There were few surprises during the passage of the Personal Care at Home Bill into the House of Lords earlier this week. Nor during its passage through its second reading.
So there’s quite a bit left to play for. It looks as though the main bone to be snarled over will involve moves to limit local authorities’ financial commitment to the £250m efficiency savings that have already been promised (by central government). This will leave Whitehall to pick up any tab should the cost exceed £250m.
It would be the very devil to calculate, cost, deliver and police. But it could provide a compromise between two forces: those on the government’s side who want this measure through as quickly as possible; and those who, following the recent survey conducted by the Association of Directors of Adult Social Services, can be sure that there is, at the very least, an additional £330m that local government would be forced to scrape together if the Bill goes ahead as it is.
It’s the ‘very least’ because the sums were done as cautiously as possible to ensure that the benefit of the doubt was given to the Department of Health. Our survey estimated that the cost of implementing this policy is a minimum of £1bn in contrast to the government's estimate of £670m. The most significant element is the cost of providing care to those not currently known to social services.
A total cost of £1bn is approximately 50% more than the government estimates. However, the implications for local authorities are much greater even than this. The government has made it clear that the maximum it will fund is £420m. This means that local authorities would have to find £580m instead of £250m - in other words they would have to find two and one third as much as suggested by the government.
The real tragedy of the whole saga so far has been the extent to which attention, that had been so purposefully focused on the green paper and the plight of hundreds and thousands of families who desperately need greater resources spent on their care, has been diverted to a very small part of that issue indeed. In that sense, politics has made us all a little smaller.
This has been about a relatively small amount of money when we know that very large amounts are needed in order to get the services, care and support that older people should have a clear and unambiguous right to. That is where the true debate lies, and that is where the true debate will have to be held sooner or later. How much of the total bill will come from individuals and their families, and how much from the state? And how much will be wrapped up in the various insurance deals that are raised in the green paper?
At the moment, the drive toward passing the Personal Care at Home Bill, the green paper/white paper ideas and the social care transformation agenda are simply not convincingly synchronised. They need to be - there’s a lot at stake.
Jenny Owen is the president of the Association of Directors of Adult Social Services
