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By Debbie le Quesne

Posts Tagged ‘funding

Care: Policy U-turn that confuses all of us

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I simply despair of the they way it appears the left hand has no clue what the right hand is doing in Whitehall in respect of the so-called modernisation of care.

I read there are now starkly contrasting policy decisions of two Whitehall departments in respect of “sector-led improvement” at play.

How do they do it?

Leaders in children’s services have been told by education secretary Michael Gove that with immediate effect all government funding for the work of the Children’s Improvement Board (CIB), which organises support by councils for other councils that are struggling to deliver good services, is to cease.

Simultaneously, those in adult services are getting increase in funding from health ministers for the Towards Excellent in Adult Social Care (Teasc), which organises support by councils for other councils that are struggling to deliver good services.

Confused? Yes, so am I.

According to the Guardian online, the CIB was set up two years ago after the coalition abolished the Department for Education’s field force advisers, who previously worked with councils facing difficulties.

Ministers no longer wanted top-down monitoring and promoted self-help within local government. With an announcement that the “peer challenging” process was due to be rolled out to all local authorities this year, to look at among other things, safeguarding issues, the plan now seems in shreds.

Unexpectedly, £8.5m government funding due for 2013-14 has now evaporated.

I understand a letter has gone out declaring the latest good tidings. Programmes for improving performance on adoption, tackling child sexual exploitation and learning lessons from serious case reviews, are all mow compromised.

Two words pop into my head: Adequately resources  . . . I really don’t think so as councils battle with government cuts to their budgets by a third.

Meanwhile, the Department of Health has increased its funding for Teasc by 60 per cent, which in many ways mirrors the CIB’s approach. Teasc has been working with councils including Cornwall, Central Bedfordshire and South Tyneside whose services have been judged only “adequate”.

What are we to learn from this? Two other words also are buzzing around my head: Utter chaos.

Like at no other team, the care sector needs championing, needs good leadership with clear agendas and also requires decisions earthed in reality.

Like so many others in the private care sector I have no faith in the government’s leadership role or its confusing and now conflicting policies on the way forward. Sadly, nothing changes.

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Councils’ association admits underfunding

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The association that represents councils has admitted care is “buckling under the weight of rapidly growing demand and years of underfunding.”

The comment from David Rogers, of the LGA, comes on the heels of a recent Alzheimer’s Society report which says more than 320,000 of the 400,000 people living in care homes in England, Wales and Northern Ireland now have dementia or severe memory problems.

The report says the figure was almost 30 per cent higher than previous estimates because of the rise in the ageing population and improvements in data collection.

And, what is worrying, of 2,000 adults surveyed, 70 per cent said they would be scared about going to a home.

Another two-thirds felt the sector was not doing enough to tackle abuse.

And just 41per cent of 1,100 family members and carers surveyed thought their loved ones’ quality of life was good.

Mr Rogers adds: “Local authorities want to offer a service which goes beyond a basic level of care but this is becoming increasingly difficult as our population ages, costs climb and the already significant funding shortfall becomes even more severe.”

In the BBC report, the Alzheimer’s Society chief executive Jeremy Hughes is quoted as saying: “Society has such low expectation of care homes that people are settling for average.

“Throughout our lives we demand the best for ourselves and our children. Why do we expect less for our parents?

“We need government and care homes to work together to lift up expectations so people know they have the right to demand the best.”

David Rogers, of the Local Government Association, which represents councils, said: “This report shows the lack of confidence in a care system which is buckling under the weight of rapidly growing demand and years of underfunding.

“Local authorities want to offer a service which goes beyond a basic level of care but this is becoming increasingly difficult as our population ages, costs climb and the already significant funding shortfall becomes even more severe.”

Fact: Around one in three people over the age of 65 will develop dementia in their lifetime.

Fact: It is estimated that there are around 800,000 people in the UK who have dementia, but many have not yet been diagnosed.

Fact: The number of people with dementia is increasing because people are living longer.

Fact: By 2021 the number of people in the UK with dementia will have risen to almost 950,000, experts believe.

We know that the government is looking to improve dementia care by building greater awareness and understanding of the condition, as well as pumping more money into research to find new treatments and hopefully a cure.

But there needs to be more money available to meet sharp-end care now.

