Last week saw the final of the three sessions hosted by the All Party Parliamentary Group on Local Government, focusing on the future of Adult Social Care. It was, in the main, a stilted discussion that was inevitably hamstrung by the continuing delay over the (allegedly) forthcoming White Paper.
Localism remains a strong Coalition theme, yet this is another example of the inept administration holding back any chance of innovation or forward thinking by local authorities. Without that White Paper, and without a framework that is desperately needed to respond to the urgent recommendations of the Dilnot Commission and the Law Commission, local authorities are hardly being best-equipped to improve outcomes for residents in the meantime given the financial and demographic pressures currently being experienced.
Local government commissioners are faced with a dizzying reform agenda, much of which has both anticipated and unexpected implications for local government. Consider for example, the dramatic impact which welfare reform is having on attempts to support people with social care needs to live independently – a significant drop in benefits (Housing Allowance and Disability Living Allowance) means rents are increasingly unviable, with local government picking up the tab for providing an alternative (potentially residential care at a much greater overall cost to the taxpayer). The recent controversies in which some London boroughs have looked to export particularly ‘expensive’ families to alternative local authority areas is just another example of the pressure commissioners are finding themselves under.
At the same time, local government is being expected to ‘step up to the plate’ (Stephen Dorrell speaking at last week’s APPG session) in influencing NHS services following the Health and Social Care Act. Dorrell is of course correct in asserting that this is a terrific opportunity for local authorities to lead efforts in creating a more efficient ‘whole economy’ system of health and social care. However, this scale of integration is an intimidating challenge given the chaos instigated by the Health and Social Care Act and an utter lack of vision or impetus for reform of social care. We don’t yet know how social care will be made sustainable. We don’t yet know what will be expected of local government in accomplishing this – either through funding or point of delivery. ‘Stepping up to the plate’ blindfolded and with one hand tied is unlikely to be a successful endeavour.
Worryingly, there is speculation that any White Paper will be half-hearted – delaying any significant legislation until the next Parliament. This is perhaps understandable given the political heat currently being experienced by the Coalition administration. Reforming adult social care will be expensive and potentially unpalatable politically. But it will be a vital piece of the puzzle if the wider reform agenda is to be anything other than an incoherent mess.