Social Care article for The Guardian

images

Week before last I wrote an article for the Guardian Newspaper about the future of social care and things our Government needs to consider as they ponder the way forward:

When you consider the plethora of social care papers that have come and gone down the years, irrespective of governments, you’d be forgiven for taking next summer’s review with a pinch of salt.

Yet, there is a feeling that this cannot go on for much longer. County areas are withstanding some of the greatest pressures in delivering and procuring social care services, coupled with the deepest reductions in core government grants.

If there was an easy answer, we would not be arriving at social care paper number 13.

Any solution must be long-term in its vision, but early noises suggest that next summer’s review could narrowly focus on funding options for older people.

Exploring a wide-range of options to ensure long-term sustainable funding, firstly to meet the £1bn funding gap that counties face in delivering social care, and for the individual to protect them from facing huge care costs, is paramount.

Whilst this is clearly crucial, the County Councils Network (CCN) argues for a more holistic approach, which brings together prevention, housing, workforce, and integration as well as sustainable way to fund social care.

We argue for a culture shift; turning the existing system on its head. It is currently too focused on the end result, or dealing with issues as they arise, rather than exploring ways to mitigate a person’s health troubles. From the individual’s point of view, who wouldn’t want to live healthier and independent longer?

This is best illustrated by how much media airtime delayed discharges get; an example of the reactionary nature of the system. We must shift thinking towards stopping people from entering hospital unnecessarily in the first place instead of institutionalised care; enabling them to be in control of decisions about the type and location of care they receive.

Housing reform will play a big part in this shift of mindset. The ability for people to stay at home and receive care – or at least to choose to do so – is hampered by the lack of adaptable housing, whilst for those exiting hospital, there are not enough reablement and rehabilitation services in England.

Another issue that often slips under the radar is the dearth of retirement property development: with 7,000 built yearly, whilst analysis suggests 30,000 are needed. The need to keep pace with England’s rising elderly population is obvious, but an increased prevalence of care housing and adapted properties will allow people to live independently longer. In turn, this means less demand on social care services and fewer delays in exiting hospital.

The green paper should seek to create the conditions to encourage more development of supported and retirement homes, including reforms to the planning process to better incentivise the building of these properties.

Integration of health and social care has been labelled a solution, especially in reducing demand. Yet for a variety of reasons, the agenda has not had lift-off. Considering that full integration by 2020 as originally planned is unlikely to happen, we should consider reforms to the way the current system works.

Instead of gunning for wholesale change in a short timeframe, government should be considering pooling its NHS and social care budgets as a precursor to full integration. Some counties already are; with councils and local NHS providers making joint decisions based around the individual; with the aim of keeping people out of hospital for longer.

At the same time, the NHS Tariff, which rewards acute trusts for patient contacts rather than outcomes should be reviewed; to reward providers for preventing people from entering crisis care unnecessarily.

In essence, we should try to build a preventative ecosystem that allows people to maintain their health for longer. This means widening the debate, to tightening the links between adult and children’s social care, and crucially, public health services.

It should also aim to ensure those currently ‘in the system’ live as independently as possible. Here, having consistency in carers is vital. Yet Brexit could impact on workforce projections, not least in areas such as Essex where one-third of its care home workforce are EU nationals. CCN is calling for flexibility in immigration rules to allow providers to recruit from Europe should they be unable to internally.

These solutions are only a cog in a much larger machine; there is no silver bullet to making social care sustainable. No-one is under any illusions of how difficult a task this is for a government, least of all an administration that does not have Parliamentary arithmetic on its side.

But without thinking long-term, and a culture shift that brings prevention into focus, next summer’s green paper could ultimately go the same way as its precursors.

Cllr Colin Noble, County Councils Network Spokesman for Health & Social Care and Leader of Suffolk County Council

The link to the article is:

https://www.theguardian.com/social-care-network/2017/dec/07/there-is-no-silver-bullet-for-social-care-but-ministers-must-not-dodge-the-issue?CMP=share_btn_link

 

 

 

Conservative Values & Budgets

CPC2006-LG-083At the moment, there seem to be a media storm in Westminster with Serious Allegations being diminished by silly ones.  Yet the business of government rolls on with important negotiation on Brexit and more immediately the Chancellors budget.

