As a social services director for 14 years until 2006, I carry the scars and bruises. Some were self-inflicted, because of the personal pain I felt from having to increasingly ration services to disabled and older people. To keep within budget, we had to use waiting lists; rising risk thresholds; frequent reviews of the levels of care people were receiving; and redefined criteria about who were entitled to help.
When patients were then stranded in hospitals, when carers were under great stress, and when the daily lives of disabled and older people at home were deteriorating, the media and the public would usually blame the social services director. But most of the pain was felt day by day by those who were denied help.
So it is about time that we all faced up to the scandal of our heavily rationed and restricted care services – services that are still trapped in the Poor Law ethos of concentrating on proving people are not entitled to help, with local councils setting their own rules about who should be assisted.
The government green paper, Shaping the future of care together, is therefore to be welcomed. It contains much that is progressive and good, recognising that the life experiences of disabled and older people are not only about social care. To those civil servants who had to negotiate ministerial minefields in getting the paper published, well done! With a foreword by the prime minister, and the signed endorsement of seven secretaries of state it might be seen to have a bundle of political clout to drive action. What a pity, therefore, that it is likely to disappear into the sands in the run-up to the next general election and that it has been born at a time of public sector financial chaos created by greedy, rich but incompetent bankers.
And this results in one of the dangers ahead for all disabled and older people, and for those of us who will become disabled and older in the future. In trying to address the need to find more money for care services, a number of creative options are described. These include insurance and investment schemes and creating funding partnerships between individuals and the government to meet the costs of care.
Of course, another simple, fair, equitable and egalitarian way of doing this would be to increase direct taxes such as income tax. But this would generate howls of derision from the megaphone Murdoch press and those rich bankers, among others. This option in the green paper is quickly dismissed because it would place a heavy burden on people of working age… but these are the carers now and the aged of the future who expect a better deal than what is currently on offer.
So, a proposed alternative is to raid the rights-based, nationally consistent, easily and consistently administered social security disability benefits, such as attendance allowance and disability living allowance. These were largely introduced to meet the higher costs of living, such as travel costs, facing disabled people. But if they are merged into the cash-limited social care budgets, administered in England by 152 different councils, they will move from reliable, rights-based social security to what will still be insecure, inconsistent discretionary-based social care assistance.
The green paper has launched a debate. Let’s hope this time it leads to action. But let’s also hope that in the fights ahead, the economically weak, and those living daily with disability, will win. But this will require political integrity, will and strength, and a press and public who can see beyond short-term selfish financial interests.
Professor Ray Jones is professor of social work at Kingston University and St. George’s, University of London. He was previously director of social services in Wiltshire
