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