Charles Dickens’ optimistic character, Mr Wilkins Micawber has a famous recipe for financial happiness. He shares it with the penniless David Copperfield:
"Annual income twenty pounds, annual expenditure nineteen pounds nineteen and six, result happiness. Annual income twenty pounds, annual expenditure twenty pounds ought and six, result misery."
The County Council’s finances are being discussed by Councillors ready for the Budget meeting at 2pm on the 22nd February. The papers will be published on the County Council website a week beforehand. They will not make easy reading. How can politicians keep electors happy when the Council’s income is going down and the demand for services is going up?
The Adults and Communities Department is in the curious position of both cutting services and spending more on services relative to other departments. How come?
People aged over 65 account for the majority of the Department’s care expenditure. The wartime generation spent their youth physically active and fed on healthy rations. Those who avoided smoking and made good lifestyle choices later on are now in their 80s and 90s. This long-lived generation are becoming frail. Post-war baby-boomers who have smoked, been less physically active and consumed excessive amounts of unhealthy food are suffering disease in their 60s.
Thanks to the public health experiment of post-war austerity, combined with the excellent care provided by the NHS, we are witnessing two generations living longer with diseases of old age at the same time.
The Adult Social Care (ASC) Department will need an extra £560,000 in 2017/18 to meet the needs of the increasing numbers of frail older people with substantial and critical needs. It will need to spend an extra £4,110,000 a year by 2020/21
Something will turn up
The ASC had hoped to save £1M through an innovative ‘Help to Live at Home’ service. Instead of spot-purchasing packages of care from lots of little providers it was going to give each geographical area to one provider. Sadly this did not work out as hoped. Unable to make ends meet, one of the bigger providers pulled out, just before the service was due to start. Finding new providers to cover the three areas affected is likely to cost the Council £200k of its hoped for savings.
The Council also hopes to save another £1M by reducing the “cost and demand for social care”. Roughly translated, “strengthening controls for the review of care packages and income contributions” means it will be harder for frail older people to get care and when they do they can expect to pay more for it.
The Council Budget papers are full of plans to trim services and attempt to make them more efficient. Some of the cuts will be false economies, pushing costs and responsibilities onto an NHS already struggling to cope.