Health Secretary Jeremy Hunt announced last year dedicated funding of up to £50m to NHS trusts and local authorities to help tailor hospitals and care homes to the needs of people with dementia.

I’d like to know if any of that money has actually been decanted into our members’ homes and services. If it has, the West Midlands Care Association certainly hasn’t a clue about such good financial fortune.

Rant . .rant . . .Oh, and happy Easter!

Growing old – the scary consequence of not heeding the alarms

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We’re living longer and costing the nation a king’s ransom – we all know it, but now the news is just about as official as it could be.

Details about the UK’s rapidly ageing population and the impact on social services’ resources have come in a Lords Committee investigation into the growth of the section of society above retirement age.

The findings are scary and have prompted calls for a proper plan to cope with the dramatic increase in those aged over 65.

Next month all will be revealed, but the committee chair, Lord Filkin, has already warned that social care, the NHS, public spending and the rest of society will inevitably face dramatic changes.

Reported in The Guardian online, the news so far from the investigation reveals:

• Half of those born after 2007 can expect to live to over 100.

• Between 2010 and 2030 the number of people aged over 65 will increase by 51 per cent.

• The number of people aged over 85 will double during the same period.

Lord Filkin, said the prospect of living longer was a “gift”, and added that studies suggest people’s happiness peaks after retirement.

“But six months of evidence gathering revealed the huge impact such changes would have on almost every aspect of public life,” the news item says.

The most dramatic warnings to the Lords committee, which focused on 2020-2030, were for the NHS.

Lord Filkin criticises health bosses for not making detailed forecasts, and evidence from experts showed the scale of the crisis facing hospitals, specialist services and care homes.

The Nuffield Trust predicted a 32 per cent increase in elderly people with moderate or severe disability, and a 32-50 per cent rise in over-65s with chronic diseases.

I have always said that life quality outweighs longevity, but if both length of years and fulfilled days can combine, great. But we all know that’s not always the case.

What concerns me most about these findings is that currently our care sector is in meltdown because funding is so restricted. Just how do we plan for a future crisis when the current issues cannot be resolved because, as I’ve heard as thousand times: ”We have no money.”

Professor Carol Jagger, of Newcastle University, forecast that unless treatment and cures were improved, the incidence of the five most common chronic conditions among the over-65s – arthritis, heart disease, stroke, diabetes and dementia – would increase by 25 per cent by 2020 and more than 50 per cent by 2030.

This fact alone is bleak.

“As a result of such stresses, the Nuffield Trust and the Institute for Fiscal Studies calculated that, even assuming “heroic” productivity improvements, the NHS would have a £28bn-£34bn shortfall – a significant proportion of its £110bn annual budget,” The Guardian says.

 

Sarah Harper, professor of gerontology at Oxford University, forecasts that about 8 million people in the UK who would be expected to live to at least 100, and some experts believe at least 50 per cent of children born since 2007 will live until 103.

The uncertainty of future, the fear of care failure, growing dementia numbers, failing fiscal policy and a Government without direction for the care sector, all amount to chaos on the horizon.

We know we need to save for our old age, but with most families stretched to their financial limits, how is that achieved?

Individuals can provide only part of a solution as I see it and I do happily stand with Lord Filkin, a Labour peer, when he says strategy along the lines of those developed for future defence needs, climate change and energy security are required.

“Today’s older people are in the vanguard of an extraordinary revolution in longevity that is radically changing the structure of our society,” Michelle Mitchell, director general of the charity Age UK, is quoted by the newspaper.

For many, however, they will be unwilling conscripts.

With the round of local authority care rate negotiations now taking place, the timing of this repot becomes politically interesting. Sadly, although its finding underpin our arguments for increased financial intervention from central government, I suspect it will be ‘just another academic exercise.’

Here’s to long life . . . and winning the Lottery!

Written by debbielq

February 25, 2013 at 10:30 am

The Google search insight in the great capping debate

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Okay, so now we have at last been officially informed that the cap on care costs for families is £75,000.

Clearly we need to reform funding of the care system, but is this the answer? I suspect not.

What I do find worrying is that while MPs on the health select committee were considering the funding issues a year ago, they were surprised to learn that over a 12-month period there had been 29m Google searches on “How do I pay my care fees?”

