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Will The Budget Tackle The Care Crisis?

27/02/2017 12:20 GMT | Updated 27/02/2017 12:21 GMT
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With just a few days until the last ever spring Budget, there are growing expectations that the Chancellor will address the care crisis on 8 March.

Predictions include a substantial and immediate cash injection to tackle urgent problems, together with a commitment to finding a long-term, sustainable solution to the care crisis.

The proof of the pudding will of course be in the Chancellor's statement. But if the predictions are correct, then a number of questions follow.

Firstly re the injection of funds. Where will the money go, will it be enough to make a significant difference and what strings will be attached?

The most immediate crisis is in homecare services, with the knock on affecting hospitals, as older people lack support at home and are either admitted unnecessarily to hospital or can't be discharged from hospital.

The difficulty is that some local authorities have much better funding and provision of homecare, and the issues re hospital admission and discharge are much worse in some parts of the country. So will extra funds be targeted where they are needed most, thereby penalising those councils which have already sorted out this problem with their health partners?

Variations in care and costs are a massive issue within both the NHS and social care. Significant efficiencies can be achieved by eradicating these variations and getting all councils, GPs and health trusts working at least above the current average.

I would therefore focus on the worst performing councils and incentivise their improvements in homecare services and joint working with health. Councils will need a guarantee of enough extra funding to make a real difference in both 2017-18 and 2018-19.

Secondly, what are the plans for a sustainable solution to the care crisis?

Worryingly the talk is of 'an independent expert' to overhaul the care system. We have been here before - several times. Just a few years ago the Dilnot commission was charged with making care funding fairer but its limited proposals (ie a cap on the cost of care which would have helped few families) were rightly kicked into the long grass.

I am sure the government knows what needs to be done and doesn't need another independent inquiry taking a couple more years. The government's own review currently being undertaken by the cabinet office should provide the answers.

The issue is whether the government will be bold and grasp all the nettles. We need a national system that is fair, simple and sustainable wherever you live. Health and care must be properly integrated, with one local body responsible for commissioning services for its local population within a national framework.

The big challenge is how to fund this solution given the differences in health and care funding and to end the postcode lottery. The NHS provides a well tried and tested model, with care free at the point of need funded through taxation.

Will the government be brave enough to adopt this model to fund integrated health and care services?

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.

Stephen Burke is director of Good Care Guide and United for All Ages