Our pre-budget analysis
15 March 2016
by Alice Mitchell-Pye
On Wednesday the chancellor will outline his spending plans for the year ahead in his budget.
These decisions will have a huge impact on the lives of disabled people over this parliament and beyond.
We hope it will be a positive one.
Supporting people to live independently
Social care is chronically underfunded — £4.6 billion has been removed over the last five years and the situation is set to worsen dramatically up to 2020 as more people than ever before need support.
The reality of this for tens of thousands of disabled people is they now receive a standard of care far below anything we can or should be proud of.
A bath or shower once a week, sitting in an incontinence pad all day, eating cold food and being supported by staff so rushed they have barely enough time to say hello.
15-minute visits force people to choose between having a cup of tea or going to the loo.
Even worse than this, many thousands of disabled people now receive no support at all.
It is important not to forget it is not just older people who need support. Hundreds of thousands of younger disabled people need vital support as well.
Without this they cannot live independently, with the opportunity to contribute economically and participate fully in society.
Bridging the funding gap
In its spending review in November, the government announced significant reductions in funding for councils who commission social care.
In return councils were offered two ways to try and bridge the funding gap in adult social care.
One was the opportunity to increase council tax by an additional 2% a year in each of the next four years, so long as any money raised from this was spent on adult social care.
This is expected to raise £370 million in the coming year for the councils choosing to do this.
The other was increased funding for the Better Care Fund — although none of this money will be available in 2016-17, and most not until 2018-19.
This amounts to too little, too late — nowhere near enough to address a challenge of this scale.
We hope the chancellor will go further on Wednesday to secure the long term sustainability of services essential to disabled people, bringing vital additional funding forward.
The government has recognised the challenges facing the NHS and made a commitment to more sustainable funding, which is welcome.
But in doing too little for social care he has left the other half of the story unfinished. NHS leaders have said the same this week.
This inequality between health and social care is more than just unfair — it is also unsustainable.
Social care is vital to the future of the NHS. You cannot fix one without fixing the other.
Without a sustainable social care system the NHS will face successive winter crises, with thousands arriving in A&E because they have nowhere else to go for vital support.
Thousands more will be stuck in hospital beds ready to go home but with no support to enable them to.
This problem isn’t new. It has developed over successive governments. It has been much talked about and discussed over the years.
It’s right there is no single solution to this — we will all have to think and do things differently.
We will all have to agree as a country what we want from both the NHS and social care and the role both play in our society.
Better integration of health and social care will undoubtedly help. Increasing the amount councils can raise through council tax may also be a step in the right direction.
But on Wednesday the chancellor must recognise the urgency of the challenge and do his bit to ensure we have a social care system we can be proud of and which supports disabled people to live independently.
Alice Mitchell-Pye is policy and research manager at Leonard Cheshire Disability.