by Nothing Personal from charity Help the Aged, older people are caught
between a rock and a hard place. The rock is the NHS, which has withdrawn from
almost all long-term care provision, while social services departments are the
hard place, able only to help older people who are most in need.
report blames under-investment in social care for the rationing of services to
older people. Changes in other policy areas, such as the NHS’s position on
long-term care, have put additional demands on social care services. Their
ability to cope has not been helped by the government’s refusal to follow the
recommendations of the Royal Commission on Long-Term Care and make all long-term
care free at the point of delivery. Other factors were changes to the capital
limits for residential and nursing home care and demographic pressures.
Following government guidance, social services departments have targeted their
resources on those most in need of support. Help the Aged is calling for more
money for community care from the government’s forthcoming comprehensive
Green, chief executive, Counsel and Care for the Elderly
"Help the Aged is absolutely right that there is both chronic
under-funding and rationing in the provision of community care for older
people. The solution lies in providing more money for services and a more
standardised and equitable approach to assessment. It is clear that the current
system is not working and needs urgent attention in both the way it is
financed, and in the way that it is managed by local authorities."
Frampton, national chairperson, Care Leavers Association
"If the current state of care for elderly people is considered inadequate,
projections that the number of people over 50 will increase by seven million in
the next two decades are alarming. The government needs to grasp the nettle of
closing the billions of pounds of tax loopholes for the rich. If they spell out
that this is needed to fund long-term assistance for older people, they will
have public sympathy."
Collier, chief executive, British Agencies for Adoption and Fostering
"It is very short-term thinking to restrict funding to those with the
highest needs. Clearly their needs must be met but if we neglect other
vulnerable people, we can expect an escalation in the highest need group in the
future. We have a real opportunity to maximise the independence of an ageing
population by offering them support now. Even if the case is not won on
humanitarian arguments, surely the financial case is overwhelming!"
Ross, social services director and primary care trust chief executive, London
Borough of Barking and Dagenham
"The real problem with rationing is that it feeds into the attitudes
of many older people – mustn’t grumble, mustn’t trouble the doctor, don’t make
a fuss…. Yet older people occupy almost two-thirds of hospital beds and are
three times more likely to be admitted to hospital than the general population.
So not offering the services they need through good primary and community-based
care is not only not fair, it makes no sense. We need to seriously empower
older people to expect and ask for better care earlier, really implement the
National Service Framework for older people, and not collude with age
Hudson, principal research fellow, Nuffield Institute for Health, University of
"It might seem churlish to be asking for more funding for community
care after the apparently generous budget settlement, but the reality is that
much of the money will go on reducing current ‘overspending’, meeting increased
national insurance contributions and paying ‘fines’ for bed-blocking. The NHS
settlement still needs a matching personal social services settlement. But it
would be reasonable for the government to require assurances that the money is
being spent on its intended purposes."