Evidence on preventive social care needed if more money to be found

The Department of Health is making a strong case to the Treasury for extra funding for social care, but councils must provide better evidence to back it up.

That was the message from DH ministers and officials at the conference,  which was dominated by discussions on adult social care’s fate in next year’s comprehensive spending review.

Hugh Taylor, acting permanent secretary in the DH, warned delegates that next year’s settlement would be “very tight” and that councils would have to make further efficiency gains in adult social care, councils’ biggest area for Gershon savings so far.

But he added: “We are making the strongest possible case we can in relation to social care and I think we are being listened to.”

However, director general of social care at the DH David Behan (pictured left) warned the evidence base for investment in preventive social care, a key plank of this year’s white paper, was weak and that the DH’s case was not helped by poor council bookkeeping.

He added: “Local government’s financial returns are not worth the paper they are written on.”

Despite its caution on the spending review, the DH gave its backing to NHS investment in social care, something many in the sector have been crying out for.

Anthony Kealy, of the DH’s commissioning policy team, said: “What we would like is to free up spending on more preventive or social care measures that will have a long-term health gain.”

He said the joint commissioning framework on health and well-being, expected in December, which will cover both the NHS and social care, would examine how to lower barriers to GPs purchasing social care.

Taylor admitted that NHS cuts carried out to achieve financial balance had had adverse effects on social care, and said that they had hampered the white paper’s agenda of shifting care from acute settings to prevention.

But health secretary Patricia Hewitt was less strident on this issue, saying cost shunting had worked in both directions.

She did promise the government would hold a fundamental debate on the funding system for social care, admitting the current means-tested system was “unsustainable”.

Hewitt added: “We need to look at social care spending, NHS spending and the disability benefits.”

This answers calls from many groups, including the Association of Directors of Social Services and Local Government  Association. However, she ruled out charges or direct payments for NHS services .