19 January 2007
Social care minister Ivan Lewis has responded to last week's damning report on the state of social care for older people by calling for a 'new fair settlement' between the state and individuals.
'We've got to have a major and fresh look at this,' Lewis told Public Finance. 'It seems to me that if we're always going to have a means-tested social care system – which the reality is for the long-term – we need to look at the creation of a new fair settlement between the state and citizens and families in terms of responsibilities in this area.'
Lewis was talking to PF in the wake of the Commission for Social Care Inspection's finding that two-thirds of councils were unable to provide the sort of preventative social care at the heart of the government's own 'early intervention' and 'care closer to home' agenda.
Whilst Lewis accepted that demographic pressures and rising expectations meant the current system needed to be looked at afresh in order to remain sustainable, he denied that the system as a whole lacked the money needed. 'Some of [social care's] pressure is because of demographic realities, but equally, some of it is because the money isn't in the right place. Too much of it is tied up at the acute [hospital] end of the system and not enough of it is in the preventative and community end,' he said.
New 'health and well being' commissioning guidance for primary care trusts and local authorities, to be published in the near future, would provide advice on shifting resources. A new duty on PCTs and local authorities to work together would also help facilitate the shift, said Lewis.
Although he accepted council resources needed to be boosted by a redistribution from acute NHS services, Lewis pointed to the variability in the different levels of service provided by councils with similar central government funding.
'Quite frankly some local authorities have chosen to put council tax up either not at all or by very small amounts. We've got to ask: are they doing their best by their local population by making those choices?'
Lewis would not comment on the on-going discussions with the Treasury over social care's settlement in this year's Comprehensive Spending Review. But he said there was no truth in the rumours his department was finding it difficult to make a case for increased resources for the sector.
The Treasury had highlighted social care as one of the countries 'great challenges' in its December Pre-Budget Report, and that recognition was an 'important step forward', said Lewis.
'There is no resistance at the Treasury to understanding the importance of these issues. But as ever they have a very difficult balancing act between all of the demands on the public purse… and there are always difficult choices to be made,' he added.
Lewis said he would be working with the social care sector in the months ahead to flesh out some 'practical solutions and a vision for the future' for social care.
He was not sure whether that would involve a new green paper. The principles underpinning that vision would be sustainability and a 'fresh look' at demographic changes and public expectations, but the government remained committed to the prevention agenda.
PFjan2007
