Cuts in social care are a complete false economy
The Shadow Health Secretary writes for PoliticsHome explaining the enormous cost in human misery social care cuts have.
One of the least understood and most disastrous cuts currently affecting the NHS are those on social care. Across the country, local authorities are scrapping services in community nursing and other kinds of social care because of central government cuts. The disappearance and downsizing of these services doesn’t just hit vulnerable people who need care – it has a direct impact on the capacity of the NHS, with a growing number of patients unable to leave hospital because there is no social care package for them.
This is a completely false economy in every respect. Vulnerable and often elderly patients are prevented from returning home or back into residential care post-treatment because no transitional social care package is in place. Waiting list times are extended – the government misses its targets in this area by ever-widening margins.
These cuts can have an enormous cost in terms of human misery. Elderly patients who aren’t cleaned regularly or whose hair remains unwashed and uncut. People needing help preparing food being giving a flying visit and a topped up thermos flask. Disabled people who need help to go to the bathroom and do not receive it, who suffer the indignity and dangers of incontinence as a result.
Social care cuts are part of a wider pattern. So much of the funding crisis in the NHS is caused not just by a lack of direct funds but a lack of public investment. Social care cuts mean that patients have to stay in hospital beds, which cost exponentially more. A lack of staff means that the NHS now spends £3.6bn a year on agency staffing. And the unwillingness of successive governments to publicly fund hospital building gave us PFI – a system that forces NHS Trusts to spend billions on interest payments to private companies
The average number of delayed transfers of care has been rising steadily. In 2015/16 there were over 1.8 million ‘delayed days’ for patient transfers. According to NHS England, the largest increase was seen in delays due to patient awaiting care packages in their own homes, increasing by 52 per cent in a single year to 314,000 days. With an average day in hospital costing £350, the cost of 1.8 million days was £630 million. Restoring funding to social care by this amount would have an enormous positive effect in alleviating the pressures on the NHS.
But this is only one aspect of the effect of the cuts. The Association of Directors of Adult Social Services estimates that councils cut £4.6 billion from adult social care budget between 2010 and 2015. This is a third of the total social care budget. Of course this is a direct result of the cuts imposed on the councils themselves by the Coalition and which have now been deepened by the Tory Government.
Each of these cuts is billed as a saving by ministers. Yet the true picture is that they entail knock-on negative effects on the wellbeing of some of the vulnerable in society. They also in many cases generate new costs to the public sector. This can be incurred by the NHS itself, as lack of social care may lead to deteriorating health or medical conditions, accidents or simply increased demands on GPs.
Other areas of the public sector are also pressured, not just the NHS. Lack of cost-effective social care can lead to increased demand on social services, residential care, increased problems and costs to schools, and even to the police and criminal justice systems.
These are the false economies of Tory cuts. For the NHS this means increased A&E waiting times and lengthening waiting lists for elective surgery beyond the 18-week target. The cuts to social care hurt us all. In the NHS as across the public sector, austerity is a political choice, not an economic necessity.
I was proud to stand alongside Jeremy Corbyn this week to announce a new plan for Britain’s healthcare system. Labour will renationalise the NHS, taking it back into public hands, and restoring it as a single service rather than the patchwork of private contractors that are sucking money away from patient care. At the core of that vision is a new deal for social care. We will fund it properly, and make it an efficient, integrated service.
Diane Abbott is the Shadow Health Secretary and Labour MP for Hackney North and Stoke Newington.