Peter Hay will not be lobbying the coalition government for a change in direction on cuts as he takes up the reins as president of the Association of Directors of Adult Social Services.
Instead Hay, currently adults and communities director at Birmingham Council, argues that Adass is a group of chief officers whose job is not to lobby for particular policies, but to point out the consequences of policies to its political masters, advise on adverse consequences and then to implement what is decided.
This approach chimes with that of his predecessors, including outgoing president Richard Jones. But Hay will have to put it into practice in a year in which councils’ budgets are due to contract by 4.7% in cash terms – on government estimates – leading several councils to withdraw social care support from thousands by tightening eligibility criteria.
“Adass’s position is that the government has a right to set the financial framework,” he argues. “What we’ve got to do as chief executives within that is try and respond to what’s a meaningful offer using those resources.”
“We are not here to critique right or wrong in relation to the cuts. That is government policy and political agenda. We are here to advise on the implementation and shaping of that.”
Hay takes over amid political controversy over the government’s health reforms, which will have significant implications for joint working with social care. Primary care trusts will be scrapped and councils will have to forge relationships with consortia of GPs; at the same time authorities will take responsibility for public health and oversee local health and social care commissioning arrangements through health and well-being boards.
This is an area in which Adass has voiced concerns, including that joint working will suffer without a beefing up of health and well-being boards.
Key reviews
And if that were not enough to contend with, two key reviews that will shape the future of adult care will publish their conclusions under his watch: the Law Commission’s review of adult care law and the Dilnot Commission’s review of funding, which will report in May and July respectively. Meanwhile, the government is pressing ahead with personalisation, with a target to provide all users with personal budgets by 2013, something Hay believes is realistic.
But cuts look set to dominate his presidential year. Many councils have chosen to cope with reduced budgets by tightening eligibility thresholds.
This includes Hay’s own Birmingham Council, which has raised thresholds from substantial to critical and was even considering restricting care to people with “critical personal care needs” only, before ditching this proposal. Ironically, a legal challenge to its decision will come to court in the week he takes over as president.
However, Hay points out that the current model of social care is unsustainable. He prefers instead to talk about a “new adult social care offer” of investment in prevention, reablement and better information and advice, alongside tightened eligibility criteria for formal care services. This is what Birmingham has done and he defends the approach.
“We want to spend more in real terms on prevention and we’ve increased our real terms spend on prevention by over 100% in just year one. So we aren’t just being defined by the eligibility criteria but by an offer across our whole community,” he says.
Shift away from the State
However, he says the future of social care in England means a greater contribution to the social care system from individuals.
“Increasingly what we’ve got to recognise is that less state funding means more contributions both in cash and kind from citizens themselves and work with all of that,” he says.
He also acknowledges that some groups within the adult care sector across England are facing “multiple effects”, for example, younger adults with disabilities who are facing benefit cuts, the closure of the Independent Living Fund to new claimants, social care reductions and cuts in housing. It is Adass’s job to watch this situation carefully, he says.
Despite the difficulties in adult social care, Hay says he would not want to do anything else.
He admits the job is challenging but says “there are lots of positives still”. However, he acknowledges: “It does feel like we are moving at an unprecedented pace.”
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