Me with my Carer!! Erica and I hope that we have a long, healthy and happy third age but we must all be aware of the problems that we face as longevity increases.
I am attending three events next week looking at adult social care. This is good because it means that adult social care is now firmly on the agenda of many organisation.
Like many I was pleased that adult social care became a prominent feature of the General Election. Again, like many, I was displeased with the way that it became a political football largely because of the crass Tory U-turn on a U-turn within days during the election.
The Government has put an extra £2 billion into the system this year. BUT that money will not be as well or properly spent as it could be. The Government has, three months into the financial year introduced a number of national priorities about how the money should be spent and financial penalties to councils if the money is not used to meet centrally defined targets. Those targets are not always the ones that are most relevant in specific areas. For example, money is currently needed in most council areas to stabilise and support the present system and its providers. This need has largely been ignored by the Government who expect new services for their money.
The injection of an additional £2 billion for social care in the Spring Budget is, of course a step in the right direction. But it is not sufficient to deal with all immediate- and short-term pressures. The LGA estimates that social care faces an annual funding gap of £2.3 billion by 2019/20.
It is now vital that the Government brings forward its proposals for the future of social care as a matter of urgency. Lib Dems believe that cross-party consensus is an essential foundation for the process of developing viable solutions for the long-term. This is not a problem capable of a quick fix. The demographic changes are long term. More of us will live longer and with more time in ill health. Unless we understand that the system is unsustainable. It’s not only a problem for the elderly. Increasingly, children who would have died at birth or at a very young age are living lives almost long as children born without such difficulties. That surely is a good thing but it comes at a cost. Looking after such people and adults can cost up to £50,000 a year.
The Government’s proposals must not focus solely on funding and mechanisms to bring more resource into the system. As important, we need to consider what type of care and support system we want for the future; this must include exploration of the clear links between care and housing. One of the events I am going to presided over by Baroness Greengross in the House of Lords is a meeting with the trade body for retirement villages. There is clear proof presented by them that if we can organise housing better it impacts well on the health and experiences of the elderly. It also saves a shed load of money because necessary services can be provided cost effectively.
But retirement villages are only one option. There is an urgent need to better provide a range of housing options to meet the wide variety of housing circumstances, aspirations and needs of people – our family, friends and communities – as they age. There is both growing evidence and a clear policy steer towards recognising and strengthening the role of housing in relation to a range of health and wellbeing issues including how well designed housing for older people can help reduce the need for adult social care and demand on NHS services (e.g. reducing residential care admissions, preventing hospital admissions/reablement, combatting isolation or loneliness, better at home care coordination, a wider community resource, and opportunities for greater personal and community resilience).
Within the diverse mix of different strategies – from building new age friendly homes, to shaping and enabling the market, integrating housing with health and care, and developing new models for adapting and creating smart homes – local leadership and collaboration between local partners is critical throughout.
Whilst it is clear that councils can help enable partnership working to deliver improved outcomes through housing, it is not easily replicated. Local government needs the resources, the tools and, crucially, the buy-in from all health and housing partners, to make it happen.
Outside housing there is much that councils could do to reduce the length of ill health by the positive promotion of good health strategies. The work that we do with our parks; community centres; libraries; bus passes; good eating campaigns; companionship programmes, often done for us by community groups are every bit as important. But these services are increasingly under threat. Council’s budgets have been cut by anything between 25 and 50% by the reduction in central government grant.
Indeed at present we have no idea what our budgets will be in 3 years’ time as the Government has back tracked on its proposal to leave all business rates with local authorities. Most urban authorities with high densities of poverty cannot cope with just the 50% business rate, council tax and service charges. Unless we get clear direction quickly for what will happen after March 2020 we will be unable to properly plan for the delivery of services with long-term contracts. Unless we can give long-term contracts, we will continually have to ‘spot buy’ services which are not as good and more expensive.
So things are not looking good either for the elderly; those moving into that category; or those that provide services to them. It goes without saying that in the Lib Dem view we must try and reach a consensus on these issues and set in place a structure and funding which will stand the test of time.