Whatever your political persuasion, you now have to accept that there will be a Conservative Government for (up to) the next five years. The majority of voters felt this best for our future, but will it be the best for social care? The Tories’ manifesto was worryingly silent on this issue.
Whereas NHS funding is protected, social care funding remains at the mercy of cost-cutting exercises. The Institute for Fiscal Studies believes that there will need to be £30bn in real-terms cuts from ‘unprotected’ departments to keep pace with the planned budget deficit reduction.
Having recognised the importance of social care in reducing hospital admissions and the further part it could play in working with the NHS, I struggle with the logic of leaving its funding unprotected. Our sector is a key player in the conundrum of how to ease pressures on the NHS, yet it remains vulnerable to further cuts. Already a sector in crisis, I fear that social care will fall on even harder times and, to me, this seems counterproductive in the grand plans of an integrated system. It can, of course, be argued that social care will benefit from the pledged £8bn of extra funding for the NHS (by 2020) through the Better CareFund and the integration of health and social care services. But I think the sector deserves more than a maybe.
The Care Act came into being pre-election, described as the ‘biggest shake-up for 60 years’.
However, there are question marks surrounding a number of aspects of its delivery, including its affordability in times of increased austerity measures. The funding reforms will not take effect until next year but will, undoubtedly, fail if inadequately funded. Also, there is the funding required by local authorities to set up the new systems to make the reforms work in practice, for example, to track the care cap for self-funders. Another concern relates to the increased responsibilities placed on local authorities by the Act and the policing of how well they deliver on requirements.
For the Act to be as effective in practice as it is on paper it must be enforced. Yet already it would appear that deadlines for the implementation of aspects of the Act have passed without action. Let me give you an example:
My column in April’s edition of CMM highlighted that councils had a new statutory duty to manage third party top-ups from April 1st 2015. This, of course, is technically not a ‘new’ responsibility; it is what councils were meant to have been doing since 2004 (as stated in LAC(2004)20), but they rarely did.
The implementation of this duty under the Care Act was supported by the development of a ‘toolkit’, jointly produced by the Department of Health, Association of Directors of Adult Social Services and the Local Government Association. Beyond this, 1st April came and went but nothing seems to have changed. I am, as yet, unaware of councils approaching care providers to explain the procedure for top-ups or even to communicate a delay in its implementation.
Not only is the current limbo state confusing for care seekers and providers alike, it is also concerning. If a third party contests the legitimacy of top-up payments made directly to a provider during this period, will the local authority be held to account – or the provider?
Where are the Care Act police? What are the consequences for councils that miss a deadline?
This is not an encouraging start to the ‘big shake-up’ and is more than a little concerning if this is how the rest of the Act will roll out. For some the Act fell short of what was needed, without its effective implementation it will fall even shorter.
Do you agree with Robert? Join the debate below. Subscription required.