Brown’s budget boost

A
seismic shift in the political landscape took place when chancellor Gordon
Brown increased taxes with effect from next year to invest in public services.

Understandably, public sector workers were
overjoyed. However, the headline figure soon lost its sparkle when local
authority leaders revealed the money earmarked for social services was far
short of their estimated spend over the next four years.

Brown may have boosted his Old Labour
credentials and taken a courageous risk with this budget, but the now familiar
double announcing of "new" money was very much New Labour.

The headline figure of £3.2bn includes £800m
already pledged for next year, leaving local authorities with £2.4bn over three
years – £550m short of what they estimate they will spend. The Local Government
Association claims the additional employer national insurance contributions
will wipe out the increase altogether in the first year.

Despite the shortfall, social services have
received a much-needed financial boost. Hopefully this will result in
innovative, needs-led services for vulnerable older people. But the government
has placed hurdles in the way. New fines for "bed blocking" will be
counterproductive, forcing councils to concentrate on moving older people out
of hospital quickly even when the alternative is unsatisfactory.

The fines may undermine partnerships too. If
the NHS is to improve it needs strong partnerships with social services. Fines
for both councils and hospitals will work against this. Both will be minding
their own backs to avoid penalties. In the middle is the older person in the
hospital bed, whose choice and independence may be threatened, and whose voice
may be ignored.

The new money can be used to increase care
home fees and that is welcome, but the fines will start before capacity has
grown in that sector or new initiatives have come on stream. They will siphon
money away from where it is really needed. The government must delay the fines
until the new money has had the chance to make an impact on services.

Marriage of convenience

The
merger of the Social Services Inspectorate with the National Care Standards
Commission is a sensible move, not least for the reasons given by the health
secretary himself in announcing it last week. Bringing the two organisations
together would, Alan Milburn said, clear up the "fragmentation and
confusion" caused by the current arrangements. Some will have wondered why
he didn’t think of that before, considering that the NCSC is less than a month
old.

Though we will have to wait up to two years
to benefit from them, the twin virtues of the proposed Commission for Social
Care Inspection will be a simplified, more integrated inspection process and
greater independence from government. The SSI is an arm of the Department of
Health, whereas the new body will be accountable to parliament and have its
commissioners chosen by an independent commission. Inspections could look at
what makes a good service, independently of the government view.

This independence must of course extend to
the head of the new body. The chief inspector of the SSI combines the job with
a major policy-making role in the DoH. If the new regime is to fulfil its
promise, having a foot in both camps must become a thing of the past.