Cuts that could destroy Scotland’s care services
Severe cuts facing care services for pensioners and vulnerable children around Scotland are exposed today in an internal document leaked to The Herald.
The survey of social work chiefs across the country reveals closing care homes and day centres, removing wardens from sheltered housing at weekends and creating waiting lists for homecare services are among the measures being taken to save cash.
Two local authorities warn patients could be delayed in hospital, blocking beds, because resources will not be readily available in future to provide community support.
Six councils say preventative work intended to stop children and the elderly reaching a crisis situation is likely to suffer.
One social work chief said: “In all services we will be moving away from our aspiration to deliver early intervention and preventative services … and focusing on delivering our statutory responsibilities.”
The document continues: “The aspiration to invest in early years’ provision will not be achieved – creating the risk that acute, intensive and more expensive care packages will be required at a later stage.”
Scotland’s local authorities are facing budget cuts at a time when demand for care services is rising. Glasgow City Council has recently published proposals to save £26.5 million on social work spending over the next two years.
The Association of Directors of Social Work in Scotland (ADSW) surveyed heads of social work departments to discover how they are balancing the books and the findings were intended to form discussions with the Scottish Government.
Out of 32 councils, 25 took part. In a summary report seen by The Herald their responses were anonymous.
Five authorities refer to care homes closing either this year or by April 2015 and one says shutting all council-run care homes is being considered in the long term.
Two councils say they have already stopped meals on wheels, dispatching frozen dinners to vulnerable residents instead. Another has agreed to remove on-site wardens from sheltered housing at evenings and weekends and another said eligibility criteria for support had been changed so only those with critical or substantial needs received help.
Reducing the levels of respite care offered, introducing charges for free services and banning overtime working unless it is a case of “life or limb” are among the measures being considered to save money in future.
Charity Age Scotland expressed concern. A spokesman said: “The short-sighted and knee-jerk reactions to the current economic climate, as outlined in this survey, will force many older people into higher level – and far costlier – care services.
“By closing residential care units, charging for services currently free at the point of delivery or just not meeting the care needs of individuals, the directors of social work would simply be passing a greater cost to other local government departments and public bodies.”
Jackie Baillie, health spokeswoman for Scottish Labour, said the SNP Government had presided over a massive cut in social care budgets. She continued: “If no action is taken we are likely to see care homes shut down, elderly people needlessly kept in hospital because there is nowhere for them to go and a massive increase in charges for services like meals on wheels.
“This simply isn’t good enough.”
Michelle Miller, president of the ADSW, admitted painful decisions would have to be made. She said: “I do not think there is any doubt that it is going to be horrendous, but we have a responsibility to cope with it in a way that does not terrify vulnerable people and that means we still have an improvement agenda. We somehow have to reconcile that.”
She said there were schemes to improve care, such as giving pensioners power to buy the home help they wanted, but these were not detailed in the survey document. She also said where risks were identified, such as the loss of preventative services, there was a drive to stop them happening.
A Scottish Government spokesperson said: “We know local authorities – like the rest of the public sector – are facing challenging financial times. Some social care commitments, like free personal care, are absolute.
“However, we know the ways in which care is delivered to older people needs to change –focusing more, for example, on telecare and other ways of helping people remain safe and independent in their own homes. Not only is that financially more efficient but it is also what older people consistently tell us they want.
“Councils have also accepted the evidence on the importance of the early years in terms of improving the life chances of children and we hope they will continue to give high priority to the implementation of the Early Years Framework. This is a commitment we are discussing with councils as part of wider financial negotiations.
“In terms of looked after children, care placements should be based on each child’s needs. Budget-based decisions would inevitably lead to children suffering worse outcomes and experiencing higher intensity and costly interventions later on. By contrast, effective intervention in the early years should lead to reduced pressure on the number of children requiring both foster placements or residential care.”
It’s time for a frank discussion
By Michelle Miller
As the economic crisis bites, all of us managing public services have to consider what we need to do to ensure that we can continue to support our most vulnerable citizens. Elected members and council officers across the land are grappling with these questions. This has to be a frank and honest discussion with nothing left off the table.
And while there are decisions that have to be taken to allow us to continue to support people in the short term, there has to be room in our thinking for the change we need if our aspirations for public services, social justice and the health and wellbeing of all are to become a reality. In a climate where public funds can’t pay for everything, what are we prepared to do without? And in a world that no longer wants to see its citizens as passive recipients of state provision, what should we expect to do for ourselves, and for others?
Some painful decisions will no doubt have to be taken. Different perspectives bring different demands on public funds. Universal provision, free for all at the point of delivery, has financial implications that impact on the few. That is the reality of democracy: we choose what we pay for.
But we need an informed debate about the consequences of those choices. And at the same time as deciding on our priorities, we need to transform our traditional model of service delivery into a system of care, support and protection that reflects our ambitions for our future.
– Michelle Miller is president of the Association of Directors of Social Work