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Sunday 12 February 2017

The future of our care services: local council funding is broken

It looks as though local councils will have to put up taxes: 
Futures Forum: The future of our care services: councils increasing tax to fund adult social care

But apparently this is not going to happen in Surrey - home of the Chancellor:
Futures Forum: The future of our care services: councils increasing tax to fund adult social care >>> but not in Surrey

Simon Jenkins has not minced his words:

The banana republic of Surrey has shown local council funding is broken


Friday 10 February 2017 Simon Jenkins

If Surrey’s ‘secret deal’ is to be a harbinger of a new health and care service then the whole murky world of local government funding needs rethinking


The algebra is simple. The NHS is having another terrible winter. It does not collapse, but “spills demand” on to the next line of defence, local government welfare. But while the NHS gets more money annually from the Treasury, local government gets less, some 30% less since 2011. It cannot cope with the new pressure. The equation resolves itself into rationing, by quantity and quality: fewer care places, fewer home visits and fewer district nurses leads to more bed-blocking, fewer operations, longer trolley waits.

Tory Surrey is a responsible supplier of post-hospital care. Like all councils, it is allowed by the Treasury to increase its council tax by 5%, specifically to boost its care budget and thus ease pressure on the NHS – which the Treasury is responsible for funding. Surrey county council regarded this as nothing like enough. It therefore activated its statutory right to hold a referendum on a 15% increase.

Far from showing delight at a wealthy council accepting this burden, the Tory government was appalled. Tories do not increase taxes. The chancellor (and Surrey MP) Philip Hammond duly did what Jeremy Corbyn called a secret deal. If Surrey abandoned its referendum and the 15% hike, it could retain revenue from a different tax – the local business rate, which normally went to the Treasury. That is, the Treasury would in effect spend more on health and care in Surrey, but secretly and, so far, just for Surrey.

This is the stuff of a banana republic. If Britain wants to spend more on health and elderly care, it should raise it and spend it honestly. Instead, the Treasury is running around its fiscal A&E department, staunching the flow of political blood by slamming on plasters wherever a patient screams or twists an arm.



The banana republic of Surrey has shown local council funding is broken | Simon Jenkins | Opinion | The Guardian
Banana councils, the NHS and social care | East Devon Watch

Meanwhile, central government's own scheme doesn't seem to be working - with comment from Devon professionals:
Care in the community ‘is not working’ claim Devon GPs - News - North Devon Gazette
“Care in the Community not working” | East Devon Watch

And from the Independent:

Government's £5.3bn plan to integrate health and social care 'failing to save money'

National Audit Office says Department of Health and NHS England over-optimistic about what Better Care Fund for England could achieve

Jane Kirby 5 days ago

A Government plan to integrate health and social care is failing to save money or stem the rise in hospital admissions, a report has warned.

The National Audit Office (NAO) said the Department of Health and NHS England were both over-optimistic about what the Better Care Fund for England could achieve. It was set up with £5.3 billion of NHS and local authority funding in 2015 to better integrate health and social care.

The NHS is suffering due to record-high numbers of delayed discharges, where patients are medically fit to leave hospital but there are delays to arranging their social care in the community.
Councils, which arrange and pay for some of the care, are also under huge pressure due to budget cuts.

The NAO report found the Department of Health expected to achieve savings of £511m in the first year of the Better Care Fund, but this was not realised. It also expected a reduction in hospital admissions, but in fact they increased.

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