I've visited eight adult social care departments this year, and talked with front line staff in all of them.
Andrew Dilnot’s report on the future funding of social care is published today. It has already started a frantic scrabble of response by politicians and other interested groups. Questions that will be hotly debated will include:
- how will we ensure equal access across the country?
- will a national contribution threshold work?
- what would an insurance market look like?
- should councils really become mortgage providers like Northern Rock?
- who should benefit and who loses?
- what about localism?
All acknowledge the unsustainable present situation has been ignored for too long, and there seems a genuine willingness to find a solution – but will it be possible to stop this turning into a debate about whose taxes pay for what can be seen as a several billion pound investment for the middle classes? Will we get another “pause and reflect” (which is basically what we have been doing since Labour decided the problem was too hard in 1999 and 2009)?
There will be no shortage of opinion on where this is going long term – but what does this mean for Council Chief Executives and Directors of Adult Social Care now? The big test will be how this national debate feeds in to budget setting for next year. Can the maturing of understanding of adult social care through the national debate be used to make good local decisions – or will it just be a diversion?
A billion has been taken out of adult social care budgets this year and probably another billion next year. Dilnot might not have a working system to change in 2014 if we don’t act sensibly now!
Jeremy Cooper, director, iMPOWER Consulting