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England’s catastrophic plunge into an uncaring society

Government spending cuts are transforming the crisis in social care into a catastrophe for vulnerable citizens across the whole country.

Stuart Weir
14 September 2015
cameron_1.jpg

Flickr/The Prime Minister's Office.

In typically restrained language the Conservative controlled Local Government Association has warned the government that the continuing slashing of funding for the work of local authorities in England is unsustainable. The government already knows this. The National Audit Office issued a stronger warning back in 2014. But this is a government which is as careless as it is incompetent and uncaring.

In response to a report on the Department of Communities and Local Government concerning local authorities in England (NAO, Financial sustainability of local authorities 2014, 19 November 2014), the Comptroller and Auditor General concluded:

Local authorities have worked hard to manage reductions in government funding at a time of austerity. At the same time, there is evidence of some service reductions. The Department really needs to be better informed about the situation on the ground among local authorities across England, in a much more active way, in order to head off serious problems before they happen. It should look for evidence of financial stress in local authorities to assure itself that they are able to deliver the services for which they are responsible. It should be clear about the knock-on effect of the various funding decisions taken by departments in Whitehall.

The NAO report found:

-  Increasing concern amongst local auditors about the future financial sustainability of some local authorities and their capacity to make further savings. This was particularly the case with single tier and county councils [i.e., social care authorities] given the scale of the savings they had already made;

-  The Department did not have an adequate means of measuring the “scale of the financial challenge facing local authorities over time”;

- The Department expected local authorities “to manage future funding reductions by transforming the way they deliver services but has limited understanding of the size and timing of resultant savings”; and

- “None of the submissions” the Department obtained from relevant spending departments to inform its comment to HM Treasury on a proposed 10% reduction in the main component of government funding to local authorities in 2015/16, “assessed the capacity of different types of authority to manage further reductions”, “Service areas such as . . . youth services  . . . were not covered.” [The proposed 10% reduction was made].

In short, in making crucial funding decisions affecting local government, the government was not well enough informed, did not know what the effects of its previous decisions had been, and did not know what the effects of its future decisions would be. The government made uninformed assumptions about local government’s ability to make savings through so-called “service transformation”, and was not sufficiently in touch with the reality of local government to assess the risks of different decisions for the people they affected and for the very financial sustainability of local authorities. Only the careless could be on the receiving end of such an excoriating indictment.

Experience since then indicates that the situation has not improved. The further £20 billion of “consolidation” to be achieved in the current “stringent Spending Review” to be announced by the government in the autumn will make things far worse because local government will continue to be outside the many protected areas of government spending - further extended in the summer budget to include the previously unprotected area of defence.

We have already had another crisis warning last month about the impact on social care from Andrea Sutcliffe, the nation’s chief inspector of adult social care, who said that funding cuts have broken the social care sector; the LGA is alarmed at the prospect of paying Osborne’s false “living wage” next year. But none of the official expressions of concern come anywhere near grasping the sheer scale and human detail of the government’s ruthless drive to cut spending.

A meticulous investigation into the social care services for vulnerable residents in Cambridge and Cambridgeshire, Social Care – from Crisis to Catastrophe, published this week by the Cambridge Commons group, shows just what awaits the quality of care across the whole of England.

The author, David Plank, a respected former local government chief executive and director of social services, is not given to exaggeration. Yet he concludes that a crisis in social care in Cambridgeshire has become a catastrophe “to which no end is in sight”. Drawing on the NAO report, he concludes that an unending catastrophe in care is happening not just in Cambridgeshire but across England.  

There are, I think, three dimensions to this catastrophe: first, for all the individual families and individuals who will get less care than they need, or none at all; secondly, for their carers, who are often either young or elderly and frail; and finally,  at the level of a community, where will be a marked loss of compassion and humanity, we are in danger of descending into an uncaring society.

Plank reviews Cambridgeshire County Council’s spending on social care from 2013 to 2020. He shows how escalating government cuts in the council’s funding are imposing devastating cash limits and “savings” on care services not only for older people, but for children, the disabled and other vulnerable groups as well.  

He says: “The effects of the cuts on people in Cambridgeshire are devastating. Older people in residential care and at home are having their incontinence pads changed less frequently and are at increased risk of distressing incontinence; adults with learning disabilities receive crisis care only and are less able to live independently; people with mental ill-health have greater difficulty getting a much needed place in residential care; children in care are at greater risk of abuse, mental health issues, homelessness and prison; even support to disabled children and their families has been reduced; and huge strain is being placed on the army of informal carers upon who we rely most to care for these people. Many are on low incomes, in poor living conditions and harmed by benefits reductions.

“This is all happening at a time when the number of people needing care is going up rapidly and more resources are urgently required. Instead resources locally and nationally are being cut and cut again. This is the hidden side of the austerity programme. Are we really to believe that, of all people, our most vulnerable fellow citizens must bear the brunt of this? No, if we really are all in it together, the government will right this wrong now. It has the opportunity to do so in this November’s Spending Review announcement.” 

Context

David Plank’s report follows on from a recent Cambridge Fairness Review, Cambridge: Wealth and Want, which examined the effects of inequality and austerity on poverty, housing, care services, state benefits, hunger and distress in the iconic city.

Nationally, the  NAO has identified a real terms reduction of 37% in central government’s funding of English local authorities since 2010. This is a reduction of one quarter in local authorities’ total income. As the NAO acknowledges, most local authorities have sought to protect social care. But the funding cut is so great that this became impossible some years ago.

In the last two years, the social care services in Cambridgeshire have had to make “savings” totalling nearly £58 million a year. By 2019/20 this increases to nearly £126 million a year when it is anticipated that the government’s Revenue Support Grant to the County Council will have ceased altogether. These massive sums are required to keep the County Council in the black and to meet some of the pressures arising from population change and additional statutory responsibilities such as the new duty towards informal carers.

And this at a time when high priority demand is going up, particularly amongst the very old but also among disabled people of all ages as birth survival and longevity have improved. In Cambridgeshire, for example, the number of people aged 85 or over, whose individual needs are greater and more complex, is projected to increase by 49 per cent between 2011 and 2021. At the very time when resources for social care should be going up they are in fact going down - and massively so.

The effects at the receiving end are devastating. The most vulnerable children, young people, disabled adults and older people, and their informal carers, are having the services upon which they rely for a minimally reasonable life, cut and cut again; many of whom are on low incomes, in poor living conditions and adversely affected by benefits reductions. Yet even bigger cuts are to come. Despite the political rhetoric from government, says David Plank , “no amount of ‘service transformation’ and improved working methods can bridge this huge gap. Service cuts are happening up and down the country way over and above savings from better practice and improved cost efficiency.”

Therefore, he says, “it is no surprise whatsoever that the Care Quality Commission is receiving even more allegations of abuse." The state relies not only on hard-pressed, poorly paid staff but also, and much more so, on the army of informal carers made up of often frail elderly spouses, parents, brothers, sisters, and many others. Cuts in support to those they care for and to themselves, are pushing some informal carers way beyond the tether; aggravating ill-health and exhausting even the most resilient in the face of demands night and day, increasingly now without the prospect of any respite. The cuts also increase the likelihood of abuse of informal carers as more and more people feel frustrated and confined, cut off from the outside world, with greater risk of “challenging behaviour”.

 

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