It’s also an important budget time for Councils as we debate and negotiate our way to our Budget proposals.  Here in Suffolk we do not indulge the grand unveiling in January before a Full Council debate in February for its implementation in May, we take a more inclusive approach and are about to publish our draft for public and Councillor scrutiny.  Last week I alongside the Leader of Kent CC, Paul Carter and Philip Atkins the Leader of Staffordshire CC, being the Chairman and vice-Chairman of the County Council Network sat down with the Secretary of State for Local Government, Sajid Javid MP to discuss the issues with funding we are as County Councils are facing and some of the things we would welcome in the Budget or if not, then in the Local Government Financial Settlement which follows between the Chancellor’s speech and Christmas.  Last Friday as a Conservative group we had our final presentation on the draft budget for 2018/19 before its draft publication.

A budget is one of the key pieces of work as a Councillor you undertake and it should reflect your values and polices.  In May 2017, we set out a very clear set of policies which we have translated into corporate priorities.  We won a massive majority pinning Labour back to but a handful of seats in Ipswich, one in Sudbury and one in Lowestoft but everywhere else soundly rejected as was their spend, spend, spend set of pledges in their campaign.  So, the course is set, steady as she goes, find new ways to do things and protect Front line services for the most vulnerable in our communities.

But its more than that, it has to be about our Conservative values.  Labour often take a very high-handed stance that as Socialists they are the ones with principles and indeed they are, one of them being that they always manage to run out of other people’s money, which helps and protects no one.  Eventually at a local Council or Government level the Conservatives’ then have to sort that out.  But as Conservatives we do have principle about fairness, incentives to get on in life, low taxes and a small state and finally last but not least a hand up, not a hand out.

At times, Conservative Principles seem more difficult to express than socialist dogma.  So as a part of our budget setting process as a Conservative group in administration on SCC we had the first of a series of sessions from one of the brightest thinker I know in Conservative Local Government.  Christina Dykes has spent the past 9 years leading the LGA Flagship political training programme the Next Generation.  Whereas most of the LGA Councillor work is cross-party, the Next Generation programme has been entirely different in that each political party run their own elements of it and each year she has been able to work with about 20 Councillors the next generation of Cabinet members and Leaders, on a year-long journey about being Conservative leaders in Local Government. (the above picture is Christina’s Next Gen 1 cohort at the launch of the programme at the BIC in Bournemouth in 2008, when the party conferences were at the seaside (that’s me on the second right, just behind Sir Eric Pickles in case you did not recognise me after 9 years in Local Government!)

I shall not go into the details of the workshops here but they are built on her years of knowledge of councils and councillors and she challenged the foundations of what we as Conservatives want to achieve in Local Government and then she get us to rebuild our vision so we are clear in our policies and our decision making what is right for our communities and this is reflected in the draft budget we will publish shortly.

My bi-weekly Newspaper column

 

Here is last weeks column I wrote for the EADT & Ipswich Star, enjoy, or least I hope you’ll find it worth a read:

Savings are, unfortunately, part of life working in the public sector.

Every authority is having to do it, including us. There’s no shying away from it. But as we continue to work on forming the budget for next year, there’s a chance to reflect on where we are and how we need to continue to work to deliver the best services for the best value.

Since 2011, we’ve saved £236.2million – no small feat. However, we do still need to save more. By April 2021 we plan to have saved an additional £56million.

These savings will help us prepare for the future. While we’re in a good place, Suffolk will change massively in the next 20 years, therefore we all need to do what we can to ensure the public purse is in the best position to face the challenges predicted.

Life expectancy in Suffolk is higher than the national average already and one in five people are over the age of 65 and by 2037 that is estimated to increase by 50% to one in three.

This is a success story in itself that people are and will be living longer, but Suffolk, its communities and its economy will change – along with the demand on the public sector.

