How the predicted cuts to social care are taking place


by Richard Blogger    
11:01 am - May 2nd 2012

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Whenever Labour try to land a blow on Cameron over NHS funding, he always brings out the tired and incorrect statement that “we have protected the NHS budget; but Labour would have cut it”.

This is incorrect, but sadly Labour have failed to even both to refute it. I have given the details why this is incorrect on my NHS Future site.

The “evidence” for the Tory assertion comes from June 2010.

Andy Burnham misinterpreted Cameron’s pledge to “ringfence the NHS”. Burnham (and, I suspect, most of the public) thought that would mean that the NHS would continue to get the real terms increases that is has had for the last 30 years. The Guardian reported this in July 2010:

He said he assumed the Conservative commitment on the spending would lead to extra NHS expenditure, amounting to more than 1% a year, coming to more than £4bn over the parliament, which would mean even larger reductions for schools and local government.

Burnham, fully knowing that Osborne was intending to cut £80bn of public spending over the parliament spoke out saying that a 1% real terms increase for the NHS would mean cuts in social care, which themselves would affect the NHS:

“If this goes ahead [1% real terms increase in funding] they will hollow out social care to such a degree that the NHS will not be able to function anyway, because it will not be able to discharge people from hospital. If they persist with this councils will tighten their eligibility criteria even further for social care. There will be barely nothing left in some parts of the country, and individuals will be digging ever deeper into their own pockets for social care support.”

Now we find that Andy Burnham was absolutely right. This week the Daily Telegraph reported that the total number of days patients have been delayed in hospital has increased by 10% in the last month.

The problem – often referred to as “bed blocking” – has increased 29 per cent when compared with figures from August 2010.

Councils have faced significant cuts to their budgets and experts have previously warned there would be a knock-on effect on the NHS.

This is exactly the problem that Andy Burnham was highlighting in 2010: if the government cuts local authority funding this will mean that there will be less money for social care and the result will be increases in delayed discharges: bed blocking.

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Richard is a regular contributor. He blogs more frequently at Conservative Policies Dissected.
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Reader comments


The cutbacks in my local Mental Health services would be like an Ealing comedy if it wasn’t all so tragic. There’s been some ‘novel’ ways to hide this from the actual service users.

Whilst ever this sort of thing goes on;

A 78-year-old from East Sussex is set to become the oldest person to have a sex change operation on the NHS. (http://www.bbc.co.uk/news/uk-england-sussex-17913771)

The public will find it difficult to take your points about ‘cuts’ seriously.

2

Gender Dysphoria can cause serious psychological distress such as depression and has been known to cause sufferers to commit suicide. Clearly you have a personal hierarchy of what constitutes legitimate intervention by the NHS and you are not on your own. Those who smoke, are obese, who participate in sports and cannot reproduce have been the focus of derision for being treated by the NHS.
Now relatives who look after people with dementia are having help with social care withdrawn, I suppose this is on the basis that it is their moral duty to take care of said relatives even when they need twenty four hour care.

Beware of getting old, it puts such a strain on health and social care budgets.

3.

I didn’t give my view on this, just my opinion on what what the public reaction will be.

The NHS is always about choices, as there is no bottomless pit of money. So, as an example, would you sooner have dementia care supported or a sex change operation for a 78 year old? Can’t have both.

Cutting out sex-change operations will only result in small savings for the NHS. Try this option for really big potential savings:

“An atlas published by the Government that maps variations in health spending and outcomes across England has highlighted some significant regional differences including amputation rates among diabetics. . . .

“Amputation rates among diabetics showed one of the most striking variations. Data revealed that the amputation rate for patients with Type 2 diabetes in the South West (3 in 1000 patients) is almost TWICE the rate in the South East. The Charity Diabetes UK was also concerned that the data showed less than half those with the disease (Types 1 and 2) had received nine key healthcare checks.”
http://www.mddus.com/mddus/news-and-media/news/november-2010/nhs-variation-atlas.aspx

David Halpern in July 2009 on how to save £90bn: “Billions can be saved, for instance, if services for those with chronic conditions like diabetes are redesigned around self-care.” Such as DIY amputations, perhaps?

David Halpern worked in Downing St as an adviser to Tony Blair.

6. Chaise Guevara

@ 4 Max

“The NHS is always about choices, as there is no bottomless pit of money. So, as an example, would you sooner have dementia care supported or a sex change operation for a 78 year old? Can’t have both.”

False dichotomy. CAN have both, unless you’d like to explain why they’re mutually exclusive.

From my ignorant perspective I’d pick dementia care if I had to, but you don’t get to make up rules saying that I therefore have to abandon the provision of sex-change ops.

@6 – I think the point was that there are limited resources available, and with this in mind priorities have to be considered carefully.

Technically the example was a false dichotomy, but not in the sense that there are limited money available.

8. Chaise Guevara

@ 7 dave

There isn’t a bottomless pit of money, but nobody’s saying that there is, so I’m not sure what that statement is supposed to refute. Taking the false dichotomy out of Max’s post, it becomes an honest “which of these two do you think is more important?”, which frankly isn’t all that interesting in this context.

What it doesn’t add up to is an argument in favour of cuts to social care. It’s just a false dilemma attached to a totally unquantified “not enough cash!” claim: basically an attempt by Max to demand that the conversation follows his arbitrary and self-serving rules. No thanks.

I, personally, am appalled by the vast amount of money wasted by the NHS and Social services, each trying to allocate costs to the other.
Meanwhile NICE, which has *nothing whatsoever* to do with clinical excellence and is solely focussed on allocating money, is authorising funding for a se-change operation for a 78-year-ld and denying cancer drugs to 70-year-olds on the grounds that they have too few years of remaining life to justify the cost.
And some of you wonder why I despise New Labour?

9

I was not a supporter of New Labour, but to be fair you cannot compare (clinically speaking) a person suffering from cancer to one with gender dysphoria, a condition which is known to create severe psychological distress, except by applying a particular value judgement.

When assessing the efficacy of any particular medication/treatment, NICE will take into consideration quality of life, therefore, if we look at the example you quote, it may be that giving a seventy year old a new cancer drug will extend their life but not the quality. However, giving a physically healthy seventy eight year old a sex change will not increase life expectency but will increase quality of life.
Promoting physical and mental health will mean that there is less demand on finite budgets. Extending life for the sake of it serves nobody’s purpose, least of all the person who is suffering.


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  7. BevR

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  8. Rebecca Devitt

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