Over the past year the chorus of voices calling for more funding for social care has become increasingly unanimous and urgent. Age UK’s new report, The Health and Care of Older People in England, provides stark evidence of the suffering that many older people with care needs are experiencing, and of the need for immediate action to avert system collapse.
Between 2005 and 2009 social services departments provided support to around 15% of all adults aged over 65. By 2013, as the numbers of older people in the population increased but funding failed to keep up, this had fallen to 9%. Not surprisingly this has led to many more older people who need support being unable to obtain it. Age UK describes this unmet need in terms of essential activities of daily living such as getting out of bed, preparing meals or using the toilet. In these terms, the number of older people with unmet needs has rocketed, up by 48% since 2010. Currently nearly 1.2 million people do not receive this essential help.
Shockingly, 291,400 older people with more than 3 unmet needs, who should all be entitled to social care, are struggling on with no help at all. Some may not have approached social services, but we suspect that others are in an appalling situation due to delays in assessing their care needs or in providing services, or because they have wrongly been refused help.
This fall in the availability of social care provision has had a serious knock-on impact on the NHS. The number of hospital days lost as a result of older people who are unable to go home until a package of care is in place has nearly trebled over little more than two years, from 12,283 days in April 2014 to 35,994 days in July 2016
Partly as a result of this pressure the NHS is also now sliding into crisis. Between 2010-11 and 2012-13 NHS providers maintained net assets of around £500 million a year, but this surplus has now fallen off a cliff; and by 2015-16 they had accumulated net deficits of £2.5 billion.
In the next few years the National Living Wage, further growth in numbers of older people and the costs of implementing the 2014 Care Act threaten to make the entire social care system unviable. The government has permitted councils to raise a special local tax levy for care but nationally this cannot raise enough to plug the gap and in any event, the areas where care is in the worst state are often places where the tax base is low.
The health and care system is now facing a serious crisis. We urge the Government to make an emergency injection of funds into social care in the Spring Budget to stave off the risk of a complete meltdown. But even that’s not enough: the Government must also get on with developing a long-term solution. This process cannot happen behind closed doors in Whitehall: we must ensure that everyone, including older people and their families and professionals working with them, can have their say over the kind of care system we want and, crucially, how we pay for it.