Service User Voice: It just doesn’t add up

By increasing funding for adult social care over the next three years the government has recognised that this area is underfunded. However, the increase, outlined in the comprehensive spending review, could easily be swallowed up by inflation by 2011. We are also promised a green paper on the future of adult care services – with the focus on older people this is not only the fastest-growing group in need of care, but also takes up the lion’s share of the care budget.

We service users have been promised greater “personalisation” of care, through the extension of direct payments and individual budgets: service user-led organisations are meant to have more involvement with supporting people through centres for independent living in each district. Policy papers, such as Valuing People, put service users at the heart of the process.

There’s much confusion over how much individuals and their families should contribute towards costs of care for older people, and little transparency in calculating what, exactly, is being paid for.

CSCI’s recent report, A Fair Contract with Older People, highlights the difficulties, and unfairness in charging policies. As CSCI chair Dame Denise Platt puts it: “This must be the only service where if you’ve got a lot of money you do not [necessarily] get a better deal.” The government promises that the green paper will look at standardising and making transparent decisions about who pays, and how much, and to end the postcode lottery in care.

With the Wanless report still fresh on ministers’ desks, the future couldn’t look brighter for those of us who need care, could it?

In the real world, older people and their families asking for help are finding that they have to contribute more than they expected, and younger, newly disabled adults and children moving into the adults system are offered less assistance than they hoped for, particularly if they don’t meet the top two eligibility criteria.

As for those of us with established care packages, we’re ever fearful that the next review won’t be based on need, but will be used to cut our services.

I recently went to a meeting for people with learning disabilities, and I was reassured when they said that their recent reviews had led to some increases in help – but they still remembered bitterly past cuts which had nothing to do with changes in their circumstances.

Simon Heng is a wheelchair user and is involved in user-led organisations