By Jaimie Kaffash
14 December 2010
Local authorities will not have the necessary resources to sustain current social care eligibility levels, the Commons health select committee has warned.
In its report on public expenditure, the committee said the government has placed ‘understandable’ emphasis on extra funding for social care, including the £1bn real-terms increase given to the NHS and the increase in personal social services grant. However, the MPs have concerns that this ‘will not be reflected’ in actual social services spending.
‘Councils will need to sustain further efficiency savings of up to 3.5% per annum to avoid reducing their levels of care, and this will not be easy,’ the report says.
The committee also expressed concern that the £1bn earmarked for social care funding in the NHS will be ‘focused on certain limited services’.
Ministers have said that the ring-fencing for local authority social care spending will be removed to give them flexibility to make decisions more effectively. However, quoting evidence from Peter Carter, the Royal College of Nursing’s chief executive, the report says: ‘The problem with not ring-fencing [...] is that it is often the budgets for people who are most vulnerable and most impoverished and are least able to fight for themselves that are raided’.
The MPs add: ‘The decision to end ring-fencing of PSS grants means that the total level of social care spending is now at the discretion of local authorities. Even though this may be welcome in principle it has the practical effect of introducing an additional element of uncertainty into the plan for meeting demand for health and social care.’
They also doubt whether the savings needed to sustain the current levels of eligibility for social care will be possible.
The report questions the costs of the restructuring of the NHS detailed in the health white paper. It says: ‘The reorganisation will bring its own costs, both direct and indirect... it is unfortunate that the government has not yet provided even a broad estimate of the likely costs of reorganisation.
‘We doubt whether the current institutional or policy structures are fit for the purpose of achieving the goal of improved partnership between health and social care.’
Doctors’ leaders welcomed the committee’s conclusions. British Medical Association chair Hamish Meldrum said: ‘Like the health committee, the BMA is aware of the sheer scale of the unprecedented efficiency savings the government has demanded from the NHS and we agree that services will be tested to the limit.’
However, he added: ‘We urge the government to give greater clarity and to explain to health care staff, professional bodies and patients, the true scale of the savings required and to ensure the service has a proper strategy as to how it is going to find them.’
Nigel Edwards, NHS Confederation acting chief executive,
said the committee had ‘hit the nail on the head with the concerns it has
highlighted’.
He added: ‘We need the government to show that it understands these issues when
it announces the next stage of its programme later this week.’
