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Gordon Brown's Listening and Learning Initiative - Carers UK Forum

Gordon Brown's Listening and Learning Initiative

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Voices of experience


The forthcoming spending review is predicted to be the tightest so far but it will raise the debate on the type of care older people want

Stephen Burke
Wednesday June 6, 2007
The Guardian


Any debate on the "first 100 days" - in this case, under the leadership of a new prime minister - suggests some quick fixes are ready to be released. What could possibly be done differently, especially after 10 years of a government? And can long-standing issues, such as the funding of care of older people, be swiftly resolved?
We won't have to wait much longer to find out: 100 days from June 27 will take us to the eve of the 2007 spending review, which has been predicted as this government's tightest. Yet there is some optimism that the new era will bring in a new settlement for older people's care.

If Gordon Brown's "listening and learning" initiative is to be meaningful, then the voices of older people, their families and carers must be heard and acted on. Their private struggles to lead independent lives, to get the help they need in their own home, or to pay care home fees, must become the subject of greater public debate.

Strengthening families requires proper recognition of the day-in day-out, mostly unpaid care, and older people and their carers must be engaged and empowered in shaping the future. One in five of the UK population will develop long-term care needs, yet the care system is not fit for the future. Our ageing population demands a new approach.

A fairer system

The Caring Choices coalition is raising the debate through regional events to explore what older people and their organisations want from care and how we reach a fairer system of paying for care in the future. The questions are clear. Who should pay for care? How do we encourage people to contribute to their care costs? How do we encourage communities and families to continue to provide informal care?

The Joseph Rowntree Foundation has already provided some solutions to helping people pay for care - particularly residential care - that could be implemented swiftly. But there are also questions to be asked about how the care system can work better. There are four areas where I believe care and support for older people could be improved by: integrating health, care and other services; making choice and control a reality for all; supporting carers; and tackling underfunding.

Counsel and Care welcomed the recently published commissioning framework for health and wellbeing. Encouragingly, the foreword was jointly written by the secretaries of state for health and for communities and local government, with the emphasis on moving from partnership to integration.

Local area agreements potentially provide a powerful vehicle to move this agenda forward. The focus must be much wider than purely health and care if we are to create places that are good to grow old in. The commissioning of a range of local services such as housing, transport, community safety and leisure is therefore critical in moving from community care to caring neighbourhoods.

The importance of appropriate, safe and affordable housing in reducing the need for health and social care services is often under-estimated. The development by the Department for Communities and Local Government of a housing strategy for an ageing population should provide the framework for progressing this through local area agreements.

Three other measures will also help. First, the creation of one-stop shops - the "Sure Start for older people" approach - providing access to services through a single gateway as well as reaching out to where older people live. Second, we need new financial incentives to promote a new approach. Third, local area agreements could be the first step towards introducing greater accountability.

The debate about the future of public service reform under Gordon Brown is raging. Social care has quietly led the way. Direct payments and now individual budgets have given some service users more say over what they want. But still too few older people - just 2% of care users - and their carers benefit from the flexibility and freedom that direct payments can bring.

Making "power to all the people" a reality requires investment in information and advice, outreach and independent advocacy services, particularly for those who are isolated or disadvantaged.

A three-pronged approach would see the development of a national one-stop care advice service; local information and advice services as a joint local government and health responsibility; and independent advocacy services in every community to support those people who are most vulnerable and excluded.

During Carers Week (June 11-17), it is expected that the government will launch its consultation on the national carers strategy. This is a huge opportunity to ensure the growing number of carers get the time, money and support they need to fulfil their caring role and have a life too.

Carers recently got the right to request flexible working. More could be done by employers and government to help carers who work - from extending tax exemptions to care vouchers to providing emergency care. Particular attention must be paid to carers, who increasingly are older. Making carer's allowance available to pensioners and providing more respite care and practical support would help.

Many carers argue that improving care services would be the best news for them. But that will require greater and sustained investment. The reality is that, again this year, local authorities have tightened their eligibility criteria, restricting the number of people who get care services. Sir Derek Wanless's review of social care put the funding gap at £1.7bn.

We need to examine some radical solutions for funding care for our ageing population - for example, from inheritance tax. It has been estimated by the Nursing Home Fees Agency that a 2.5% "care duty" - 2.5% of lifetime transfers and estates between £10,000 and the inheritance tax threshold - would raise around £1.5bn. The framework for collection is already in place and such a care duty would provide instant funding. It offers a fair and just way of delivering the funding needed.

Resources prioritised

We also need new incentives to encourage health and local government spending to move away from expensive acute treatment to community-based services and support that help people stay in their own homes. At the moment, these practical services that promote independence are severely underfunded as resources are prioritised towards those with the highest needs.

There is increasing evidence about the positive cost benefits of a range of preventative services from falls prevention and telecare to home improvement agencies. Investment in early intervention and community services could be encouraged by reducing rates of hospital admission for older people, for example, and the savings re-invested. What we need now are much more effective incentives to keep people out of hospital. Local authorities should also be motivated to increase the take-up rate of direct payments, which for older people is still very low.

Finally, in thinking the unthinkable, we must look again at eligibility criteria. Are they really the way to help deliver a modern care system that is fit for the future and delivers independence, health and wellbeing for older people?

· Stephen Burke, chief executive of Counsel and Care, will speak at the Progress debate on First 100 Days: Labour's Priorities for Health and Social care on Tuesday, June 12, at Committee Room 11, House of Commons. Details tom@progressives.org.uk. counselandcare.org.uk

· Email your comments to society@guardian.co.uk. If you are writing a comment for publication, please mark clearly "for publication"
Please remove this if you do not want it on the boards, but I thought it followed on from the previous post about care, and giving us something that we can actually do.
Wendy
Hi Wendy,

I had already put a link to this on forum last night along with 2 others

http://www.carersuk.org/Forums/viewtopic.php?t=658

We need to know whats happening out there, that is going to affect us and if this means we share articles we find with others,it can only be for the good of us all.Some dont have time to search for news items and I know from emails received that many benefit from links that get posted here or other forums.

Following on about care,our local Soc Services really tightening up on eligibility criteria, same as in what is happening country wide.

Examples......More day services get with withdrawn/reduced
Direct payment criteria harder to meet.
Care packages being trimmed to the bare bones to save money
Short breaks money nigh on impossible to get.

We hear all the time about our carees rights and carers rights but how can we access them totally when government/councils/boroughs putting their financial budgets ahead of the needs of people.

Rosemary
x x x
Please accept my apologies Rosemary.
I had not read it last night.
Wendy
Hi Wendy,

No need to ever apologise Image .Like always you were thinking of us all and wanted to share some information.Makes no difference if we post something 10 times as long as it reaches those it affects.

By the way,I went in your chat room,notice said.....No geordies allowed.. Image .Maybe that was why no one was there,you had fore warned them Image Image.

Take care
Rosemary
Since GORDON BROWN made his speech re help for carers ive sent out now 256 emails to G.B. and his department and other ministers ive also sent out 55 letters with s.a.e. enclosed up to now ive had not one reply
so who`s listening
My mum sent a carers week postcard to her MP (Patricia Hewitt, Secretary of State for Health) and got a standard holding reply that said she would contact the relevant minister.

Presumably she talks to herself a lot then. Image

I'm sending mine in Carers Week.
Since GORDON BROWN made his speech re help for carers ive sent out now 256 emails to G.B. and his department and other ministers ive also sent out 55 letters with s.a.e. enclosed up to now ive had not one reply
so who`s listening
Nobody. That's why its a waste of time (and money).