London has biggest social care spending cuts in England over last decade

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The Government says social care is an “absolute priority” – so why has it allowed huge spending cuts on its watch?

Spending on adult social care in London has fallen by more than 13.5% over the last decade, the biggest drop of any region in England.

The capital’s councils have had to deal with large funding cuts due to austerity, exclusive analysis shows.

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Last week, the Government announced an increase to National Insurance contributions of 1.25 percentage points to fund health and social care.

Prior to that, new health secretary Sajid Javid had said that fixing social care was an “absolute priority” for Boris Johnson’s administration.

New analysis by NationalWorld - LondonWorld’s sister title - has revealed the reality of stark spending reductions in communities across the country over the last 10 years – despite our aging population – with London bearing the brunt of this.

Outside of London, there is a clear north-south divide in cuts to adult social care spendingOutside of London, there is a clear north-south divide in cuts to adult social care spending
Outside of London, there is a clear north-south divide in cuts to adult social care spending

NHS Digital data shows London councils spent £2.8billion on adult social care in 2019/20.

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After adjusting for inflation, that was a real-terms cut of £438million (13.5%) compared to 2010-11, when spending stood at £3.25bn.

Hounslow Council had the biggest reduction in spending of any local authority in England.

There was a 33% reduction, from £96m in 2010-11 to just £64m.

Lambeth had the second biggest reduction in the country, with spending reduced by 32%, with Westminster third, having similar social care spending cuts.

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Adult social care includes all support for people aged 18 or over, including short or long-term care in the community or residential settings, for physical or learning difficulties or ill health.

London had far bigger spending cuts than England on average - with the national level of reduction just 2%.

The figures refer to gross current expenditure. It only includes day-to-day spending on care, excluding capital spending such as on buildings or other physical assets, and includes the contributions made by clients towards the cost of their council-arranged care.

A recent report by the government spending watchdog the National Audit Office (NAO) found spending had fallen by 4% nationally since 2010-11.

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That uses a measure known as net current expenditure – the same as gross current expenditure except it excludes client contributions, to only look at the cost burden on councils.

Here too the analysis reveals huge disparities – the North East was worst hit, with a drop of 16.4%, followed by London on 15.5%.

This type of spending in the capital fell by £453m.

Chris Thomas, a senior research fellow and health and care expert at public policy think tank IPPR, said he believes social care provision has been cut “as a consequence of wider central government cuts” during austerity.

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He was responding to figures showing there had been a drop in the number of over 65s receiving long-term support.

The NAO said data gaps meant the Department of Health and Social Care was unable to say if this was because provision had been reduced by councils, or if they were doing better preventative care to reduce the need for long-term support later.

Mr Thomas said: “I think with the data points as they are, the wiggle room that it always gives government is not being able to say with 100% certainty, but I would be hugely surprised if that was down to prevention getting better and efficiencies working and austerity being a system that’s somehow put pressure on local authorities and providers and it somehow working well.

“The UK is one of the countries of any comparable country that is least good at using preventative social care interventions and I’m not aware of anything thats suggested that that has been improving.”

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“There is a finite amount of support the council can offer, whether that’s staff or funding,” added senior research fellow Erica Roscoe.

Council-arranged social care is funded through a mix of central government grants, general council tax and the social care precept portion of council tax, as well as means-tested fees for those receiving care.

The NAO report said central government funding to local authorities had been cut by 55% since 2010-11, which had reduced their spending power by 29%.

Mr Thomas said the new health secretary needed time to demonstrate his commitment to social care.

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He said: “Hopefully it will be taken forward now in tangible action but I think the proof of the pudding is basically the Government has a commitment to bring forward a proper reform plan for social care by the end of the year.

“If the plan is either weak or delayed, as we know social care plans are very liable to be delayed from recent experience, that will be a very bad sign in terms of is there commitment there.”

The Department of Health and Social Care was approached for comment.

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