“The Conservatives are the real party of public services.” This was one of the many bold claims from the dispatch box during this year’s autumn spending review. But in the wake of the now-published adult social care reform white paper, this promise rings increasingly hollow.
Although austerity may for now be over, it is certainly not being undone and crucial services like adult social care have been left in an extremely precarious position. After years of significant underfunding, sector representatives have warned that the promises made in the spending review do little to address the disastrous state of adult social care. To provide a sense of the gap, analysis from the Health Foundation suggests that adult social care in England requires additional funding of around £7.6bn in 2022-23 rising to £9bn in 2024-25. This is needed to meet future demand, tackle unmet need and increase the prices paid for care so that providers can raise quality and wages.
There is also an acute need for more money in the here and now – to help crisis-hit care providers through the challenging winter ahead. Services are currently being stretched to breaking point and, alarmingly, care workers are quitting to become Amazon warehouse pickers in a growing staffing crisis that could leave 170,000 vacancies by the end of the year. In this fractious environment, and despite pleas for the injection of more money, the long overdue white paper, which finally appeared this month, offers no new funding to help with the immediate crisis.
The problem, however, is not just a lack of money in the system but a more fundamental lack of belief in the state to deliver public services. Three decades of incremental outsourcing and financialisation in the social care sector has left a legacy of fragmented services and a dependence on big capital providers. The consequence of this laissez-faire approach is a sector that is now more oriented to delivering private profit than to the needs of the people it is supposed to serve.
In the context of a broken system, one suggestion for public sector reform is the return to an approach reminiscent of the Cameron-era “Big Society”, with a number of Conservative MPs joining the call for more “community power” – in short, giving people control over the way that local services are run and putting public services and assets into the hands of mutuals, social enterprises and charities.
On the face of it, this is a step in the right direction. Communities absolutely should have a role in the planning and delivery of the services they use and their voice is often overlooked. However, there are currently many positive examples of the local state and community working together in partnership to deliver services such as adult social care – particularly in areas such as Wigan, Newham and Knowsley, to name but a few. Newham Council – to pull out just one fine example among many – is using commissioning opportunities with the voluntary, community and social enterprise (VCSE) sector to provide a more bespoke and personalised service and to promote its community wealth-building ambitions. For example, the council has recently commissioned a local social enterprise to run “memory cafés” and “music for the mind” sessions in Stratford and East Ham. These provide opportunities for people with dementia and their carers to meet in informal and social environments in their local community. In line with its community wealth-building aspirations, and as part of this commissioning arrangement, the council also insisted on the service paying the London Living Wage.
But, while the VCSE sector has a key role to play in the design and delivery of public services, it is not a panacea. For one thing, huge gaps in capacity and resilience affect the sector’s ability to participate. Take, for example, the 4,000 plus mutual aid groups that sprang up throughout the pandemic. Evidence suggests these groups emerged overwhelmingly in places with strong existing neighbourhood networks and a thriving social economy – in practice, more affluent communities that are better equipped to develop responses, compared to those with less capacity to mobilise resources and reach out to vulnerable groups.
And, let us be clear, the lack of networks to facilitate community action in many of our places is no accident. The austerity period since 2010 has contributed significantly to the erosion of social infrastructure. Starved of money by central government, UK councils have been forced to sell off 12,000 public spaces in the past decade. We’ve seen the closure of 800 libraries, the privatisation of leisure centres, as well as the demise of shopping centres in many areas. All of these developments have led to a decline in the availability of social spaces that are required for community collaboration and social participation.
With more money in the system, community power could be a positive agenda, promoting choice and control for service users. But in the absence of proper funding, calls for the community to play more of a role in the delivery of public services risks creating a slippery slope in which struggling communities are expected to deliver more with less. Dressed up in the language of empowerment, the reality is that this smokescreen will have the opposite effect, while also contributing to the weakening and hollowing out of local government and threatening the scrutiny, accountability and democratic oversight that the local state provides.
The swingeing cuts to local authority budgets have not been reversed. Any expectation that communities could pick up the slack is, at best, damage limitation. There is an urgent need to properly fund local authorities to deliver services such as adult social care and rebuild local social infrastructure, with due attention paid to the geographical inequalities in need and demand. We are in an era of political contestation and we ignore the UK’s austerity-addled political economy at our peril.
Tom Lloyd Goodwin is associate director of the Centre for Local Economic Strategies, a think and do tank promoting progressive economic policies for the UK’s councils.