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Social care is on the brink

Lambeth council Cabinet Member for Adult Social Care Councillor Jackie Meldrum blogs on the huge challenges facing the sector, with rising demand and huge Tory cuts pushing services to crisis point...

Adult social care is intrinsically linked with our National Health Service (as the current Hospital series on BBC2 about the five London hospitals in the Imperial College Healthcare NHS Trust has illustrated brilliantly).

Social care and the NHS effectively operate as a single sector, particularly as most people who have social care needs also have health needs. Adult social care is the responsibility of local government and provides non-medical care for the most vulnerable adults in our communities. Extreme financial pressures facing health and social care are leading to a crisis point in both these services.

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This crisis is extremely worrying as many of the people who rely on those services are some of the most vulnerable in our society. The most frequent type of service is provided by care workers who visit people in their own homes to help them get out of bed, wash, eat & keep their home clean. If not living in their family home people with disabilities may live in small scale shared homes run by voluntary or private sector organisations. Extra care housing schemes provide care when required for older people. People recovering from mental ill health may need help with day to day living as part of their recovery. When people are very vulnerable a nursing care home can be the best alternative.

There are many different arrangements – packages of care are designed around the individual’s circumstances. Social care is means tested, unlike the NHS and in Lambeth there are about 4,000 adults at any one time receiving some level of social care via the council. For those able to fund their own care the council can help with advice & information. 

With a growing older population however, demand for care services is rising rapidly. Across England there are already 1.5million people over the age of 80 and we are heading towards having a million people living with dementia. By 2030, we will have 15 million people over the age of 65, up from 11 million today.

Unfortunately, while demand is rising, the stark truth is that there is just not enough money coming from central government. Simon Stevens, the Chief Executive of NHS England has called for extra funding urgently. The crisis is such that we’ve even seen Tory Surrey council announce that they are holding a referendum on raising council tax by 15% to fund the care gap: in London there is an estimated £900 million shortfall in what we need to give our population adequate services.

In Lambeth, as in councils throughout the country, social care services are struggling because of these pressures. High housing and transport costs in London make it difficult to employ care workers meaning that the NHS, care agencies, care homes and other providers find it hard to recruit– so the public sector ends up with a high percentage of agency staff that cost more.

The pressures on the system mean that these issues are finally getting the media coverage they deserve. And, while as Labour councillors we have been highlighting the impact of government cuts for years, we are now seeing a cacophony of voices, from the care and health sectors to Tory MPs and councillors across the country, calling on the government to act.

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Sadly that pressure did not lead to any government action in the Autumn Statement last year. Instead the government solution has been to introduce a ‘precept’ option to add an extra 3% to council tax.  While we, like most councils across the country, will take this option, we know it is little more than a sticking plaster on the real problems the services face. 

It is time for a fully-funded, national solution to the adult social care crisis. We will continue to deliver our services in Lambeth, by working more and more closely with local GPs and hospitals, as efficiently and effectively as possible. But we will also continue to put pressure on the government to do the same. I urge everyone who wants to see our NHS survive this current care and health crisis to write to Philip Hammond, Chancellor of the Exchequer and David Mowat, Minister for Social Care,   asking for proper funding for both the health and care sector. Together, we need to demonstrate our commitment to these services, and our determination to reject this government’s plan to keep running them into the ground.

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