Adult social care expenditure in England has been virtually unchanged, in cash terms, during the years from 2009-10 to 2016-17.
In the same period, NHS spending rose by over 20% across the UK. Yet the NHS is under massive funding pressure, in part because some social care costs have been transferred from councils to the health service.
The consequence of this cash freeze on adult care spending is recurring news. Rising numbers of older people in need of care have driven demand up during a period when spending has fallen sharply in real terms.
Local authorities are having to squeeze contract prices for private accommodation which, in turn, is leading to the closure of care homes. In some parts of the country migrants, whose future is now uncertain, are the mainstay of the staffing of such homes. Hospitals increasingly pick up the costs of people kept out of care.
What a mess! There is much debate in the press at present about ‘post-truth’ politics and media reporting. The funding of English council services long ago faced the unhelpful reality that coalition government ministers were saying local authority spending was rising when the budgets councils directly controlled were actually falling. Needy older people have seen their entitlement to care reduced accordingly. Post-truth cuts are the same as any others.
Theresa May and Philip Hammond appear, largely, to have moved away from flashy gestures and creative statistics. Nevertheless, the autumn statement left the previous chancellor’s local government spending totals unchanged. Councils will spend the same amount in cash in 2019-20 as in 2015-16. Even if the 2015 spending review commitment to longer-term additional resources for adult care is fully implemented, local authority budgets will be under unrelenting pressure.
Mr Hammond’s new deficit reduction plan means the UK will not eradicate its public sector deficit before 2022-23. It is hard to imagine any retreat from austerity before then, though capital spending will receive a boost. The country is no nearer sorting out the longer-term challenge that the public expects better services than it is prepared pay for. Social care and the NHS will have to struggle on against this backdrop.
Tony Travers, director, LSE London