a perpetual unionist majority has been demolished,” Gerry Adams declared.

Other factors are also working in Sinn Fein’s favour. The party is refusing to enter a new power-sharing agreement at Stormont unless the DUP agrees to terms more favourable to the Irish nationalists. Sinn Fein will win if the DUP agrees to this, but it will also win if there is no deal – and London further inflames nationalist sentiment by imposing direct rule.

McGuinness’s recent replacement as Sinn Fein’s leader in Northern Ireland by Michelle O’Neill, a personable, socially progressive 40-year-old unsullied by the Troubles, marks another significant step in the party’s move towards respectability. As Patrick Maguire recently wrote in the New Statesman, “the age of the IRA old boys at the top is over”.

More broadly, Scottish independence would make the notion of Northern Ireland leaving the UK seem less radical. The Irish republic’s economic recovery and the decline of the Roman Catholic Church have rendered the idea of Irish unity a little less anathema to moderate unionists. And all the time, the province’s Protestant majority is shrinking: just 48 per cent of the population identified itself as Protestant in the 2011 census and 45 per cent Catholic.

The Good Friday Agreement provides for a referendum if a majority appears to favour Irish unity. Sinn Fein is beginning to agitate for exactly that. When Adams and McGuinness turned from violence to constitutional politics back in the 1980s they opted for the long game. Unfortunately for McGuinness, it proved too long for him to see Irish nationalism victorious, but it is no longer inconceivable that his four grown-up children might. 

This article first appeared in the 23 March 2017 issue of the New Statesman, Trump's permanent revolution