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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“Journalists are too scared to come”: Refugees on the forgotten war in Yemen

Only the few who have managed to flee the war-torn country can reveal the suffering of those left behind.

Last weekend’s BBC Our World report on the humanitarian crisis caused by the Yemen civil war highlighted that not only is the conflict a forgotten war, it is also an unknown war. Since war broke out 18 months ago in March 2015, surprisingly little has been written about the conflict, despite its similarity to ongoing and widely-reported other conflicts in the region, such as the Syrian crisis.

The main conflict in Yemen is taking place between forces allied to the President, Abdrabbuh Mansour Hadi, and those loyal to Zaidi Shia rebels known as Houthis, who forced Hadi to flee the capital city Sana’a in February. The loyalties of Yemen’s security forces are split, with some units backing President Hadi and others his predecessor Ali Abdullah Saleh, who is seen as the leader of the Houthi forces.

While these two forces have been at war, separate terrorist groups have been gaining more and more influence on the ground. Opposed by both the Houthis and Hadi’s forces, al-Qaeda in the Arabian Peninsula (AQAP) have staged deadly attacks from strongholds in the south and south-east. They are also opposed by Islamic State, which has claimed responsibility for a number of suicide bombings in Sana’a.

After rebel forces closed in on the president's southern stronghold of Aden in late March, a coalition led by Saudi Arabia responded to a request by Hadi to intervene and launched air strikes on Houthi targets.

I have spent the last couple of months working in the “Jungle” refugee camp in Calais, home to refugees from Sudan, Afghanistan, Syria, Iraq, Eritrea, Somalia – to name just a few. Having heard very little about the civil war, I was surprised to meet a handful of Yemeni men living inside the camp.

Hussein*, 28, is a film producer and dancer from Yemen who fled the country two years ago and has travelled through 11 countries to reach the Calais camp, where he has been living for just over a month. In a mixture of English and French, he tells me how groups of Houthi militia forcibly try to confiscate cameras and notebooks from both local and international journalists. He knows local journalists, friends of his, who have been threatened, tortured and even killed by Houthi forces.

He pulls out his phone and shows me a picture of his friend, Mohammed, who worked as a photojournalist, documenting brutality as a result of the war. Mohammed’s friends and family have not heard from him since April; the best-case scenario is that he is being detained, but Hussein seems pretty certain that he is dead. As a result, many who otherwise would have reported on the conflict have fled from besieged cities such as Sana’a, Aden and Taiz to the relative safety of the countryside in the north of the country, or have left Yemen altogether.

His friend Jamil, with whom he shares a tent, adds: “from other countries journalists [they are] too scared to come”. He claims that there are only “five or seven” foreign journalists in the capital city, Sana’a and tells me about journalists from the UK, France and the US who, after spending days being held up by countless militarised checkpoints while trying to reach the main cities, are then interrogated and detained by Houthi forces. If they are let go, they are harassed throughout their visit by National Security officers.

After watching his mother die during an airstrike in the city of Hodaida in January, Jamil took the decision to flee Yemen and claim asylum in Europe. He is worried about his father and his friends who are still in Yemen, especially after hearing reports that random border closures and cancelled domestic flights have been preventing crucial aid convoys of food, medical supplies and trained aid workers from accessing the citizens who are desperately in need of humanitarian assistance. Jamil reminds me that Yemen was in economic crisis even before war broke out, with widespread famine and limited access to healthcare or clean water.

Movement within the country is restricted and dangerous, and in the last twelve months alone, four Médecins Sans Frontières (MSF) facilities have been attacked and destroyed by airstrikes. Writing on 15 September 15, MSF head of mission in Yemen, Hassan Bouceninem spoke of:

“Other health centers, schools, markets, bridges . . . [that] have been attacked and destroyed by airstrikes, shelling, or bombs. Such attacks create direct victims but the war (economic failure, access problems, closing of hospitals, no health staff etc.) also causes a lot of indirect victims within the population.”

Such widespread instability and the resultant lack of access for journalists and aid workers means that it is difficult for the world to know how much Yemen is suffering. Only by speaking to the few who have managed to flee can even begin to grasp the realities of daily life for those left behind.

*Names have been changed to protect the identities of our sources.

Neha Shah has been volunteering in the Calais camp.