News and Comment from Roy Lilley.

There are whizz-bangs, fireworks, explosions, detonations and blowing-up.

Yesterday’s report, from the National Audit Office was a boom, bang and blowing-apart of social care policy.

I don’t think I have seen such an excoriating dissection of policy, ever.  Here are some extracts: 

  • In 2016-17, the annual turnover of all care staff was 27.8%. 
  • The vacancy rate for nurses more than doubled between 2012/13 and 2016/7. 
  • Since 2010, regulated adult social care establishments have to have a registered manager… in 2016-17, the vacancy rate was 11.3%. 
  • The Department does not have an up-to-date care workforce strategy and roles and responsibilities of the bodies involved in delivering care are not clear. 
  • The Department cannot demonstrate that the sector is sustainably funded. Between 2010/11 and 2016/17, spending on care by local authorities (including funding transferred from the NHS through the Better Care Fund), reduced by 5.3% in real terms 
  • Around half of care workers were paid £7.50 per hour or below (the National Living Wage is £7.20). An hourly rate of £7.50 per hour equates to an annual salary of around £14,625, before tax. 
  • Four-fifths of local authorities are paying fees to providers that are below the benchmark costs of care. 
  • The Department does not have a current workforce strategy and key commitments it has made to both enhance training and career development and tackle recruitment and retention challenges have not been followed through. 
  • There is no evidence that the Department is exercising oversight over local authorities and local health and care partnerships for their responsibilities relating to the adult social care workforce. 

The DH have made a response to all this but it is so puerile, I can’t be bothered with it.  

In a move, the day preceding the publication of the report, Communities Secretary, Savid Javid gave local authorities a £150m bung for next year.

All this against the background of Northampton Council, if it were a business, would be on the edge of doing a Carillion and ten other councils up to their necks in irrecoverable debt.

What does this mean?  Well, there is an annual social care funding gap of about £2.3bn.  Unlike the NHS, local authorities must balance their books each year.  They cannot carry forward a deficit.

A fairer-funding review is on the way.  A green paper on the future of funding adult social care has been pulled from the Treasury and given to a Minister in the DH.

Local government is skint.  

The knock on effect; to make savings councils have changed their eligibility criteria for receiving adult social care, consequently the number getting care has dropped by a quarter.  After 2014, the way the data was collected has changed, now no one knows what’s going on.

It’s probably fair to say about 900,000 elderly frail people, in receipt of no care whatever, are refugees in our own system.  

And, the NHS is propping up social care.  Central government funding for councils was cut by a third during the last Parliament. Of the £16bn LAs spend on adult social care, £2bn came from the NHS.

So, from what I can discover those are the facts.  The ugly, stripped-pine facts.  Facts of neglect, nonchalance, unconcern and a cavalier disregard from a blasé government which neither we nor the older people in our society deserve.  

I don’t know what to say… this government is drifting, it is losing the intellectual high ground, it is not facing up to the big challenges.  

It looks to me like government has given up on its people….

It is shelving problems, delaying answers and procrastinating.  We are watching the infrastructure of care crumble away. 

On June 7th 1983, in the back of a car on the way to a speech in Bridgend, Neil Kinnock scribbled some notes.

His voice hoarse from campaigning he delivered the speech of his life.

He concluded with;

‘I warn you not to be ordinary, not to be young, not to fall ill… I warn you, not to get old.’ 

… dynamite.

Have a thoughtful weekend.


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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.