The cost of caring for over 85s will be nearly £300million and the number of people living with dementia in Suffolk is likely to almost double in the next 20 years – 24,300 people. Most of these diagnoses will be in those older than 85 years old.

Based on current admission rates and lengths of stay, an additional 792 acute beds will be needed – that’s nearly enough to fill another two West Suffolk Hospitals.

And while we have a higher percentage of people employed when compared against the rest of the county, but wages are low. This results in lower labour productivity and when you also factor in rental prices, which are forecast to rise twice as fast as incomes, by 2030 around 40% of under-40s will be living with their parents, compared to 14% now.

There are also other statistics that mean we need to prepare for the future. It is estimated that by 2037 the working age population will be similar in size to the dependent population. At the moment, there are around six people of working age to just over four dependent people – in 20 years it is estimated to be closer to five people of working age to five dependents – three older people and two children.

These figures show how different the county will be. We need to be prepared, but also look at what can be done at this point of time.

We must also to ensure the benefits of economic growth in the county – of which there can and will be plenty – are shared by all. We, along with our partners, must also look at addressing housing provision because the current approach will not compete with future demands.

Everything is being looked at. Funding, grants, provision. We’re having to be innovative in how we work, and instead of going it alone, we’re having to work collaboratively with our partners to get the best possible outcomes for the people of Suffolk.

For those starting out in life, we need to continue our focus on the value of a good education. For those carrying out their business, or working in Suffolk – we need to make the county as attractive as possible in order to create jobs and investment. For those retiring, we need to look at how we currently provide health and care. Our current models will not be able to cope with the increases predicted.

One way that we’re looking at changing how we provide health and care is using the Buurtzorg model of care, delivering dedicated personal and healthcare to patients in a neighbourhood. We’re working with our partners in health to deliver this in the west of the county. We’re leading this nationally I’m proud of the work we’re doing so far to change things for the better.

These are challenges that won’t be easy to tackle. But we are ready to face them, head on, with our partners, and get the best for those living, learning, working and retiring in Suffolk.

 

County Council Network Conference 2010

On Saturday I learnt that the Deputy Leader of Suffolk could not go to the CCN conference and so the Leader Jeremy asked if I might be able to go along, I said we had a family Sunday Lunch plans but I could come along after that so late Sunday afternoon I picked him up and off we drove to Gatwick Crowne Plaza, a County Council Network Conference in the middle of Gatwick!

The conference was excellent and it never ceases to amaze me that somehow over a period of time you get to know a lot of different people and beyond the sessions and discussion groups some of the most useful time is spent over coffee or a glass of wine chatting about the challenges we face, none more so as this was sort f the first get together after the announcements of the Comprehensive spending revue and we are getting a clear steer as to the cuts that are coming our way.

Ben Page from Ipsos Mori was his usual funny and very informative self as to exactly what the public think about the coalition, CSP and of course Councils, which is err…. shall we say not a lot!

In the private Conservative CCN Group Meeting each county represented gave a brief overview of their issues and a number of common themes emerged that we all agreed to work on. I thought the best quote of the session was “If you are going to stop something do it quickly don’t let it fester!” and there was a general sense that the scale of the savings required needed us all to have a very open and honest dialogue with our residents as to what is required rather than attempt to shield them from the harsh realities.

A line I am certainly taking when I speak on the Radio or write an article for a Parish magazine or two is that if you don’t agree with a cut proposal that’s fine but in commenting you have the responsibility that you must suggest where else that saving should come from, you simply cannot oppose a cut without having that thought process because there is simply not an alternative ‘do nothing’ position.

Eric Pickles MP was guest speaker at the Dinner but was not tight lipped about exactly what was to be in the Localism Bill but he did go around the tables chatting here and there.

Jeremy and I left the conference this morning with a clear sense that we are not alone in our concerns as to the scale of the saving required and the inevitable cuts that would require but that we, through our New Strategic Direction, seem to be slightly ahead of some with a strategy as to how we want to do it.

%d bloggers like this: