15th of December 2016
CORE CITIES UK STATEMENT ON ADULT SOCIAL CARE FUNDING
The crisis in Adult Social Care funding is an issue of national concern, and it is right that Government should respond to this in its announcement today. But the measures set out do not go far enough, and will lead to places with greater needs getting less money.
The Core Cities UK – the ten cities at the heart of the country’s biggest urban areas outside London – are committed to finding a working solution to the immediate crisis and the long-term challenge in a way which will reduce public costs, benefit the economy and realise more of the potential of our communities. We call on Government to work with us to deliver this.
How we treat society’s most vulnerable is a litmus test of the values of our nation. People with complex needs require joined-up services to help them become more productive and engaged citizens, reducing costs. The way we look after our elderly is a message to future generations, as well as today’s older people who have put a lifetime’s efforts into contributing to their country only to face an uncertain future.
It also means that our system is not recognising the potential of older people as assets to our communities and the economy. This is disastrous for families and individuals and bad for the morale of the nation at a time when our Government needs to show social as well as economic leadership, delivering on its promises of an economy that works for everyone.
Adult Social Care funding reductions are having a major impact on NHS costs. This will worsen next year with increased costs to the NHS that far outweigh the investment required for social care.
For example, 20 hours’ homecare costs around £300-£330 for a week, while a bed in hospital for a week is in region of £2,500 and if left in a bed an elderly person is very likely to leave with high levels of community health and social care needs. It also means that funds cannot be invested upfront in prevention, which would avoid many of these costs altogether.
The NHS is investing in transformation of its vanguard services, but there is no such investment for local authorities, yet managing social care is one of the main ways of reducing NHS costs.
Addressing this issue cannot be solved by council tax increases alone. A long-term solution requires dedicated funding, which needs to work jointly with health services. The two must work together at the local level, and a truly place-based integrated system of health and social care is required to re-focus investment into prevention, not just picking up the cost of crisis.
An increase in Council Tax to address the under-funding of adult social care will be unfair, leaving many local authorities with the biggest burdens least able to raise funds because they have low Council Tax bases, whilst more well-off areas with less need will ironically be able to raise more funds. Paying for an increase in Council Tax will therefore place additional burdens on some of the least well-off in our cities, on top of cuts in Council Tax benefits for our poorest residents. Nationally, it will not raise sufficient money to plug the gap, even if funds were redistributed.
The improved Better Care Fund was designed to iron out some of this unfairness by allocating additional funds to more deprived areas. Bringing forward this allocation will help to ease some of the immediate pressures on adult social care. Currently, funds will not flow significantly until 2018-19, and the situation faced by local authorities will worsen severely in 2017-18 because of the large reductions they face in Revenue Support Grant from Government at the same time.
Left unchecked, this situation threatens to undermine the place shaping and economic leadership role of big cities at a critical economic moment for the UK, because a disproportionate amount of resources and efforts are brought to bear on this single issue.
Economic and social policy are linked, particularly for the Core Cities which deliver 25% of the UK economy between them, and have large ageing populations. When people are in good health, in work or closer to the labour market, the economy benefits and public finance costs go down.
Social policy, including adult care, is a driver of growth and productivity, not something to do once we think we can afford it. Going forward, national and local government must work together to deliver Inclusive Growth, improving living standards for the many.
A dedicated funding solution to health and social care will enable cities to direct more effort toward creating high quality conditions for growth, tackling the challenges which constrain local economic productivity, improving skills, inward investment and job creation.
Core Cities UK remains committed to working with Government and local and national agencies to achieve improved outcomes and efficiencies through health and social care integration.
To fully realise this, we recommend that the Better Care Fund is brought forward, contributing to stabilising Adult Social Care and pump priming more rapid integration with the wider health system. A mature debate is also required to reach a cross-party consensus on a long-term solution, and Core Cities offer is to work with Government to achieve this outcome.
Cllr Jon Collins
Leader, Nottingham City Council; Core Cities UK Cabinet Member for Finance and Investment