We can't afford a fight for resources

Friday, March 12, 2010

Better alignment of services and budgets are a vital part of the struggle to improve our currently failing system of care for older people, delegates at Public Service Events' Later Life conference heard. Alison Thomas reports

It is time to bring the debate to a close and start to take action on adult social care. And that should mean seeking a cross-party consensus and a unified attempt to persuade the public of the need to invest in caring for an ageing population, "one of the greatest challenges of our generation".

That was the message of Liberal Democrat shadow health minister Sandra Gidley to Public Service Events' Later Life Conference.

"We can't afford to dither any more, or to let petty differences get in the way of a unified and coherent strategy," Gidley told the London conference, which was sponsored by Partnership Life Assurance. "We must persuade the public that we need to invest – and that some of the money will come out of their pockets."

There had been years of missed opportunities to address the social care challenge, she claimed.

"With government departments preparing for cuts, the debates on how to solve our social care time bomb continue apace. And that's part of the problem – I can't remember how many conferences I have spoken at on the issue of social care and the need for change. It seems that's all we do – talk about it, at length.

"All parties know the answers aren't easy. The current method of means testing can't address the challenges. There is currently just not enough money being invested in care, regardless of what type of funding system or where the money comes from."

Gidley said the current means-tested system punished people who had worked hard and saved money, with Joseph Rowntree Foundation research suggesting that those most disadvantaged were people whose income was just above the means test threshold, but who could not afford to pay for long-term care.

"Means testing is to all intents and purposes a massive and disproportionate tax on those people who have up to this point lived their lives sensibly and prudently," she said.

There was acceptance that people should make some contribution to their care, and all political parties had to be up front about the costs of personal and residential care. But there were drawbacks to the partnership models put up for debate by the government – whether voluntary insurance schemes would be taken up by the public, for instance. And Conservative proposals for an £8,000 levy to be paid up front or taken from a person's estate would not bridge the immediate funding gap.

Stephen Burke, chief executive of Counsel and Care, called for radical ideas on financing care, such as a "care duty" tax in addition to death duties.

"We need a simple, consistent, transparent and flexible system," Burke said. "Currently it is unfair, under-funded and unsustainable, with a huge level of unmet need."

National Audit Office director for health Karen Taylor said a lot of the current care system budget was "spent badly, and not where people want or need it". But there was scope for immediate improvement to the current system, in addition to the long-term review.

"A big issue is the fact that the people spending their time caring for the old and most vulnerable are the least trained – that is something that could be addressed now, quickly," Taylor said. "And commissioners just don't have the information they need and the capacity to commission services in the most cost-effective way. The strategies are good but we don't see consistent implementation."

David Rogers, chairman of the Local Government Association's community wellbeing board, said social care had to be looked at in the context of a wider debate on improving wellbeing, using partnerships to coordinate policy objectives.

"The reality is we cannot meet the funding gap we all know exists in adult social care simply by doing what we are doing now in more efficient manner," Rogers said. "In this context additional money for adult social care must be part of wider debate on all money available to support wellbeing at local and national level.

"Partnership working is key to a reformed social care system, working with a whole range of services including health, housing, transport and leisure and the private and third sectors.

"We need better alignment of services and budgets and the relationship between social care and health is particularly significant, not least because both face a lengthy period of financial austerity over the next few years. This should not become a fight for resources."