According to a report published by the Association of Directors of Social Services and the Local Government Association, there is a predicted shortfall of £1.8bn for social care, partly as a result of the funding crisis within the NHS, and partly because of increased costs, particularly for residential care, older people’s care and an unprecedented demand for services for children with learning difficulties.
Eight out of 10 councils are looking to respond by the tried-and-tested method of tightening the eligibility criteria for services – that is, to reduce the number of people who can get assistance by excluding those whose needs aren’t “critical” or “substantial”. Basically, unless you’re at risk of dying, or of your life completely falling apart without paid care, you will have to pay for it yourself, go without, or rely on relatives. We will force more people to become informal carers, and put more responsibility on those who care already.
Given that two out of 10 authorities don’t intend to tighten their eligibility criteria, what this means in practice is that we will have a greater postcode lottery in social care as well as health – and the poorest provision of either will probably be in the same geographical areas, hitting the same vulnerable people twice over: service users are, unsurprisingly, the heaviest users of the NHS.
I’ve been through this process before, when my local authority was in financial difficulties. At that time, every service user had to go through a “reassessment”, and it was clear that the assessors were looking to reduce costs by aiming to pare down care packages. We felt we had to justify each and every component of our care: did we really need so much social contact?
Could we manage with a few less hours of care each week? The process was desperate and demeaning.
The recent health and social care proposals emphasised the need for preventive interventions, so that people could be helped to maintain their independence: condoning cuts in budgets and services can only mean that users and their families will slide into greater dependency.