The current crisis in social care in England (and let's be under no illusions, for 'crisis' is what it is) should come as no surprise. Demand and need for social care, especially but not exclusively, for elderly people, has been rising for many years, and is forecast to grow at accelerating rates for many more years. as it has for younger adults.
On 8 March the Chancellor must show that he understands both the immediate care crisis and the need for a radical and sustainable long term solution. Older and disabled people and their families and carers have been waiting too long for the answer. Let's hope that their expectations aren't dashed yet again.
An extraordinary second Monday in December may have heralded long-awaited government action to tackle the care crisis. With more than a million older people not getting the help they need and cash-strapped local authorities squeezing fees to fragile care businesses, the care system seems close to collapse. Now all eyes are on the government's funding settlement for councils later this week. Will it simply allow councils to raise council tax to fund care or will it offer something more fundamental?
In order to save money in the future and to make our NHS sustainable, I believe the evidence shows that we must invest more in preventative medicine and in informing the lifestyle choices of the public. Supporting people to live independently healthy lives is just as important as treating ill health when it occurs.
That last point, which for many gets to the heart of why the ambitions for the Care Act aren't being realized, is certainly a fair reflection of the current climate. However, for me, finding solutions is as much about creativity as it is requests for more money. Carers do amazing work in their unpaid role, and as a society we need to show the same resolve in finding ways to support them.
Wait and see if social care providers fail, or put in some extra money to help councils pay the true cost of care. There is precious little understanding of what care provision really costs, and regardless of whether a provider has a profit making model or a not-for-profit model, the true cost of care is one that is greatly undervalued. The living wage will help to ensure that staff are more valued in the future, but without providers to work for that will be irrelevant.
By cutting public health budgets in-year by £200 million, the government has put enormous pressure on local authorities to make significant savings. Worryingly these savings are surfacing as cuts to services for people living with and at risk of HIV, leaving the more than 103,000 people in the UK living with a long team health condition with reduced local support facilities.
Children who may be suffering or who are at greater risk of neglect, but whose circumstances do not reach an authority's threshold to receive social care support, are less likely to get the help that they need. Instead, their situations can be allowed to deteriorate to become even more desperate or dangerous. It is a tragedy that due to a lack of gathering the right information, children whose lives could be improved are needlessly put at further risk. Child neglect can be stopped in its tracks.
The General Election is just 10 months away. But the focus of its debate is a generational challenge to share the benefits of growth, in an environment of ongoing reductions in public spending. The good news is that the current squeeze in living standards is not inevitable and there are choices we make to reach a different outcome.
Children's homes providers, Local Authorities and Government are united in the aim that the right placement is made at the right time for the right child at the right cost. If are to match the Secretary of State's ambitions we need to be bold and address all the issues we face reforming not only children's homes but Children's Services more widely.