Social care is a vital public service providing care and support to disabled people to live the lives they want to lead.
At the moment many thousands of disabled people who need social care support do not receive it. Those who can afford to must pay for their own and those who can’t afford to must make do without.
We want to make sure that no one misses out on the social care they need because they cannot afford to pay for it.
Campaign update!
Thank you to all those of you that have written to your MP about why Social Care Matters. Over 1000 of you have sent letters so far and it really makes a difference.
Hopefully you’ll have received a reply, including a copy of a letter from Phil Hope, the Minister for Social Care. If like us, you found the letter a bit unclear, we’ve put together a guide below to explain just what it was the Minister was trying to say.
The Minister’s reply was very thorough but some of the MPs responses we’ve seen have not been. If you don’t know what your MP thinks about social care now is the time to write to them and ask them for their views.
We’ve written a letter which you can send to your MP asking them what they think about social care. Don’t forget this is in response to the letter you’ve received and if you add your own comments the letter will be much more effective.
DH response: "I note your constituents' concerns, but I should explain that it is for local authorities to manage their social care priorities and decide how resources shoudl be distributed. They should do this in accordance with locally determined practices and in the context of local accountability. However, in making these decisions local authorities also need to consider preventative services - helping people with lower needs to avoid admission to hospital or residential care."
Explanation: The Minister is right that it is for local councils to decide how to spend their money on what they think is most important. But this way of deciding how to spend often means that disabled and older people with lower and moderate needs don’t get the care and support they need, because their local council doesn’t think that their needs are important enough.
Much of a local authority’s budget comes from central government. If the government wanted to, they could tell local authorities that they should spend more of their money making sure that everyone who needs social care could get it.
DH response: Local authority funding for social services is derived from a variety of central Government sources and is also determined locally. Local authorities have received large real terms increases since 1997 in the funding they receive from the Government. These increases should be sufficient to fund their adults' social care commitments.
Central Government will provide more than £73 billion in 2009/10 for local authorities in England, a 4.3 per cent increase on 2008/09. This will increase to over £76.5 billion in 2010/11. By 2011, overall central Government funding for local services will have increased by 45 per cent in real terms compared to 1997. The total spent on Adults' Personal Social Services rose from £13.84 billion in 2003/04 to £15.27 billion in 2007/08, an average increase of 2.5 per cent per year in real terms.
Explanation: Since 1997 the NHS has seen an almost 90% increase in funding for health services. In comparison, local authorities have received a 40% budget increase and from that social care services have only received a 14% increase. But the costs of care are increasing, and demographic changes mean that more and more people need social care support. This means that increasingly the funding available just cannot keep up with demand – this is why more and more councils have tightened their eligibility criteria for social care. It is clear from the huge numbers of disabled and older people who aren’t getting the care and support they need that local authorities budgets are far from being sufficient to meet the need for social care services in their area.
DH response: We have developed an extensive transformation programme for adult social care to ensure that these resources are used effectively. Service users are already benefiting from greater choice and control over the support they need.
For many people with disabilities, better outcomes depend on health and social care services working well together. As part of our plans to improve services, we published Putting People First: a shared vision and commitment to the transformation of Adult Social Care in December 2007. This agreement sets out a cross-sector commitment to personalising services and the need for the state to empower people to shape their own lives and the services they receive. The three-year trasformation programme will put in place a high quality system that is easy to access and supports people to live independently, have choice about services and maintain control over their lives. This change is being supported by the Social Care Reform Grant, which makes £520 million of ring-fenced funding available to councils to support the necessary redesign and reshaping of social care over three years to 2010/11.
Explanation: The Minister is right that the way social care services are provided by local authorities and by private companies and charities is changing. But these changes will only benefit those disabled people who get council funded care services, or who can pay for their own care. These new ways of providing social care won’t help disabled and older people who don’t receive care from their local authority and who can’t afford to pay for their own care.
Leonard Cheshire Disability wants to see all disabled people who need it have access to these new services.
DH response: With regard to 'postcode lottery' in social care, we are committed to ensuring that everyone can get what they need from the support system. However, we cannot compromise the values on which the Welfare State was founded: funding should be targeted fairly to those who need it most. If extra care is not provided for those in greatest need then the less well off will subsidise those who can afford to contribute to care costs.
Explanation: The founding principles of the Welfare State were universalism and comprehensive coverage – this means that everyone should be able to get the care and support they need regardless of whether or not they can afford to pay for it. If the social care system better reflected the founding principles of the welfare state more people would be receiving the social care that they need.
DH response: Under Section 47 of the Community Care Act 1990, a local authority is required to assess the needs of any person who appears to them to be in need of community care services. The Department of Health published Fair Access to Care Services in June 2002, which provides councils with a national framework for setting eligibility criteria for adult social care.
