Social care leaders have slammed the government's failure to commit additional resources to the sector through today's White Paper.
Today's package of measures, also including a draft Care and Support Bill and progress report on reforming the funding system, came under fire from charities, providers and council leaders alike for the lack of action to tackle social care's funding shortfalls.
Ministers have provided councils with an additional £300m from 2013-15, much of which will be used to implement measures in the White Paper, leaving little to address existing funding shortfalls and compensate for cuts already made to adult care budgets from 2011-13. Also, the government made no commitment to implement a cap on lifetime care costs for older people - as proposed by the Dilnot commission - despite accepting the measure in principle, saying this would be considered as part of the next government spending review due in late 2013 or 2014.
Alzheimer's Society described the proposals as a "massive failure" while Carers UK said carers would "despair at yet more delay in tackling the fundamental challenge of social care funding".
While accepting many of the White Paper's other proposals on promoting prevention, personalisation and integration with the NHS, Association of Directors of Adult Social Services president Sarah Pickup warned: "The proposals brought forward today, however measured and helpful, cannot compensate for the absence of a fundamental resourcing solution which will need to sit alongside new ways of working with the NHS through joint commissioning and service reform."
Government funding for councils is being cut by 28% in real terms from 2011-15, partially compensated by the transfer of £2.7bn in funding for social care from the NHS. Adass surveys have shown that almost £2bn have been taken out of adult care budgets since 2011 and, though most of this has come through service efficiencies, about a quarter has come from cutting services or increasing charges on service users.
Pickup pointed out that there were also hidden costs in service efficiencies through councils not funding providers' cost pressures. "We cannot sustain a position where inflationary pressures faced by providers go unfunded," she added." Our concern is the potential impact on the availability of services for individuals before a longer term solution is found.”
Among providers, Bupa said the government had "ducked the fundamental question about how to sustainably fund a social care system that has been chronically underfunded for over a decade".
Think-tanks the Joseph Rowntree Foundation and the King's Fund, which have researched the funding of social care over many years, also slammed the lack of a funding solution.
"The consequence of indecision will see a widening gap between the care people need and what is available and mounting pressures on reducing local authority budgets will in turn compromise providers’ ability to maintain quality care," said Richard Humphries, senior fellow at the fund. "An increasingly crisis driven service will in turn place greater pressures on the NHS and on carers."
In the White Paper, the government maintained its long-held review that the 2011-15 spending review provided enough resources for councils to maintain services at 2011 levels, so long as they adopted a "rigorous approach to efficiency". It has not taken a view on whether services were under-funded prior to 2011.
On the government's failure to commit to Dilnot's recommendations, health secretary Andrew Lansley said: "I think the Dilnot commission sets out a funding model that we support and we want to implement. We will look for ways to do that, but it may involve public expenditure consequences, and these will have to be weighed agianst other priorities."Mithran Samuel is Community Care's adults editor.
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