The social care system is on its knees: what is the Chancellor going to do?

This week's Spending Review and next week's Lords debate of the Care Bill provide the government with opportunities to start solving our care crisis.

On Wednesday millions of older and disabled people who rely on support from their council to get up, get washed and dressed and get out will be closely following the Chancellor’s Spending Review.

The social care system is on its knees.

Budget cuts to councils have seen them upping the bar for eligibility for support, with 83 per cent of councils now setting the threshold at a higher level. According to London School of Economics 69,000 disabled people have been pushed out of the system.

At the same time many are squeezing the support for those that are in the system. A Scope survey found almost 40 per cent of disabled people who continue to receive social care support are not having their basic needs met including eating properly, washing, dressing or being able to get out of the house.

The consequences are dire. Take away the preventative support and people fall into crisis.

It’s no surprise that there’s now a widening consensus that the crisis in local care is a factor in the pressures on A&E.

It’s also no surprise that there’s cross-sector and cross party backing for the Chancellor to use the Spending Review to invest in preventative social care.

Intriguingly on Friday there were strong hints that the Department for Communities and Local Government, while potentially taking a 10 per cent budget cut, could take responsibility for £3bn from other departments' budgets.

The momentum is there and social care looks set to be a crucial Spending Review issue.

But in case the Chancellor needs further convincing let me introduce Angela Murray.

Angela is an independent, sociable young woman who has a degree in psychology. She volunteers three days a week. She’s also disabled; she was hit by a car when she was two.

For the last ten years, she’s lived in her own home and has had support from her council to get up, get washed, get dressed, go to the toilet, cook, eat and shop.

But recently her social worker told her that her care was being cut from 20 hours-a-day to just three hours. Angela was given five days’ notice.

Angela described her new care routine as ‘depressing and undignified’. She had to be in bed at 9.30pm every night. She also lived off microwave meals because her 30 minute evening call didn’t give the carer enough time to cook for Angela as well as take her to the toilet.

Angela says if she has to live under that regime for the next 50 years, life would not be worth living. She’s fighting back: the local media have already covered Angela’s story and she has a solicitor on board fighting the changes.

The council, reluctantly, agreed to temporarily reinstate Angela’s old care package until a second reassessment, when her care package is likely to be cut again.

And while we’re at it, let me also introduce the 45,000 members of the public who have signed Angela’s petition calling on the Chancellor to invest in social care. It’s clear that Britain cares about social care.

Wednesday will be crucial. But it doesn’t stop there.

The following week the Government will publish its plans for deciding who is in and out of the social care system. This is critical.

The announcement will come as the Care Bill is debated in the Lords. The reforms seek to tackle the crisis in care by introducing a cap on costs, a new means-testing threshold and national eligibility to end the postcode lottery in care.

But the plans, as they are, will also raise the bar for eligibility to social care (see p32 of the White Paper). According to the London School of Economics (LSE) this will leave 105,000 disabled people outside of the system altogether.

If the Chancellor takes the opportunity to invest in social care, that cash needs to be channelled into a system in which disabled people are eligible for care before their situation has deteriorated into crisis.

Properly funded social care is now a ‘no brainer’.

Research by Deloitte has shown that investing in £1.2bn in social care for disabled people will result in a £700m return for central Government and £570m return for local Government and NHS, because it prevents disabled people falling into crisis and needing to access more costly support.

By acting decisively the Chancellor can go a long way to solving the social care crisis, protect A&Es, and save cash across government departments. It’s a triple win.

But the Government will only be able to claim that it’s solved the social care crisis once it has decided who is in and who is out of the system.

Richard Hawkes is chief executive of the disability charity Scope

Take away the preventative support and people fall into crisis. Photograph: Getty Images

Richard Hawkes is chief executive of the disability charity Scope.

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France is changing: an army stalks the streets and Boris Johnson wanders the Tuileries

Will Self on the militarisation of France, and Boris Johnson at the Foreign Office.

At the corner of the rue D’Hauteville and the rue de Paradis in the tenth arrondissement of Paris is a retro-video-games-themed bar, Le Fantôme, which is frequented by some not-so-jeunes gens – the kind of thirtysomethings nostalgic for an era when you had to go to an actual place if you wanted to enter virtual space. They sit placidly behind the plate-glass windows zapping Pac-Men and Space Invaders, while outside another – and rather more lethal – sort of phantom stalks the sunlit streets.

