news analysis of government’s announcement of extra cash for older people

Lauren Revans finds out why the government’s £300m
investment in social services for older people has received a mixed
response from social care professionals.

Last month the Local Government Association called on the
government for £300m this year “to help avert a crisis
in social care services”.

Health secretary Alan Milburn and local government secretary
Stephen Byers responded by announcing a £300m “cash for
change” initiative, spread over the next two years, to tackle
the problem of delayed discharge  (News, page 6, 11 October).

Despite the obvious discrepancies – not to mention
conditions for reform – the LGA hailed the investment as a
lobbying success. In particular, it welcomed the government’s
decision to hand the money directly to councils, rather than
channelling it through the NHS.

The strings attached were outlined in a new
“agreement” between the statutory and independent
health care, social care and housing sectors. The agreement talks
of closer working between commissioners and providers of services
for older people, stating that “early and on-going
involvement” of the independent sector providers is no longer
optional, but essential. But speculation is rife about who will be
the agreement’s beneficiaries. Unsurprisingly, many in the
independent care home sector are delighted with the announcement.
The National Care Homes Association – whose vice-president
Barry Hartley was one of five representatives of the independent
care sector involved in the development of the agreement –
describes the move as “an opportunity to restore confidence
to the sector”.

Others hearts, however, are proving harder to win. Public sector
union Unison has criticised the government’s failure to grant
the money “condition-free”.Unison’s national
officer for social services, Owen Davies, explains: “It is
nonsensical for the money to be specifically earmarked for spending
in the private sector when some local authorities need the money to
keep open their own residential establishments.”

Kent Council described its £2.1m share of the £100m
available for the rest of this financial year as “a
short-term drop in the ocean”.

Director of social services Peter Gilroy says the government is
also wrong to infer, by tying the money to the new agreement, that
local government is failing to work innovatively with the private
sector.“I have had three independent inspections of my
procurement processes,”

Gilroy says, “and on every one they have been commended.
“To say that, by having some arrangement with the private
sector, somehow it will be all the things you want it to be is
naive. The costs of care are greater than the money available.
It’s as simple as that.”

But LGA project manager for health and social affairs Jeni
Bremner believes the agreement’s emphasis on the independent
sector is no more than a reflection of good practice in
commissioning in local government today.

Similarly, chairperson of the Association of Directors of Social
Services older people’s committee Glenys Jones – one of
three statutory sector representatives involved in drawing up the
agreement – says it is impossible to ignore a sector that
accounts for three-quarters of local authority-supported
placements.

She denies that the initiative is about dealing with the
“bigger  problem” of the level of fees paid to
independent care homes by some cash-strapped councils. Stressing
the initiative is about capacity building, ADSS president Moira
Gibb warns: “If it is not adding places, it is not solving
the problem.” One element on which everyone seems to agree is
that the long-term care sector needs serious longer-term
investment. The £300m will help, but will not by itself
resolve the deep-seated problems of local authority fees and home
closures. In addition, by couching the problems associated with
long-term care provision within a wider discourse about cutting NHS
waiting lists and emptying NHS beds, the government appears to be
saying that local authorities are worth helping only as a means to
achieving progress in the health system, rather than in their own
right. As chief inspector of social services Denise Platt notes in
her 10th annual report: “Waiting list pressures have tended
to cut across the whole system’s development of intermediate
care facilities.”

Agreement at website www.doh.gov.uk/buildingcapacity