The scale of the web inquiries points to a hugely anxious society, and the truth is, it still is.

I’ve ranted about the capping level before, so I won’t go there again. But we need to know that this measure is not designed to underwrite private care homes. It will pay out on pay out on council rates only as I understand it.

According to the Guardian on line, the analysis is thus: “Currently local authorities pay about £500 a week for residential care and so-called ‘hotel costs’. If your hotel costs are capped at £12,500 a year, then that means £240 a week. That leaves you liable for £260 a week to find from your own pocket on care – until you spend £75,000.

“That would take five and a half years. Most people stay in care homes for between two to three years. Even if you were to spend five and half years in a home, the government will only provide you with cash of £260 a week as a subsidy.

“Even worse is that currently you only get free elderly care if you have assets of less than £14,250. For every £250 in assets, the state can charge you a pound in contributions – up to a maximum of £36 a week, when you will have £23,250 in assets. And any richer than this the state says you have to pay. Under the new thresholds the elderly could face bills of about £420 a week in contributions.”

Clearly, if these scenarios are true, getting old can be a financially catastrophic business.

Perhaps the latest move is a signal, if nothing else, for planning for old age care – the ultimate solution.

Pre-funded care insurance, however, has not been popular and I cannot see that changing as many families battle the economy in survival mode.

Will the new proposals bring it back? I doubt it.

As I see it, the only good thing about the capping – good or bad – is that it moves the debate forward and confronts some hard choices which have to be made, with or without political will.

Unpopular Mr Osborne’s backlash

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George Osborne is not a popular man in the care industry and today the headlines keep coming, spelling out a chorus of warnings of what his budget cuts will mean to the most vulnerable of our society.

We know that social care in on the verge of collapse, but George Osborne failed to announce any new funding to help support older people, or those who have long-term conditions and need professional nursing intervention at home.

In a statement on their website, Age UK said: “While it’s reassuring that the National Health Service budget has been protected from the cuts falling on other areas of government spending, unless funding for social care is urgently addressed then the knock on costs to the NHS will continue to grow.

‘We already see hospitals under severe pressure because of a lack of community and social care services for older people who are left to struggle to cope without the vital support they need.

“’The Chancellor’s announcement that, in two years’ time, councils will have to cut another 2 per cent from their budgets is likely to lead to more cuts to frontline care and support services that are already in many cases stripped to the bone.

‘Allowing the social care system to limp along leaving too many older people isolated and afraid of what tomorrow might bring, is not only morally questionable but makes no financial sense.”

I think that just about sums up my sentiments.

Chief executive of the Alzheimer’s Society Jeremy Hughes said: “The decision to cut local authority funding by two per cent in 2015 will have a devastating impact on a social care system which is breaking at the seams and crying for investment and reform.

“Many people are already being forced to go without essential support and care they rely on to live well. We understand the need for austerity in combating the deficit, but with Britain’s ageing population, there will be over a million people with dementia by 2021. We can’t afford to continue to let down the most vulnerable in society.”

He too adds that the shortsighted nature of the cuts will load pressure on the NHS.

National Pensioners Convention general secretary Dot Gibson was even more scathing, saying: “George Osborne might gloat about how he intends to give older people a guaranteed 2.5 per cent increase in the state pension next April – but that guarantee was only put in place to avoid a repeat of the 75p debacle that happened 12 years ago. What he didn’t make clear was that this is just £2.70 a week extra and only £1.60 a week more for millions of older women who don’t get a full pension.

“Even with this increase, one in five older people continue to live in poverty, 3m pensioner households are in fuel poverty and millions more are struggling just to make ends meet.”

Ms Gibson continues: “His refusal to address these issues signals another twelve months of belt tightening amongst Britain’s pensioners – at a time when the super rich are still getting a 5 per cent reduction in their tax rate. It’s frankly immoral, but if he thinks we’ll go away by ignoring us, he’s got another thing coming.”

Well, that’s just the tip of the iceberg. What do we have to do to get this government to hear us? Clearly, they have no deep awareness of the suffering ‘out there’. I would remind the Chancellor of a Dalai Lama quote I learned at school: “ Love and compassion are necessities, not luxuries. Without them humanity cannot survive.”