Care in places – Inequalities in local authority adult social care spending power
Jul 19, 2019 | REPORTS
In the face of ongoing delays in the publication of the Government’s promised adult social care green paper, consensus around the need for a new national system of social care provision, funded through a risk pooling mechanism (such as National Insurance) continues to grow.
However, while much of the current debate around the design of the new system has largely focussed on questions of increasing the overall funding envelope for care, and ensuring that individuals do not face catastrophic care costs, little attention has been paid to the ways in which any new or improved funding for social care provision will be used to develop services in a fair and effective way at a local
In this report, supported by the Salvation Army, we examine the impact of the current system through which responsibility for funding social care services is devolved to the local level. We explore the extent to which the current funding system is effective in aligning the need for social care support with the capacity to fund social care at the local level.
Through our analysis we have demonstrated that significant inequalities exist in local authorities’ capacity to fund the social care their older residents need. This analysis demonstrates:
- County councils tend to be in a worse position than unitary authorities in terms of their ability
to fund the social care their residents need; and
- Smaller, post-industrial towns and cities fare worse in terms of their ability to spend on social
care than larger urban centres.
As the Government develops policy for the future of social care it will be vital that the question of how social care will be delivered in place is factored into discussions. This is critical because our analysis shows that:
- There isn’t just one crisis in social care, there are lots of crises, of different types and in different areas.
- Inequalities in the ability to meet the need for social care are systemic.
- Local leadership alone cannot overturn the current inequalities.
The formulae through which any national fund for social care is distributed at the local level to support the development of services must be designed to build out the structural inequalities and lack of basic fairness revealed by our research.
While the current system is intended to balance the desire for a standardised national system with the need for local flexibility to allow tailored, responsive services, and most envisage a continued role for local authorities in commissioning and funding care in future, it is clear that the current structures for funding care are not working effectively.
As we seek to address both the immediate and the long-term challenges in social care it is vital that these local differences are taken into account. Without specific action to address these inequalities, any future social care settlement will leave some local authorities, through no fault of their own, less able to meet adult social care needs among their residents.
Author: Dan Holden