Magazine article Public Finance

Time to Grasp the Social Care Nettle

Magazine article Public Finance

Time to Grasp the Social Care Nettle

Article excerpt

The warning from care services minister Ivan Lewis this month that there are no easy answers to the adult social care issue hardly came as a surprise. There are, nevertheless, huge expectations riding on next year's promised green paper, despite the backdrop of economic gloom and a nervy government.

The green paper can lay the foundations for reform, even if implementation is delayed. What is needed is a settlement that all political parties - and society as a whole - can sign up to: a framework to give individuals the confidence to plan ahead.

We are starting from a low base in older people's services. We have an overstretched system with a worsening divide between those who are eligible for formal social care support and those outside the system. At the same time, budget pressures are forcing councils to tighten eligibility criteria, causing real hardship. There is also a hugely complex landscape at local and national level - with diverse accountabilities, inconsistency and confusion over access and eligibility through which it is almost impossible for individuals to navigate.

How can we start to turn around an illogical system, where councils are having to juggle the 'competing' priorities of meeting critical needs and investing in prevention?

Reform has to start with the wider picture. Grants to councils should reflect just how crucial discretionary services are to the wellbeing of older people. Designing 'age-friendly' homes and neighbourhoods reduces the number of falls, combats loneliness and helps people remain independent.

We can build on the Department of Health's pilot Partnerships for Older People Projects, whose initial findings show that a focus on prevention reduces hospital stays and admissions, and cuts costs.

For prevention to improve, we need a more personalised system, with stronger partnerships and increased pooled funding. Such changes to funding will require additional, earmarked cash to protect frontline services.

Integrated services should move from being patchy and struggling to being deliberate and planned. In July, the all-party parliamentary local government group inquiry on older people suggested NHS money should be channelled to councils through Local Area Agreements, allowing investment in additional preventive services to reduce health costs.

The report, Never too late for living, said organisational boundaries between local authorities and primary care trusts should be progressively dismantled, leading to the merger of commissioning, led by the local authority. …

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