I often go to Paris for work, and so have been able to register the incremental militarisation of its streets since President Hollande first declared a state of emergency after last November’s terrorist attacks. In general the French seem more comfortable about this prêt-à-porter khaki than we’d probably be; the army-nation concept is, after all, encrypted deep in their collective psyche. The army was constituted as a revolutionary instrument. France was the first modern nation to introduce universal male conscription – and it continued in one form or another right up until the mid-1990s.

Even so, it was surprising to witness the sang-froid with which Parisians regarded the camouflaged phantoms wandering among them: a patrol numbering eight ­infantrymen and women moved up the roadway, scoping out doorways, nosing into passages – but when one peered into Le Fantôme, his assault rifle levelled, none of the boozing gamers paid the least attention. I witnessed this scene the Saturday after Mohamed Lahouaiej-Bouhlel ran amok on the Promenade des Anglais in Nice – it was a little preview of the new state of emergency.

On Monday 18 July the French premier, Manuel Valls, was booed at a memorial service for the victims of the Nice attacks – while Marine Le Pen has been making all the populist running, whipping up anxieties about the enemy within. For many French, the events of the past week – including the failed Turkish coup – are steps along the way limned by Michel Houellebecq in his bestselling novel Submission; a via dolorosa that ends with La Marianne wearing the hijab and France itself annexed by a new caliphate.

Into this febrile drama comes a new player: Boris Johnson, the British Foreign Secretary. What can we expect from this freshly minted statesman when it comes to our relations with our closest neighbour? There is no doubt that Johnson is a Francophile – I’ve run into him and his family at the Tuileries, and he made much of his own francophone status during the referendum campaign. In Paris last winter to launch the French edition of his Churchill biography, Johnson wowed a publication dinner by speaking French for the entire evening. He was sufficiently fluent to bumble, waffle and generally avoid saying anything serious at all.

Last Sunday I attended the Lambeth Country Show, an oxymoronic event for which the diverse inhabitants of my home borough gather in Brockwell Park, south London, for jerked and halal chicken, funfair rides, Quidditch-watching, and “country-style” activities, such as looking at farm animals and buying their products. Wandering among ancient Rastafarians with huge shocks of dreadlocks, British Muslims wearing immaculate white kurtas blazoned with “ASK ME ABOUT ISLAM” and crusty old Brixton punks, I found it quite impossible to rid my mind of the Nice carnage – or stop wondering how they would react if armed soldiers were patrolling, instead of tit-helmeted, emphatically unarmed police.

I stepped into the Royal Horticultural Society marquee, and there they were: the entire cast of our end-of-the-pier-show politics, in vegetable-sculpture form and arrayed for judging. There was Jeremy Corbyn (or “Cornbin”) made out of corncobs – and Boris Johnson in the form of a beetroot, being stabbed in the back by a beetroot Michael Gove. And over there was Johnson again, this time rendered in cabbage. The veggie politicians were the big draw, Brixtonians standing six-deep around them, iPhones aloft.

The animal (as opposed to the vegetable) Johnson has begun his diplomatic rounds this week, his first démarches as tasteless and anodyne as cucumber. No British abandonment of friends after Brexit . . . Coordinated response to terror threat . . . Call for Erdogan to be restrained in response to failed coup . . . Blah-blah, whiff-whaff-waffle . . . Even someone as gaffe-prone as he can manage these simple lines, but I very much doubt he will be able to produce rhetorical flourishes as powerful as his hero’s. In The Churchill Factor: How One Man Made History, Johnson writes of Winnie overcoming “his stammer and his depression and his ­appalling father to become the greatest living Englishman”. Well, I’ve no idea if Bojo suffers from depression now but he soon will if he cleaves to this role model. His Churchill-worship (like so many others’) hinges on his belief that, without Churchill as war leader, Britain would have been ground beneath the Nazi jackboot. It may well be that, with his contribution to the Brexit campaign, Johnson now feels he, too, has wrested our national destiny from the slavering jaws of contingency.

Of course the differences between the two politicians are far more significant: Johnson’s genius – such as it is – lies in his intuitive understanding that politics, in our intensely mediatised and entirely commoditised era, is best conceived of as a series of spectacles or stunts: nowadays you can fool most of the people, most of the time. This is not a view you can imagine associating with Churchill, who, when his Gallipoli stratagem went disastrously wrong, exiled himself, rifle in hand, to the trenches. No, the French people Johnson both resembles and has an affinity for are the ones caught up in the virtual reality of Le Fantôme – rather than those patrolling the real and increasingly mean streets without. 

Will Self is an author and journalist. His books include Umbrella, Shark, The Book of Dave and The Butt. He writes the Madness of Crowds and Real Meals columns for the New Statesman.

This article first appeared in the 21 July 2016 issue of the New Statesman, The English Revolt