‘While more and more people need care, fewer and fewer get it.’ Photograph: Getty Images/iStockphoto
In last week’s autumn statement, the chancellor failed to even acknowledge the crisis facing adult social care. Ignoring one of the country’s most under-appreciated public services has become a bad habit of governments of all colours. Yet it was a habit that charities, councils, social care workers, NHS managers, former ministers, and of course those who need care, had all hoped the government was finally going to break, as part of its bid to build “a country that works for everyone”. It was not to be.
It is not an overstatement to describe care as life support. It is as basic as washing, dressing or eating. If you have a family member who relies on it, you will know what it means for the whole family for your loved one to get the care they need to be safe and to live with dignity.
Yet demographic changes, combined with chronic underfunding, mean that while more and more people need care, fewer and fewer get it. Indeed, more than 1 million older and disabled people do not get the care they need, and investment has shrunk by a third in just five years. This amounts to an overall shortfall of £4.6bn in investment in social care, because of £1.6bn worth of cash cuts in social care budgets.
What this means in practice is that some of those who are most in need of help, whether it’s because they are living with dementia or Parkinson’s or fighting cancer, are not being given the help they need to get up in the morning, manage around the home or go out. More than a million older and disabled people are unable to get the care they need. As many families will know, the impact of this lack of help can be heartbreaking.
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Councils are unable to pay for the full price of care, as the funding is simply not there, and care homes are closing at increasing rates. Government figures released from the Insolvency Service show that 380 care homes, nearly 100 more than originally reported, have collapsed since 2010. When care homes close, people have to go further away from family to find a place, which makes it harder on families to visit.
This lack of help can cause increased physical and mental health issues. For example, a third of autistic adults have experienced severe mental health problems due to a lack of support. In addition, it has a massive knock-on impact on carers – stress and absenteeism caused by juggling work with caring is estimated to be costing UK businesses more than £3.5bn every year.
Underfunding of care also has a significant impact on the NHS. The latest delayed discharge figures have remained at a record–breaking high for three consecutive months. We are now witnessing delays that we would normally only see during winter crisis times. Social care consistently accounts for 30% of all delayed discharge, and last year it resulted in 650,000 lost bed days and a waste of up to £300m.
Given these challenges have been in place during summer months, health experts’ warnings of an impending winter crisis in the NHS need to be heard. Investment in care will help prevent entry into the health system as well as supporting discharge.
The government needs to look urgently and seriously at this issue, right the wrongs of overlooking those that need care and move urgently to develop a sustainable care system that is fit for purpose.