In the UK we have many issues, even though there is much to be proud of.
In 1948 the Government of the day created the Welfare State and in doing so the NHS was born.
This was a great achievement and one we have all become to be proud of, yes, there are many problem issues, but the concept is to be proud of. Universal health care free at the point of delivery for everyone was and is a great concept.
Unfortunately, in 1948 this concept was not extended to social care and while it was improved it was not put on a formal process until 1970 when it became fully in the realms of the Local Authorities. But, as with all Government projects where the Government gives responsibility to others, the Government never fully funds the project, if they fund it at all.
Even with the NHS, it became very clear early on that the funding was not right, as in 1950s a prescription charge had to be introduced, I believe it was 1 Shilling.
Although the NHS has continued to be Government funded, not always to the extent that it should have been, as any area liable to Government funding , is, in effect, dealt with as a ‘political football’ it is kicked about and the funding is dependent on the Government of the day and the so called, ‘economic conditions’ of the day and not as it should be the real need of effective and sufficient finance.
But Social Care as never been subjected to Government direct funding, when it should have been, but left to each Local Authority, (LAs) to fund social care as they deem necessary, but not by need, but by funding resources. To do this LAs obtain some funding locally through Council Tax, Business Rates and some from Government ‘Grants’.
Council tax is based on each individuals property whether it is rented or owned and no account of the individuals income is taken into account, so you could have a Millionaire, or Billionaire in a subsidised council house or a be in a large privately owned property with very little income, so ability to pay is not all that recognised.
With Government Grants, since 2010 the tory Governments have not been fully funding LAs though the grants and have been subjecting them to austerity cuts, perhaps to at least deductions of 50 to 60 % of the grants being deducted before payment. The premise was that these cuts would be funded through LAs making savings, but in effect many of the assumptions from Government of savings being there was false and saving could only be achieved by making cuts to services. While in many instances Social Care was tried to be shielded from service cuts by LAs in effect cuts have had to be made as, in effect, social care has never been sufficiently funded. This has all been taking place while the need for social care has been increasing as with the advances in medical science means more persons with disabilities and more complex disabilities are in evidence and while the mortality for persons, especially with learning disabilities is found to be around 20 years younger than that the ‘normal’ researched mortality rate. So the need for social care is increasing year by year by around 5% while the funding is being substantially reduced, meaning many in need of care are not receiving as much as they need or none at all.
At the beginning of this message I started by comparing the NHS and social care in many ways, but effectively both the NHS and social c are are in need to each other and are forever to be linked in need, but due to ineffective Governments they are not in many ways joined together in systems and especially management, while there is much more day to day involvement in front-line day to day activities, even through the systems get in the way.
Much of this is around funding, need and availability for lack of health being looked after leads to more need of social care. While the meed of social care or the lack of it leads to health deteriorations.
Also when NHS patients are ready to be discharged from hospitals, they may not be ready to look after themselves and could need some social care immediately or some time thereafter to enable safe discharge. This, therefore slows the discharge process and does lead to the unfortunate comment of ‘bed-blocking‘. But, it is not just the South but UK wide.
This inability to discharge means that patients coming into A&E where inpatient admission is required is delayed until beds are available. In this, it also means that ambulances can’t delivery their persons from ambulances into A&E. which means ambulances are retained outside A&E for longer and longer. This then reduces the numbers of ambulances available to attend other emergency calls, so people waiting for ambulances have to wait much longer.
All this leads to more unnecessary suffering to persons in ill-health and at times results in early deaths.
Hospitals including A&E and ambulances have target times which they are subjected to and they are missing these targets through no fault of their own, but due to insufficient funding of both the NHS and Social Care which is at the door of the Government, especially the Prime Minister and the Secretary of State for health and Social care, but is the blame placed on them, no it is placed on the respective organisations NHS Hospitals and A&E and the ambulance services.
It is essential that both the NHS and social care are always sufficiently funded and each and every Governments needs to listen, understand and they do what is required and not as they currently do just ignore the problem and hope it goes away, as it will not do until the funding is sorted.
Currently there are threats of strikes in the NHS and again the Government is not listening and even when there is eventually a settlement of the pay disputes, not all the eventual pay will b e funded by the Government and will have to come from funding already agreed, so therefore even less funding on patient care delivery. This is due to the fact that Hospitals have to delivery a fully balanced budget in January/February of each year, while the actual pay settlement is much later in the year. An allowance will have been made in the budget for pay settlements, but when there is rampant inflation as there is currently the pay settlement forecasts in the budgets will be far less than than it actually is.
Again, the system is not ‘fit for purpose’ so the Government should always fully fund any pay settlements.
Funding is a major crisis in social care but there are other problems
a major lack of persons willing to enter social care as a profession
the rate of pay is in no way near the amount it should be for the responsibilities care workers have to take on
Immigration policies are not allowing sufficient persons to enter the UK to come into social care employment
Work conditions of employment are in desperate need to revisions as there are many unsocial hours worked with no sufficient pay for doing so, much technical knowledge required to use the persons in need of care equipment, sufficient payments for travel time, no sick pay arrangement and much more.
I have been campaigning for many years together with other family carers, but hardly was anyone listening. however, I see that social care is now much more in the news and many others are taking onboard what is required, but still this Government is showing deaf ears, just as through they are the ‘3 wise monkeys‘, unfortunately this is very unfair on monkeys.
Many people can’t see the need for social care and feel the families should do more, even some in Governments have said so, but families have always provided care, but family members get older and with caring their health deteriorates too, so they only look for social care when they eventually realise that they themselves are unable to provide the degree of care required to look after their loved ones.
But as I have said social care and the NHS are so intertwined and rely on each other. One can’t exist without the other. With the state of social care being so dire, not only the degree of the NHS, but its very existence depends on a viable social care to be there, which if the Government does not act more sooner than later, than social care in any form will not exist and that will mean that the NHS will not be that far behind. So, even if you don’t use social care, you will be using the NHS, so it is in your interest that social care is to be saved and not just saved, but be in a far better state than it is at present, just so the NHS can survive.
So whether you need it or not it is in everyone’s interest for the required funding, at least is made available to social care and ideally all the other aspects be greatly improved.
Yes, social care is expensive as is the NHS and some people do have to pay for the full cost of their social c are and that is, currently, anyone with savings above £23000, but if you or your relative does need social care your savings will be quickly depleted and then the La will fund the social c are required, subject to a contribution from the person in need of care to their care package, which could be around £100 or more per week, but that could be reduced by applying Disability Related Expenses, (DREs).
Also, please note that social care is more than care homes for the elderly as social care is needed by children and adults in home care, Supported Living, Respite, hospices, etc
So lets us all get on to this Government and make them, eventually, fund LAs so social care can be fully funded to not only save social care but the NHS.