“Mr Q has moderate learning disabilities and autistic spectrum disorder. Mr Q lives with his father, who has a full-time job. Mr Q can undertake his personal care and doesn’t need help with eating and drinking, but has no sense of danger and a fascination with water. There is a substantial risk to his safety and that of others, when his father is unable to supervise him.” (London Borough of Lambeth eligibility criteria, A Guide for People with Learning Difficulties.)
This is an example of the type of person who will lose services in Lambeth if the council’s proposals to raise the eligibility criteria for social care services from “substantial” to “critical” are ratified later this year.
In 2001, the Valuing People white paper enshrined the principles of rights, inclusion and choice as those on which services should be based. Now, the limited practical gains from the white paper are being eroded by restrictions in eligibility, charging for day services and in some places such as Lambeth wholesale cuts to voluntary sector funding.
The care services minister Ivan Lewis has acknowledged that the government is struggling to deliver the vision of Valuing People but wishes to “re-energise” its impact. But cash-strapped local authorities that have to ditch the cornerstones of inclusion and choice because of funding pressures are likely to de-rail this process.
Users and their families will suffer because of loss of key services. I also believe that what little confidence has survived six years of making Valuing People a reality will be lost in the aftermath of cuts in social services. This will be true even if local authorities stop short of implementing the worst of these changes. For many service users, it is merely the fact that these cuts have even been considered that is so hurtful.
Insufficient financial support by Labour has left Valuing People at the mercy of short-term local financial decisions. Lambeth has decided to make services for vulnerable adults a lower priority. Many people will have to do without services until they reach a point where their independence and ability to cope have deteriorated. When they become “critical”, they will need expensive care packages that fly in the face of the Valuing People vision. Imagine the quality of life for Mr Q and his father after six months with no services while they wait for his needs to become critical. Is this chaotic approach, which undermines users’ hopes for independence, really what social care should be about?