Restoring order

2011 was a difficult year for the care sector. We saw the demise of Southern Cross, the country’s largest residential care group, and hardly a week seemed to go by without some issue around care hitting the headlines. These were difficult times for social care, but at least we had finally got ourselves much higher up the political and public agenda.

Column inches

There are several issues which are currently occupying a lot of column inches, and stimulating a lot of debate both within the sector, and the political class.

The Dilnot Commission report on the future of social care funding has given us all a clear framework within which to discuss how we are going to fund care in the 21st century. Andrew Dilnot has managed to deliver a report, which has got a fairly broad base of support, both within the sector and also within the political elite.

He has been extremely clever in the way in which he has presented his case and, in particular, positioning social care and its expenditure in the context of government’s global budget. For the first time people can see that social care expenditure is not enormous against the backdrop of the government’s budget and a relatively modest investment, coupled with a clear understanding about what the individual will supply, can solve a problem that has been eluding politicians for the best part of 20 years.

As a sector, our challenge now is to keep up the pressure on the government and to ensure that the essence of the Dilnot proposals become the cornerstone of the government’s White Paper on social care.
The failure of Southern Cross was a critical moment for residential care and particularly for an approach to a plural economy of care, which is very much based on delivery by the private sector.

There were temptations for people to say this proves the private provision does not work. However, this approach was largely ignored and people realised that there were weaknesses in the business model that produced this catastrophic failure, as well as problems with how care is commissioned.

The response to the Southern Cross failure from the sector, local authorities, and from the Department of Health was a good example of how the system can come together at times of difficulty and craft a joint response. Many of the horror stories that were circulating in the tabloid press about older people losing their homes and being turned out of residential care units did not come to pass. This was largely because the whole system worked together to ensure continuity of care, at a time of enormous difficulty. This partnership approach should form the basis of how we work together in the good times, as well as the bad.

Lagging behind

The failure of Southern Cross brought into sharp focus the implications of underfunding care. In many local authorities the funding to care providers has not kept pace with the costs of delivering care and for some years providers have been having real cuts in their funding base. As the year progressed and as more local authorities indicated they would be delivering zero per cent increases, the time finally came for the sector to start court proceedings to challenge the way in which care commissioners were abusing their monopoly power to force down care costs.

This approach was high risk, but it was an indicator that we were in the final phases of negotiation, and care providers were so pressurised that they had little hope of sustaining their businesses without increased funding.

When these challenges finally got to court, in just about every case, the judicial review was won by care providers and local authorities were clearly seen to be behaving unreasonably.

The arrival of legal redress has forced some authorities to revisit their decisions and to talk to their providers on the basis of a real conversation about the true costs of care. It was sad that we had to get to this point and in future we must try to air our differences and seek solutions through negotiation.

However, local authorities should be in no doubt that if they behave in an unacceptable way, they will be called to account. They will then have to face their providers in court and, they will probably lose.

The amount of time and taxpayers money that has been spent in defending the indefensible is quite simply a scandal and local authorities should remember that their primary duty is to provide services to their citizens, though I do have some sympathy with the fact that the need is increasing, but the government is not giving them more resources.

Bright future

Despite all this doom and gloom, I believe it has been evident recently that the long-term prospects for social care remain very strong. Demographic change and increased expectations will ensure that the sector has a long-term and sustainable future.

Given that the evidence of the need is there, we have got to get this to translate into an understanding of the importance of social care in our national life.

Care services are often spoken of in the context of how much they cost the taxpayer, but there is another story. That is about a sector that is expanding and is an important part of a local economy, which makes it a sector that could be used to provide employment and stimulate growth. Social care is a good news story and it is a net contributor to local economies and should be seen as such.

I want our sector to be as important to the Treasury and the Department for Business Enterprise and Skills as it is for the Department of Health. It is only when we take our rightful place as an economic generator will we be seen in a different context and our status will improve.

These are challenging times everywhere but I believe social care has a bright future and we must make sure that we all work together to achieve that goal.

Martin Green is the chief executive of the English Community Care Association