The publication of the green paper on care and support of older people in an aging society raises the bar for debate. This isn’t just about building a fit for purpose social care and support system, but also asks us to consider the future of an aging Britain. Where then does government see the role of local councils in this?
It is important to plan for the demographic changes that face not just Britain but most developed countries around the world, in the years to come. This is a national issue that requires a national vision – how do we care for the elderly members of our communities?
However, at the same time, it is important to realise that care is accessed at a local level, and should always, primarily, be the responsibility of local government. The idea of a National Care Service, modelled along the lines of the National Health Service, would not work, if taken literally. This is because the care and support that local councils provide is part of a vast web of services, incorporating not just health and social care, but also housing, access to libraries, leisure facilities and so on. It would be impossible to extricate care and support from the other services provided by local government and deal with it in isolation.
Furthermore, social care and support cannot be squeezed into a ‘one size fits all’ model. Local communities differ greatly depending on their location and demographic, and the needs of a community in somewhere like Cumbria, say, would be very different to those in inner city London or Birmingham.
As we debate the issue of how to fund social care and support in the future, there needs to be greater analysis of the resources already in the system, across both health and social care. There needs to be more recognition of the pressures placed on local authorities in delivering social care, alongside so many other services, in order to provide members of the community with a personalised service that addresses their individual needs and offers choice and independence.
There does need to be a national framework for social care and support, as well as standards that can be used to assess how well local authorities are delivering this care and support. However, such standards must reflect the real needs of service users at a local level. For example, in Hackney, we have invested heavily in reablement and rehabilitation services that are well established in partnership with the Primary Care Trust and the local hospital. These work across the whole system of health and social care, providing for more rapid discharge from hospital, and then working with people in their own homes – as well as in day centres – to deliver rehabilitation therapies, in order to move away from traditional/institutional care. We also have developed supported living schemes which are personalised in aiming to help allow people to stay at home for longer and avoid having to go into residential care unnecessarily.
This isn’t just about how different sectors will work together in the future to work more efficiently and use funds more wisely, it is about instilling a sense of social responsibility in all members of a community. Likewise, it is about establishing a framework that will provide the necessary care and support for society well into the future: a framework that must continue to have local government at its centre.