Busy government sees initiatives undercut by funding shortfalls

While the UK’s governments have been keen to reform services, budget restrictions have caused progressive schemes to flounder. Elsewhere, the adult care white paper and the children in care green paper were just some of the highlights of social care in 2006

Older people
Finance was the dominant theme of older people’s services, and adult care more generally, in 2006.

The white paper, Our Health, Our Care, Our Say, published in January, promised a shift from acute to preventive care.

However, the Local Government Association claimed budget shortages were forcing councils to focus care on fewer, needier people – the opposite of the vision.

In March, Derek Wanless’s King’s Fund-sponsored report on older people’s social care made the case for a significant increase in investment to cope with the ageing population and modernise services.

Care services minister Liam Byrne appeared to be listening, co-opting Wanless on to a Department of Health review of adult care funding, designed to shape its 2007 comprehensive spending review bid.

But in May, Byrne was reshuffled out of his post. Replacement Ivan Lewis spent 11 years working in the sector but has been notably more sceptical about the funding case, despite a new financial problem emerging during the year: the knock-on impact of NHS cuts on social care.

An LGA survey in July revealed significant evidence of cost-shunting, with councils forced to take responsibility for service users treated previously by the NHS. 

At October’s National Children and Adult Services Conference DH ministers and officials called for more evidence of the funding case and reminded delegates that social care faced a tight spending review settlement in which efficiency savings would be paramount. But the issue remains alive, as a House of Lords debate this month showed.

Mental health
Months of speculation over the future of mental health legislation ended in March when the government announced it would abandon plans for a new law and amend the Mental Health Act 1983 instead.

Much of the content remained the same, however, with measures to abolish the “treatability” test and extend compulsory treatment. Campaigners also complained that positive aspects, such as a right to advocacy, had been dropped.

A bill to introduce the amendments was unveiled in November and savaged by the House of Lords when it was tabled this month.

Mental health services were also hit by the NHS funding crisis. Charity Rethink claimed in April that mental health trusts were having to make cuts of at least £30m in England.

Learning difficulties
Nicola Smith started work in May as co-national director for learning disabilities at the Department of Health. She was the first service user to be appointed to a high-level government post.

Widespread abuse of people with learning difficulties in the care of Cornwall Partnership NHS Trust was revealed in a damning inspection report in July. The Commission for Social Care Inspection and the Healthcare Commission uncovered evidence of staff hitting people, withholding food, giving out cold showers and over-using medication to control people’s behaviour.

Youth justice
The two-year public inquiry into how 19-year-old Zahid Mubarek was battered to death by his racist cellmate at Feltham young offender institution ended in July. It found 186 failures to prevent the murder in 2000 and singled out 20 prison staff for public criticism.

The Prison Service later confirmed that none of the staff would be disciplined. Zahid’s family were angered to learn that the Home Office had offered them just £25,000 in compensation.

Disabilities
The government’s green paper outlining its proposals on welfare reform was published in January. The proposals would replace incapacity benefit with an employment and support allowance, under which people with more manageable conditions would be required to engage in work-related activity to be eligible for the top rate. Before the green paper’s publication, disability campaigners had feared a time limit would be placed on how long people could claim the new benefit but this did not materialise.

Children
The government announced the first national fostering allowances in August and in October came the publication of the children  in care green paper, Care Matters. The paper proposed testing GP-style social work practices, a tiered qualification and payment framework for foster carers and a veto for young people over leaving care before they turn 18.

The Safeguarding Vulnerable Groups Bill, published in March, outlined the government’s plans to bring together List 99, the record of people barred from working in education, the Protection of Children Act List, the record of people barred from working with children and the Protection of Vulnerable Adults List, the equivalent for those working with adults, into a single vetting and barring scheme from autumn 2008.

In October the government published new regulations tightening the List 99 scheme until it is replaced by the new system. The regulations followed the revelation in January that a “small number” of individuals on the sex offenders register had been cleared by the Department for Education and Skills to work in schools.

Schools minister Andrew Adonis tabled an unexpected amendment to the Education and Inspections Bill in November forcing schools in England and Wales to promote children’s well-being. The move came after long-standing calls for schools to be made to engage with the Every Child Matters agenda.

Scotland
The year-long 21st Century Review of Scottish Social Work published its findings in February. It called for the creation of para-professionals, more responsibility for front-line staff and a shake-up of education and training.

In May, the Scottish parliament’s health committee highlighted its concerns over the running of the country’s free personal care policy and recommended councils cease operating waiting lists for people to  access care to which they should be entitled immediately. But the wrangle over whether the executive is giving councils enough money to deliver the policy continues today.

Wales
In February the Welsh assembly government, much to the anger of disability groups, scrapped its manifesto pledge to provide free home care to disabled people saying the costs were much higher than it originally thought.

Fulfilled Lives, Supportive Communities, the assembly government’s 10-year blueprint for social services, was published in August. Although still to be turned into concrete proposals, the vision talked of a greater focus on prevention and changes in the make-up of the workforce, but was quiet on funding and stopped short of recommending a split in social services departments.

In July, local government expert Jeremy Beecham delivered his review of the Welsh public sector. His verdict: the days of every council delivering a full quota of services are gone to be replaced by more joint planning and delivery.