National director for social care Kathryn Hudson acknowledged last week that inadequate funding had been a recurring theme in responses to the adult services green paper.
Launching an analysis of consultation responses at the National Social Services Conference, Hudson said the Department of Health had heard the message about resources “loud and clear”.
The report’s foreword, written by care services minister Liam Byrne, appears to confirm that the department has dropped its previous insistence that the green paper’s vision was “cost neutral”.
While noting that the 1,511 response submissions gave “overwhelming support for the vision we set out”, Byrne says they “also tell us that these ambitions will require resources to achieve them”.
He lists the extra money being pumped into the system – £60m for pilots on preventive services, £80m for telecare and £80m for extra care housing and, inevitably, savings made through efficiencies.
But he also says the consultation responses provide “invaluable evidence to inform our work for the next spending review”.
He suggests relaying to colleagues at the Treasury the view among respondents that there is already great pressure on existing resources – something that will increase as the population ages.
The proposed shift to preventive services also provoked “significant concerns” about “the ability to facilitate this shift within existing resources”, the report says.
Concerns were raised that resources should not be diverted from people who have high-level needs or may have them in the future, and there was scepticism over whether a preventive shift might be sustained.
The Audit Commission, in its response, suggests the evidence base for the long-term benefits of prevention is “underdeveloped”.
Recruitment and retention of staff were considered by more than half of respondents to be a significant problem, with a “universal level of concern” about pay.
“There was a perception that this should be tackled in advance of other issues relating to recruitment, retention and cultural change,” it adds.
British Association of Social Workers director Ian Johnston says pay needs to be improved “to make sure it really is on a par with similar occupations”.
But he says there needs to be far greater appreciation of the demanding nature of social care work and more ways to sustain people over the long term in a stressful job.
The report says respondents felt that the quality and quantity of available training was “inappropriate”, and Johnston says there is insufficient training capacity to meet the interest in social work careers.
Together with the IT improvements needed to support a new system of service user choice, respondents’ calls for greater investment in the workforce, prevention and the ageing population appear to have undermined the cost-neutral theory.
Jennifer Rankin, health and social care researcher at the Institute for Public Policy Research, says the government does appear to have softened its stance by even acknowledging the sector believes more resources are necessary.
And she believes last week’s announcement of a joint health and social care spending review submission by health secretary Patricia Hewitt might mean there will be more resources to fund what appears a popular green paper vision.