Political bravery is needed to plug the gap in social care

New research shows there is a current funding gap in adult social care of about £634 million per year. Government and local authorities are going to have to make brave decisions


The lack of money to fund appropriate care for the elderly means that politicians and local authorities need to start thinking innovatively.

How do you want to spend your old age? Many of us would prefer to spend our final years in our own homes, but not to be completely isolated. If we have to go into residential care we want that setting to be comfortable, safe and stimulating. In sum we want dignity, autonomy and security in our old age.

However for too many people residential care is catastrophically expensive, poor quality and disconnected from the full range services they may need.

A new paper written by LGiU for the RSA and published Friday 2 November highlights the scale of this problem, not just for national government but especially for local government which funds and commissions the vast majority of social care.

As recently as April this year Paul Burstow, then social care minister, told the House of Commons health select committee: “There is no gap in the current spending review period on the basis of the money that we are putting in plus efficiency gains through local authorities redesigning services.”

Our research challenges that view, showing that there is a current funding gap of about £634 million per year. For many local authorities the gap between rising demand and shrinking resource will become impossible by 2015.

This view is gaining ground and the new social care minister Norman Lamb recently told an LGiU event that the system was fragmented, unfair and unsustainable and that funding reform was essential within this parliament.

There are now encouraging signs that the government will adopt the Dilnot Commission’s recommendations on funding.

But we argue that funding reform, while necessary, is not sufficient to meet the needs of older people. We will be throwing good money after bad unless changes to funding are accompanied by a wholesale restructure of the care system to be more integrated and more focused on prevention.

Easy to say, but hard to do. Shifting budgets away from acute services to prevention will require real political courage.

There are grounds for optimism, however. Across the country we see local authorities beginning to lay the groundwork for a future system, demonstrating that there are things that are already being done, to help ‘plug the gap’ between rhetoric and reality – and deliver effective care to older people despite budgetary pressures.

Some local authorities are managing the demand for care by helping people live independently for longer. Some are managing the cost of care by helping people stay financially independent. Some are stimulating innovation and increasing the range of options that are available both to individuals and to public agencies by shaping social care markets.

Examples include Hertfordshire spending £4m a year supporting carers to help people stay in their homes, Leeds City Council setting up a network of 6,000 neighbourhood volunteers to provide services to older people, or Bradford City Council organising job clubs for older citizens.

Taken together, this triple perspective of independent living, financial independence and market shaping constitutes a local pathway towards care.

Crucially, the steps along this pathway: financial advice, carer support, joined up services or effective commissioning can all be achieved at little or no cost and can all be achieved right now.

Each local authority should develop its own local strategy based on these this tripartite approach so that they have a clear vision of how to achieve the best possible care within their resources.

Adult social care is big politics but it is also the stuff of every day lives.

Jonathan Carr-West is director of the Local Government Information Unit, LGiU.