Over the last several years, public services have been squeezed as austerity and public expenditure cuts have dug ever deeper into budgets, even as demand for services has increased. And social care has been squeezed more than most.
Most social care is funded by local government. Spending on adult social care services by local authorities fell from £18.4 billion in 2009/10 to just under £17 billion in 2015/16, a real-terms cut of 8 per cent. To set the larger context, local government budgets have been cut across the country, with some authorities losing a staggering forty percent of their funding.
The consequences for social care services, their quality, their staff and their providers from all sectors has been well documented. On the ground, the impact on service users and carers has, quite simply, been ‘devastating’.
For several decades, social care provision has been provided and managed by a range of charitable, social enterprises and staff mutuals, business and public sector organisations. Within this multiplicity of organisations, however, charities have experienced some of the most severe pressures and dilemmas as VODG and others have reported.
Far too often, public sector commissioners and procurers (and my personal experience of this goes back to the 1970s, when I worked in the sector) have seen the charities as ‘soft’ (and in particular, softer than businesses) when it comes to negotiating and accepting contracts.
Charities are driven by a mission to promote the interests of their beneficiaries and service users. Inevitably then, it is hard for them to say ‘no’ or to terminate care for someone with needs. They are reluctant and, one hopes, always resistant to commissioners unilaterally and often without tangible evidence, re-assessing a client’s needs to save money rather than to maximise their comfort and rights. And, of course, this is the case too for many business, especially smaller business providers.
The current level of funding and the behaviours it fosters must change. Government must facilitate the provision of significant additional funding including funding to address the current ‘sleep-in’ back pay. And local authority and NHS commissioners must change tack, and see providers, particularly charities, as their partners rather than merely contractors, to be boxed around the ears and treated at arms’ length.
My advice to charity sector providers and indeed others is:
- always hold true to your mission
- resolutely be prepared to say ‘no’ to contracts which are fundamentally not sustainable
- beware of using charitable income to subsidise the public sector
- recognise the real costs for quality service provision, and press for these to met in full with a margin on top
- be exemplary employers paying decent wages
- offer to engage fully with local authorities and the NHS to plan strategies for service delivery and commissioning
- at the same time, however, always advocate on behalf of beneficiaries and service users, and be ready to challenge local government and others on their behalf
- understand the pressures that local government is under and respect the sector
And my advice for local government and the NHS is:
- respect charities and their right to speak for their beneficiaries
- respect them when commissioning, contracting or grant aiding services, and ensure payments that are timely and commercially sustainable
- never expect or pressurise a charity to involuntarily subsidise your statutory duties
- use grants when this will meet a public benefit test ahead of competitive tendering
- involve charity providers in the development of policy and strategies, commissioning, and service and policy reviews
- don’t ever allow assessment of need to be financially driven and consequently distorted
- ensure that local and smaller charities have an opportunity to contribute in every way when they can add value
Charities can and should join local government in pressing Government for more money, and in explaining to service users and communities that it is central government that has cut core budgets and underfunded social care.
Providers and local government and the NHS should find common cause to serve local people and local communities. Not only is this possible – it’s essential.
John is passionate about social justice, fairness, human rights, localism and democracy. His professional, non-executive, trustee and voluntary work reflects these objectives. John’s successful career has been and continues to be values based.
John has worked in and now provides strategic advice to local government, the wider public sector, the voluntary and community sector, trade unions and businesses as well as academia; and includes contributing as