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.

Photo: Getty
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Donald Trump's inauguration signals the start of a new and more unstable era

A century in which the world's hegemonic power was a rational actor is about to give way to a more terrifying reality. 

For close to a century, the United States of America has been the world’s paramount superpower, one motivated by, for good and for bad, a rational and predictable series of motivations around its interests and a commitment to a rules-based global order, albeit one caveated by an awareness of the limits of enforcing that against other world powers.

We are now entering a period in which the world’s paramount superpower is neither led by a rational or predictable actor, has no commitment to a rules-based order, and to an extent it has any guiding principle, they are those set forward in Donald Trump’s inaugural: “we will follow two simple rules: hire American and buy American”, “from this day forth, it’s going to be America first, only America first”.

That means that the jousting between Trump and China will only intensify now that he is in office.  The possibility not only of a trade war, but of a hot war, between the two should not be ruled out.

We also have another signal – if it were needed – that he intends to turn a blind eye to the actions of autocrats around the world.

What does that mean for Brexit? It confirms that those who greeted the news that an US-UK trade deal is a “priority” for the incoming administration, including Theresa May, who described Britain as “front of the queue” for a deal with Trump’s America, should prepare themselves for disappointment.

For Europe in general, it confirms what should already been apparent: the nations of Europe are going to have be much, much more self-reliant in terms of their own security. That increases Britain’s leverage as far as the Brexit talks are concerned, in that Britain’s outsized defence spending will allow it acquire goodwill and trade favours in exchange for its role protecting the European Union’s Eastern border.

That might allow May a better deal out of Brexit than she might have got under Hillary Clinton. But there’s a reason why Trump has increased Britain’s heft as far as security and defence are concerned: it’s because his presidency ushers in an era in which we are all much, much less secure. 

Stephen Bush is special correspondent at the New Statesman. His daily briefing, Morning Call, provides a quick and essential guide to British politics.