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In a new report, a coalition of older people's organisations including Age Concern and Help the Aged blames underfunding for the bottlenecks in the care system. Such is the shortage of services, the National Service Framework for Older People and the NHS Plan itself could be scuppered, the coalition says. The picture is made bleaker by the fact that the government has earmarked an extra £900m for intermediate care and £300m to bring an end to "bed-blocking" by 2004. Far from helping social care agencies find the answers, these initiatives are now more likely to be used as a stick to beat them with when lasting solutions fail to materialise.

Social services departments already spend £4bn a year on older people's services, which is 9 per cent more than the government gives them to spend on these services. Beside these figures, the extra money is a drop in the ocean. Health secretary Alan Milburn's obsession with waiting lists and hospital discharge targets has skewed spending priorities in a way that damages the interests of older people and undermines the government's own objectives. Fewer older people are receiving home care even though the main recipients, those over 85, are more numerous than ever. More therefore have to be admitted to hospital in an emergency. The result? A seemingly endless cycle of emergency admission and discharge, and unacceptable waiting lists for less urgent cases.

Government policy has also been thrown off course by the crisis in residential and nursing home care. More than 35,000 beds have been lost through care home closures in the past three years and the fees paid by local authorities to those that remain are inadequate. The free nursing care payments intended to help clients are being used by many home owners just to make up the shortfall.

Yet there are many innovative ideas that, with more investment and more autonomy for social care agencies to decide their own priorities, could make preventive care a reality for older people in their own homes.

Local government secretary Stephen Byers and home secretary David Blunkett have recently held out the promise of more independence from the centre for the public sector. Older people will wait in hope.

- See news, page 8

Haringey's real lessons

Haringey's North Tottenham office at the time it dealt with Victoria Climbie‚'s case is not typical of local authority child protection work. Unless you work there, the revelations about Haringey's past and seeming inability to co-operate with the inquiry in a helpful or efficient manner should be seen as a macabre sideshow. We must be wary of making it the main event.

However, there are elements of the crisis in Haringey which do apply elsewhere: a lack of support for front-line staff; excessive caseloads, particularly for inexperienced workers; an inward-looking and self-protective organisational culture; poor record-keeping; managers accountable to government targets but not to their staff.

If we draw the correct lessons from Haringey, we must ensure no practitioner ever again has to undertake child protection work in such an environment. To do that properly would be complex and expensive - but right.

If we draw the wrong lessons, based on Haringey's own particular problems, it will be tempting to wash our hands of local authority-based child protection. The danger is, that might look cheaper, more media-friendly - and closer to the radical solutions Alan Milburn is poised to consider.

- See news, page 6