Chancellor Osborne is fond of wearing a hard hat. These days it is not uncommon to see him on a construction site – somewhere in the ‘Northern Powerhouse’ for example – looking resolute in a hi-vis jacket.
But Osborne may need protective gear of an altogether different sort if he fails to secure the future of ailing care services in the upcoming Spending Review.
Only a politician with their head in the sand could have missed signs of a looming crisis in social care. Funding has been dramatically cut, the older population is growing rapidly and – as our recent report shows – the sector is struggling just to recruit enough staff. The Chief Inspector of Social Care has acknowledged that these stresses and strains have started to affect safety, with
two in five care homes now rated as below standard.
Worse still, there are
400,000 fewer older and disabled people receiving care servicestoday compared with the situation just five years ago. To put that in perspective, that’s the same number as the population of Cardiff. A city’s worth of people with social care needs, going without.
And this has happened – silently, without causing a huge amount of outrage – as local councils have reduced by
£4.6 billion their adult social care budgets since 2009-10.
What this means is far fewer people with serious care needs getting the basic home help and practical support to get out of bed, get dressed and wash, with all the obvious consequences for their own health and, indeed, for the NHS.
Independent Age
estimates 70,000 older people with the most critical needs– unable to complete three or more basic tasks at home – aren’t getting any help.
We have also heard what could go wrong in the near future unless care services receive a major cash injection. The Care Minister, Alistair Burt, even recently admitted that the Government are
busy drawing up contingency plansshould a big care provider could go bust. Care providers are struggling to manage the twin demands of burgeoning numbers of older people who need their help, and shrinking fees paid by councils (their main customer) that simply don’t keep up with the real costs of care.
Four Seasons, Britain’s biggest care home operator with 470 homes, has debts of £500m. To make the overall picture gloomier still, credit rating agency
Standard & Poor’s has warnedthat the company could run out of money within six months. And this isn’t a one-off: we have recently heard how
37,000 care homes beds could be lostacross the sector in the next five years due to a £1billion funding gap.
Everybody in the know worries the next provider collapse will dwarf what happened in 2011, when the sector scrambled to finds places for thousands of vulnerable older people after Southern Cross collapsed.
The Chancellor knows how to dodge political brickbats. He has seen many damning reports from charities, think tanks, private providers and market analysts suggesting care services for older and disabled people are in crisis.
He is used to the dire warnings from Royal Colleges that the NHS is on the brink of collapse. And he has weathered many storms as local councils feverishly speculate when they will run out of cash.
As the Chancellor sets out his spending plans for the next few years, there will of course be a chorus of voices putting their case: the police federations calling for more bobbies on the beat; the generals calling for more boots on the ground; the doctors’ and nursing unions’ calling for more resources and funding for over-stretched hospitals.
But when the evidence points to a public service – and to a market – that has become so utterly dysfunctional, it would be incredible for any Chancellor to take timid action.
Earlier this year, the Government saved £6bn when it announced it would
delay a proposed cap on the cost of carefor individuals until 2020. The Government said at the time that this wasn’t just about saving money, but because our local authority administered care system wasn’t ready.
Well at the moment, that same care system needs at least an additional £700 million a year over the Parliament just to keep going. Unless the £6bn that was going to fund the care cap is now committed to social care, we worry that the quality of care services, and the numbers of older people able accessing them – will soon go into sharp decline. The social care sector may be just one of a chorus of voices, but – for the vulnerable older people we support - the consequences of refusing to listen to on November 25th are too scary to imagine.