Funding of Care and Support

Lord Rix Excerpts

Thursday 24th November 2011 Lords Chamber

[Lord Rix]

My Lords, like others I welcome this very important debate and I commend the noble Baroness, Lady Pitkeathley, for affording her fellow Peers the opportunity to discuss this issue at such a timely moment. I also declare a personal interest as president of the Royal Mencap Society, an organisation that is greatly concerned about the current social care situation facing many people with a learning disability across the whole of the United Kingdom. In the context of the recommendations made by both the Law Commission and the Dilnot Commission about the reform of social care, there is clearly a demonstrable need and appetite for a change to the system to be achieved as soon as possible. While Government austerity measures have significantly reduced settlements to local authorities, it is important not to overlook the pre-existing underfunding that the social care system has experienced.

The Government spend around £16 billion per year on the provision of social care support, in comparison with £110 billion on health and £180 billion on welfare. Despite the vast number of individuals who rely on social care support to ensure their independence and dignity, these figures suggest that it has become something of an afterthought which merely succeeds in papering over the numerous cracks in the provision received by some of the most vulnerable members of society. I dare to suggest that extra funding awarded to social care, evenly distributed around the country, would reduce the NHS budget by a similar amount.

Matters are only likely to worsen. The number of people using social care is increasing and, within this demographic, the number of people with a learning disability is expected to increase by almost a third over the next 20 years. This is a group which is often highly reliant on social care support. Indeed, adults with a learning disability constitute 24 per cent of the social care budget, and so it is essential that their needs are met. However, this is increasingly not the case as the upward curve of social care need jousts with the downward spiral of funding per head in the system. Organisations such as Mencap and the Learning Disability Coalition warn that the consequence of this is that effective and appropriate social care provision is often increasingly out of the reach of a growing number of people with a learning disability.

According to recent research conducted by Mencap about local authorities’ eligibility criteria, 83 per cent of councils are only supporting people with critical or substantial needs, an increase of 10 per cent on the previous year. This reflects a wider culture of “tightening” eligibility criteria so that only those with the “greatest needs” are able to receive support, whereas those with milder or more moderate needs, who nevertheless still require social care support, stand to miss out. It indicates that, sadly, the funding situation for social care is worsening. Indeed, only two weeks ago, the courts ruled that plans by the Isle of Wight Council to provide assistance to those with critical needs and only for some people with substantial needs, was unlawful for failing to give due regard under disability legislation, alongside other reasoning. While it is encouraging to see that such action is being curtailed, there is the wider point that some councils feel obliged to make such contentious decisions as a result of the limited social care resources that they have at their disposal.

The real costs of underfunding become all the more quantifiable when individuals are affected. Susie is a 47 year-old adult with a severe learning disability, which means that, for all of her life, she has been the recipient of social care services and was able to attend a day centre five days a week. She was then offered the option of having a personal budget, which she accepted and, on reassessment, the council gave Susie a financial budget which amounted to only one and a half days’ worth of services.

What that case represents is the corner cutting that is happening throughout the country. But this is not a problem without a solution. What it does not require is yet more papering over the cracks. Instead, action is needed to bring about fundamental reform of the whole system in a way that does not shrink from making difficult decisions. It also requires a fundamental overhaul of the various processes, the various duties and the various means of support associated with social care provision.

This would help overcome the current postcode lottery of care that exists throughout the UK and which dictates that people with equal needs can receive wholly different outcomes purely as a result of where they live. Essentially, this brings together the recommendations of both the Law Commission and the Dilnot commission reports. The latter points out that the current system of funding of care and support,

“is not fit for purpose, and has desperately needed reform for many years”,

while the former urges that a wide of social care overhaul is required as:

“There is no single modern statute to which local authorities, service users, carers and others can look to understand whether services can or should be provided”.

While I fully appreciate the limitations of the current natural climate, the Government would do well to consider the wisdom of RH Tawney in the context of the future of social care when he wrote in The Acquisitive Society:

“As long as men are men, a poor society cannot be too poor to find a right order of life, nor a rich society too rich to have need to seek it”.