The eligibility framework is based on risks that arise from needs associated with various forms of disability, impairment and difficulty and is designed to help councils to promote the independence of those seeking their help. The guidance prioritises the risks faced by individuals into four bands - critical, substantial, moderate and low - and requires councils to adopt these bands in determining their criteria.
Explanation: The Minister is right that it is for local councils to decide how to spend their money on what they think is most important. But this way of deciding how to spend often means that disabled and older people with lower and moderate needs don’t get the care and support they need, because their local council doesn’t think that they are important enough.
Much of a local authority’s budget comes from central government. If the government wanted too, they could tell local authorities that they should spend more of their money making sure that everyone who needs social care could get it.
DH response:In light of the concern that local authorities may focus on those groups with highest meeds, in January last year Department of Health Ministers asked the Commission for Social Care Inspection (CSCI) to undertake a review of the Fair Access to Care Services eligibility criteria, their application by councils and their impact on service users. CSCI engaged the Association of Directors of Adult Social Services, the Local Government Association and other relevant stakeholders in the process of the review. The subsequent report, Cutting the Cake Fairly, was published on 22 October last year. The report and the Government's response can be viewed on the Department's website at www.dh.gov.uk
The CSCI review has highlighted the differing interpretations placed on the Fair Access to Care Services guidance by local councils, some of which are contrary to the intention of the guidance, and areas of concern around additional rules introduced by councils that may exclude certain groups of users. I welcome the recommendation that we should rework the guidance to ensure that it is transparent and focuses on outcomes for people. We plan to work with key partners to revise the exisiting guidance and intend to consult on new guidance this year.
Explanation: The Minister is explaining here what the government is doing to try to tackle the postcode lottery in social care. In January 2007 the Government asked the Commission for Social Care Inspection, which regulated social care services, to review the guidelines issued to councils to help them work out whether someone has low, moderate, substantial or critical needs. The review found that different councils were using the guidelines in different ways, which means that in some areas disabled people are getting the care and support they need and in other areas they simply aren’t.
The government is going to publish new guidelines sometime this year and ask people who use the services and people who provide the services what they think of the new guidelines.
Leonard Cheshire Disability wants to make sure that the new guidelines mean that disabled people can get the same high quality care and support wherever they live in the country.
DH response:Over the longer term, the Government has acknowledged the need to reform care and support services to meet the challenges posed by a society in which people live longer and fuller lives and, quite rightly, expect more from care services. In May last year, the Prime Minister launched a six-month long public discussion to ask the public and stakeholders for their views about the future of care and support. This period has now drawn to a close and the views received will help inform a Green Paper, to be published this year, that will set out the key issues and proposals for reform. Further details are available online at www.careandsupport.direct.gov.ukExplanation: The government will publish proposals for changing the way the social care system works, probably in June. These proposals will be published in what is known as a Green Paper. A Green Paper is the first stage of the government introducing a new law. The Green Paper is a chance for the government to publish suggestions for what it wants to do and how it wants to go about doing it. Once a Green Paper has been published the public have a chance to comment on the Government’s suggestions and tell the government whether they think they are good ideas or bad ideas, and to suggest other ideas.
Once the government has published a Green Paper and received the views of those who want to comment on it, it then publishes a White Paper where it sets out what it is going to do. After that it publishes a Bill which is debated in Parliament before it becomes law. Because the time from publishing a Green Paper to introducing a Bill can be so long, sometimes over a year, it is likely that there will be a general election before any changes to the social care system can be made.
Before the next general election Leonard Cheshire Disability thinks it is really important that we know what each political party plans to do for people who use social care/
DH response:Finally, your constituents ask whether there are any plans for a social care constitution. Several clauses in the NHS Constitution refer to social care and its relationship with the health system. However, htere are currently no plans to produce a constitution specifically for social care. We are instead focusing on the publication of the Green Paper. The engagement process last year was extensive and looked at the underlying principles required to make the care and support system fair, affordable and sustainable in the long term. In particular, this involved a discussion of where responsibility for providing and paying for care should rest. Findings from the engagement exercise will be published at the same time as the Green Paper. As such, it would be premature to give further consideration to a social care constitution at this stage.
Explanation: The NHS Constitution was introduced by the Government to mark the 60th anniversary of creation of the NHS. It sets out what patients can expect from the NHS and what the NHS and NHS staff can expect from patients. The Minister doesn’t explain here what the clauses in the NHS Constitution that relate to social care mean for people who use social care.
Leonard Cheshire Disability would like to see a constitution for social care which sets out clearly what disabled and older people can expect from the social care system and what social care staff can expect from people who use social care. Having a constitution would make the social care system much easier to understand.
