The Simon Heng column

During a web chat last week, health secretary Patricia Hewitt was asked about the increasing demands on the adult social care system. Her answer implied that the solution could come from anywhere: “We need to thinkabout how we share the costs between individuals, families and society through taxes.” The one thing she was sure about was that “we do need to get much smarter about how we use taxpayers’ money to support elderly people”.

Along with the news that many local authorities have struggled to meet the “efficiency savings” demanded by the government, and the warning that the increase in local authority funding will be less than inflation, the message is clear that central government still thinks that local government is wasteful and is not be ­trusted to regulate itself.

But it is central government that has raised expectations for adult care service users: that older people can expect to maintain their independence for longer, that disabled adults will be given more opportunities to control their lives and become more integrated into their communities, free of stigma and the threat of abuse.

Adult services are expected to implement these initiatives with no extra resources in fact, front-line care is being reduced in many parts of the country. Your needs now have to be critical, not just substantial, before many local authorities will offer help. This usually means that your life would be unsustainable within 24 hours if you didn’t receive help. How can any system look to be progressive, to enhance the quality of people’s lives when it is operated on such a knife edge?

Vulnerable adults protection, for instance, was meant to be led by local authorities it was supposed to involve local organisations and co-ordinate investigations of abuse, introduce preventive measures and change the cultures of organisations where abuse was acceptable, or just ignored. This was meant to be done from existing budgets: if a local authority invested in this in any meaningful way, how many hours of care, how many preventive measures would have to be cut to pay for this?


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