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costs of care
Many councils are worried about the costs of implementing the Care Act, especially in London where costs are even higher and there are unique demographic challenges. PSE spoke to Hillingdon council leader Cllr Ray Puddifoot, London Councils’ executive member for adult social care.
he Care Act was notable for its relatively easy journey through Parliament, with
cross-party backing, the willingness with which the government accepted amendments, and how quickly it became law.
Both the Local Government Association (LGA) and London Councils are supportive of the reforms under the Act (some of which are listed in the box-out), but both have concerns about a shortfall in proposed government funding for councils to actually deliver those reforms.
The LGA said that of 152 councils it surveyed, 134 are concerned about the implementation cost.
London Councils is also specifically concerned about the timescale of the implementation in the capital, which has many unique challenges, such as the relatively high cost of care and its demographics.
Funding gap
Cllr Ray Puddifoot, who has led the London Borough of Hillingdon since 2000, is London Councils’ executive member for adult social care.
He told PSE that while the measures in the Care Act are sensible, good for residents and have cross-party backing among London’s local authorities, “the difficulty, as always, comes down to funding and timing”.
London Councils’ own research has estimated that implementing the Care Act’s provision will cost the boroughs about £90m – which is £36m more than the government’s apparent funding offer of £54m, and lower than the Department of Health’s earlier provisional London allocation of £73m (which included £29m from the Better Care Fund).
The Care Act could increase the number of people eligible for council support by 27% in the capital.
Cllr Puddifoot said that although London’s councillors appreciate the scale of the deficit
22 | public sector executive Oct/Nov 14
and the state of the public finances, “we’re asking for a conversation with the government about the pace at which we deliver the changes, because there will be training needs and all sorts of things”.
‘Councils are already stretched’
He wanted the government to do more to try to meet the costs of implementation, considering how stretched councils already are, having taken average reductions in funding of 35% since 2010.
“We don’t come into this in an awfully strong financial position. But we want to work with the government on this – we think the Care Act is a very good idea; it will give people more certainty about the future costs of their care. But we do have concerns about huge responsibilities dropped on us without adequate resourcing.”
London has “unique challenges”, Cllr Puddifoot said. “There was always an expectation that there would be a funding gap, because we are seeing such funding gaps in many areas of council services. But London has some unique challenges.”
That meant a ‘national approach’ was not necessarily the right one, he said, pointing out that higher care costs in London means the average care user will hit the £72,000 cap in
Key reforms under the Care Act
• A new ‘wellbeing principle’; • A minimum eligibility threshold for care;
• A duty to consider the physical, mental and emotional wellbeing of the individual needing care;
• A new duty to provide preventative services to maintain people’s health; • Implementation of many of the reforms in the light of the Mid Staffordshire hospital scandal and subsequent reports; • Wider roll-out of personal budgets; • A care cap of £72,000;
• Means-testing kicks in at an earlier level, meaning 35,000 more older people will get help with their care costs from April 2016, and up to 100,000 more by 2024-25; • A deferred payment scheme to prevent people needing to sell their home during their lifetime;
• Provider profiles; • Stronger regulatory powers, including prosecution where necessary.
three to four years, whereas in other regions the figure would be six years.
“There’s also a shortage of trained staff in London, and wages are higher than elsewhere, for the people to administer this. We’ve probably got the most diverse population in the country – that will have cost implications, for delivering information and advice to different groups.”
We asked Cllr Puddifoot whether having a single national cap was the right approach, considering the different challenges in different places, and he said: “It’s a separate argument, but there is a good case that there should be a different cap.”
He doubted the government would listen to that argument though, because it would increase the costs and complexity of administering the new system centrally, and introduce new problems if people move between local authority areas.
Timing and implementation
Cllr Puddifoot said: “To reiterate, we’re very positive about what they’re doing, but it is a huge ask to get this done in the timescale and for that money.
“We’re not crying wolf here, we think our figures are fairly reasonable. To be fair, the
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