Local Authority Grants: Impact of Cuts

Baroness Hollins Excerpts

Thursday 9th December 2010 Lords Chamber

[Baroness Hollins]

My Lords, perhaps I may first say how much I welcome this debate, and I have listened with great interest to the contributions.

In June, the Government stated their commitment to creating fairness in society, and dignity and respect for disabled people. It is against this backdrop that we are participating in today’s debate. We have already heard about the extent of the savings required by the comprehensive spending review, and I will not repeat them. However, there is no doubt that even with efficiency gains and other savings, cuts of this magnitude and over this timescale will pose a significant challenge to many of the services used by disabled people.

For too long, social care services have been the Cinderella of local government—underfunded, under-resourced and under-valued; and the important role that social care can play in helping to transform peoples’ lives is too often misunderstood. Many people who are disabled rely on social care services to live their lives and gain some independence. It might be a few hours’ help for them to go shopping, assistance in the home to help with domestic tasks such as cleaning, or even support in going to the cinema. All these examples and more demonstrate the importance of delivering effective social care and the huge difference that it can make to the quality of individual lives. Crucially, this support often allows disabled people to access other services such as education, health and transport.

I must disclose an interest here, because two of my adult children are disabled people who are in receipt of social care.

The pressures on social care services have not suddenly developed as a direct consequence of the CSR; if only that were the case. For many years now, local authorities have wrestled with increasing demands on their services, partly, as we have heard, as a consequence of demographic change and an increasingly elderly population. Local authorities have already rationed resources in an attempt to manage a range of competing demands.

There are 1.5 million people in the United Kingdom with a learning disability and I will focus my remaining remarks on their needs, to illustrate how one group of disabled people and their families may be put at risk by the proposed spending cuts. With respect to demographic change, we know that there are about 170,000 people with a learning disability who live with parents or carers who are over 70. As time goes on, both they and their carers will need support from social services in order to live their lives with dignity and respect. In addition to a high number of older carers, the number of people with complex needs is also increasing; and this combined with longer life expectancy means that demand for social care services is increasing and will be needed for longer. The number of people with a learning disability who need services has also been increasing by between 3.5 per cent and 5 per cent per year—much faster than anticipated.

These challenges and others have led councils to tighten their eligibility criteria to make a greater use of charging, and to reduce services. In recent years, most local authorities of all political persuasions and none have decided to reduce the services they provide to only those with “critical” or “substantial” needs, in an attempt to balance the books. Following the latest pressures on resources, those few local authorities which still provide social care services to those regarded as having only “moderate” needs are in the process of consultation about removing the remaining services.

It is in response to long-standing pressures on the social care system that the Learning Disability Coalition, or LDC, was established in 2007 in an attempt to address these concerns and to lobby the Government for change. My noble friend Lord Rix, who cannot be here today, would want to speak about the LDC as president of Mencap, because the LDC is a coalition of 14 member organisations such as Mencap, People First and Turning Point, and was set up to make the case for better social care services. The LDC argues that people with a learning disability are entitled to have the same choices and life chances as everyone else, as indeed is laid out in the UN Convention on the Rights of Persons with Disabilities. However, in order to make these choices, we need a social care system that is fit for purpose and helps to empower people.

It is for this reason that I welcomed the announcement in the CSR that an additional £2 billion would be allocated for social care over the next four years, some being to support joint work between health and social care. However, as part of the coalition Government’s commitment to localism, we know that the additional funds to local authorities will not be ring-fenced. What guarantees will we have that GP consortia will spend the additional NHS funds as intended? There are no guarantees that the extra money will end up being spent as the Government intend it should be. What sanctions will the Government have if GP consortia do not do so?

Recent evidence from the King’s Fund shows that an increase in spending on social care for a person actually decreases the amount which needs to be spent on their healthcare. Short-term cuts in social care today can lead to long-term consequences tomorrow.

Failure to provide support to people with a learning disability can increase the risk of social exclusion and offending behaviour, and can lead to health problems, particularly mental illness. This can lead to expensive acute intervention when a person reaches crisis point. Sadly, some specialist psychological help that is available to other citizens, for example through the improving access to psychological therapy programme, is not being made routinely available to people with learning disabilities, and thus the stitch in time that might be expected to ameliorate relationship and lifestyle difficulties is not provided for them.

The personalisation approach is to be welcomed, but there are more challenges inherent in implementing it for this group. People with a learning disability are some of the most vulnerable in society, and are less able to advocate for themselves to ensure the fairness that this Government are committed to achieving. Does the Minister agree that whatever reductions in social care budgets are made in the future, people with learning disabilities must not be made to bear an unfair share of the cuts?