The chaos for families caught in care cuts

First in my series of articles for False Economy featuring people who rely on the NHS, council services (especially care) and benefits like the DLA. As government reforms start to bite, I’ll be publishing more stories with people who rely on those services to chart the impact of these policy changes on real lives. These first articles feature people living in the northwest.

Perceptions of Lancashire council spending priorities: why the left should care

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Updated Saturday 2 April 2011

Wonder if the good burghers of Lancashire know that their zero council tax increase is being funded by the county’s most vulnerable residents?

On Thursday, Lancashire council’s cabinet member for adult and community services agreed to tighten care services eligibility criteria. The council also agreed to introduce new charges for adults who receive care services at home.

From next week, the eligibility threshold for accessing adult social care services (under Fair Access to Care Services) will be raised from “moderate and above” to “substantial and above.”

Life with “moderate” care needs is perhaps not the hayride that the word “moderate” would have us suppose. A person is deemed to have “moderate” care needs if, without care services:

“• there is, or will be, an inability to carry out several personal care or domestic routines, and/or

• involvement in several aspects of work, education or learning cannot or will not be sustained, and/or

• several social support systems and relationships cannot or will not be sustained, and/or

• several family and other social roles and responsibilities cannot or will not be undertaken.”

A lot of people – about 3900 – fall into the “moderate” needs category in Lancashire. All will have their care packages reviewed over the next 12 months. The council will need to pay for additional staff to carry out these complex reviews of all service users – it admits as much in its own reports.

The amount of money this changed eligibility proposal will save is, apparently, chickenfeed – about £2.5m in 2011 to 2012, with savings “rising to £5m in a full year.” The council offers no estimate for the cost of the additional staff who will be needed for the 3900 reviews. It’s not hard to spirit one up, though – 20 or so additional experienced staff on, say, a relatively small salary of £20k apiece for the year would push costs towards the half-million mark. I suspect that at the very least, that guess will be as good as the council’s – unless, of course, the additional staff are compelled to forgo salaries and turn in Big Society freebies. I suppose we will have to wait to see the realities of costs at that end.

As for consultation – forget it. The council has. It acknowledges that the majority of people who responded to its recent “Making Difficult Decisions” consultation exercise on care service eligibility wanted Lancashire to keep providing care for people with “moderate needs.” The council’s reports bat those responses aside – the savings, the council says, must be made.

I note, by the way, that the budget meeting at which the council agreed cuts proposals took place about ten days before the “Making Difficult Decisions” consultation exercise ended. The council’s own papers say the consultation ran from 6 December 2010 until 28 February 2011. The meeting at which the budget was agreed took place on February 17. That 17 February meeting described the “Making Difficult Decisions” consultation exercise as “ongoing,” but nobody was fooled. Disability Equality Northwest is looking at challenging the council’s consultation exercise on social care through the courts.

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I think it’s also worth noting that there’s a lot of tetchiness around about council spending priorities. Relatively meagre published savings totals like £2.5m and £5m strike people as ridiculously small amounts to pursue (even if councils argue, as they do, that it all adds up). The feeling is that those sorts of sums could, somehow, be found.

There is certainly a feeling that council finance and spending priorities are warped. There is, for example, mounting fury about council reserves and about the amount of money town halls make available for capital projects – town hall improvements, city centre improvements, road improvements, whatever. People are well aware that infrastructure budgets are to be spent only on infrastructure projects – not least because councils never shut up about that now. These are sensitive times and councillors are quick to fall back on rules to explain massive outlays on building and roadworks. That doesn’t mean service users care for those explanations, though. The feeling is that care services users ought, somehow, to be prioritised ahead of town centre improvements and new bypasses and so on. That feeling should carry some weight with the political left.

I met with a Lancashire parent (Ned Ludd) of a disabled man about a fortnight ago and we talked about this. We talked about it, because the first thing he did was show me a copy of the council’s brag-rag – a propaganda sheet called Lancashire Vision. He was seething about the front-page story – a puff piece about the council recently agreeing a capital programme of £294m for road, transport and building projects.

The council, of course, made clear in the story that the £294m was available only for infrastructure projects – “finance rules means this money is reserved for investment in the county’s infrastructure and cannot be used to offset the savings needs elsewhere,” its paper prattled.

