Able spoke with Head of Policy, Anna Bird, at charity, Scope to get her perspective on the state of care in the UK.
What’s your broad assessment of the state of care in the UK at the moment? Is it working?
We’re just on the cusp of a new care Act coming into force. It’s going to come into force in April 2015 so it’s a huge opportunity for the whole of the care system to be reformed and what the Government has brought in is a really significant set of reforms that will modernise social care. Its promised an end to the postcode lottery and we know that it certainly will drive up quality and promote wellbeing.
The details are as yet still under the tarpaulin so to speak…
Exactly. What’s been agreed in the Care Act is a really positive forward-looking set of reforms to how the care system will work. The question is: ‘are you going to be eligible for care in the first place?’ The regulations that set out the threshold for care have now been published (June 2014) and what we’re particularly concerned about is that they seem to kind of, ‘hardwire’ into the system the rationing that currently exists where too many councils set their criteria at really substantial levels of need. That means that too many disabled people that need to get support to get up, get dressed and out of the house don’t get it. So that it’s difficult to escape from that, no matter what the financial settlement looks like.
The Care Act that was passed in May 2014 and it’s coming into force in April 2015 and is all premised on the concept of wellbeing, so care should promote disabled peoples’ and older peoples’ wellbeing and should be there to safeguard that – and that’s a real step forward. The care system is a kind of hotchpotch of laws and regulations and hasn’t been fully reformed for 60 years so this is a great step forward but the key issue is really about funding for care and who benefits from that care system. So again, we come back to two questions which aren’t really related to the reform itself but to who’s eligible for it and how it’s funded.
What kind of issues do people most frequently need to discuss on the Scope helpline?
We speak with disabled people every day. Obviously, we have calls to our helpline where people can speak to people in our services (department). There are many different issues that disabled people face. Some of the key issues are around money matters and work issues and access to care as well.
We did a big piece of research at the end of last year (2013) to ask disabled people what their priorities were for change. We’ve identified that there are three key areas for change: one, is exactly this issue of care, so making sure that people who need care get it; another is that life costs more if you’re disabled. We’ve just done some research that shows that on average disabled people spend £550 a month on expenditure relating to their disability. So they’re spending £550 on average a month just because they’re disabled – that’s a huge penalty on life and one that we need to tackle.
Then there’s a piece of work we’ve also done around employment – there’s a lot of focus on getting disabled people into work and yet when we have looked at the figures, twice as many disabled people left the workplace last year as moved into it so there’s something about what happens in peoples’ jobs and about retention at work and why disabled people are losing their jobs and what’s happening in the workplace that’s not fully supporting people to get on and move up in their careers.
All of those things are really important. When the issues surrounding disabled peoples’ living standards are discussed, (we find that) you can’t tackle any one of those things in isolation and so we’ve launched a campaign that’ll really push the new government elected in 2015 to really focus on those three areas.
This is about spending money wisely, not just spending money, isn’t it?
I think that’s right. I think it’s about making sure that money works better so what we’ve seen is that where services aren’t joined up enough or where there isn’t enough focus on the outcomes for disabled people – how their lives are going to look as a result of the services they receive, we miss a trick and disabled people lose out as a result. So if people don’t get the care they need, they’re never going to be able to get out to work in the way that they would like and fulfil their aspirations and contribute to society as they would like to. Similarly, if we allow the situation to continue where disabled people have to spend so much every month just to manage their disability, just to manage the costs of their disability, it’s going to be very difficult for disabled people to contribute to society on an equal footing with non-disabled people.
We need to think really carefully about what the enablers are for those things and how we can make it possible for disabled people to contribute but we’re really clear that actually as the recovery starts to kick in and as we start to see growth, disabled people want to contribute to that and definitely should play their part. We need to think about how we can make the labour market respond to that and how we can make sure that the care system works and that there’s an adequate financial settlement in the care system so that it all works.
When we talk about childcare we use words like ambition, aspiration and ‘Labour market response’ for working parents. Why is that ahead of adult care on the political agenda?
Actually, I think that’s quite a new thing as well. I think that as a country we’ve got a real shared understanding of what our health system should do. There’s becoming a public appetite as well about childcare as a national issue we need to deal with. Care (for adults) is the next agenda. It’s something we’ve got to tackle. We’ve got an ageing population, increasing levels of disability in the population. It’s something we’ve got to grapple with and it’s something that the next government needs to prioritise because we can’t really afford to let this slip any longer.
The recovery from the 2008 recession gives us two things: a sense of optimism but also an opportunity to look back and see just how damaging starvation of public services is. What have you observed?
There is certainly evidence that as public sector cuts kick in, that some of that is passed on to care so we know that councils have had to reduce their adult social care budgets by £2.6 billion over the past three years and inevitably that’s going to have an impact on who can benefit from the care that’s provided and who has access to care. Everyone’s being squeezed and that’s really tricky for councils to manage. They’re left in a really unenviable position.
Ultimately, we think the care system is on its knees and we need a new funding settlement from the new government. They have to prioritise that in the next funding round.
There are lots of different ways that it could be funded but certainly some of the current Government’s thinking around integration of health and social care is obviously useful. I think ultimately, we just need to see more money getting into the system and then we need to think about how it’s used to best effect – we need to look at the outcomes of care and make sure that, particularly for working age disabled people, that we’re thinking about how disabled people can move on and contribute to society too. I think unless those things are joined up and unless we start to bring public services together we’re not going to find the solutions.