Technically, that is correct (to an extent), but parents like Ned Ludd couldn’t care less. That is important for the left to note. If you want to understand public anger about council cuts, you need to understand how distribution of council resources is perceived by people who feel that they’re at the rough end of that distribution. It’s not a question of the facts of council finance – it’s a question of public perception of the facts of council finance. Ludd took that £294m capital spend story as a slap in the face – a confirmation that Tory councils prioritise 4×4 drivers over disabled service users and use public money to publish stories that celebrate that point. Technically, he may be wrong, but morally, he is right. That’s a point the left needs to note.

Similarly, Lancashire council’s massive £110m reserve pot makes people furious. Agitation about this giant stash continues among service users: people want unallocated reserves to be used to extend revenue budgets for a year. I have some time for that argument, as it happens. Some councils have argued in favour of drawing on reserves to protect services in the past few months – although plenty, of course, have argued in favour of hoarding reserves and abandoning services. Unison, to its credit, has made such an argument to Tory administrations in councils like Notts county. At the very least, a strong, co-ordinated left argument in favour of using reserves to buy time for service users should by underway by now. We need to start addressing this sense of inequality of distribution – the sense that there is no political will to direct funds to those who most need them.

Lancashire Tories and lives without care

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To be updated.

To Lancashire, now, where disabled service users ready themselves for the realities of Tory Lancashire county council’s horrendous care service cuts.

In February, Lancashire agreed service cuts of £179m over three years, even though the council has about £110m in reserves and plans to pour £294m into road works and transport schemes in the next four years.

This council has rounded on its most vulnerable citizens for service cuts. Children’s respite carehomes will be shut. Eligibility criteria for care for disabled adults will be tightened (nearly 4000 service users will be reviewed) and care charges introduced.

Charges for some services will be introduced and the council plans to cut fees paid to some residential and nursing providers (who, naturally, will very likely look to recoup their losses from service users. I wonder if the good burghers of Lancashire know that their much-celebrated zero council tax increase is being paid for by people with disabilities).

Disability Equality Northwest is seeking a judicial review of the council’s consultation processes. Fair play to them, too – I’ve spoken to service users who say they weren’t aware for some time that consultation about their services was officially underway. Others say that the council tried to keep them out of the “public” consultation meetings that the council held in late January and early February.

If reviews go ahead and the courts find against Lancashire, they could force the council to re-run consultation exercises, which would buy service users time to lobby politicians and think up other protest and service alternatives. Judicial reviews are hardly cure-alls, but they can slow a council’s cuts ideologists down.

The rest is a shambles. Parents keep up the fight for respite centres. Nobody seems to know how many council staff will lose their jobs. Figures of up to 6000 are doing the rounds in the press – numbers the council neither confirms, nor denies. Meanwhile, parents and families of severely disabled people linger in a – well, soulless limbo.

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The first thing Ned Ludd tells me when we meet is that he’s tired. I see it right away, then: red, bleary eyes in his otherwise appealing face and skin that is about the same shade as his grey hair and beard. He looks exhausted.

He was up all night looking after his severely disabled adult son. His son has cerebral palsy and a range of health problems – some remain undiagnosed. His son can’t move independently, or speak. He is fed through a stoma and tube. He suffers regularly from fits (about ten a day) and breathing problems and chest infections. The chest infections frighten Ludd, because they’re potential killers. They have nearly killed his son several times. Continue reading

Lancashire cuts

Update January 12 2011: The link to the pdf on Lancashire council’s site below seems to have broken, so I reposted it here.

So – here’s a sorry pile to read, if you were looking for one: Lancashire county council’s proposals for service cuts.

Not much escapes the scythe here. Note the proposal to tighten eligibility criteria for adults needing care (page 18: the council wants to raise the base eligibility rate from “moderate to substantial”) and to increase charges for homecare (page 68). There’s a general proposal to cut the overall level of non-residential social care services: a move that would reduce the levels of support by up to 20%.

As one parent of a severely disabled man said to me today – “they’re going to consult us on how they cut, but they’ve already decided to do it and decided how in a fair amount of detail.” Indeed they have. A great deal of time has been spent on the paper linked to above.

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