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THE ATTACHED TRANSCRIPT WAS TYPED FROM A RECORDING AND NOT COPIED FROM AN ORIGINAL SCRIPT. BECAUSE OF THE RISK OF MISHEARING AND THE DIFFICULTY IN SOME CASES OF IDENTIFYING INDIVIDUAL SPEAKERS, THE BBC CANNOT VOUCH FOR ITS COMPLETE ACCURACY.


TX: 10.01.07 - CSCI Report on Social Care

PRESENTER: JOHN WAITE


WAITE
Many elderly people and those with disabilities need help at home. They may not be classed as ill and so they won't come under the NHS for care but they still need some extra support to live independently like assistance with dressing or the preparing of meals. Well according to the Commission for Social Care Inspection, the regulator for care services, that help is now available to fewer people than ever before and its State of Social Care Report says that many councils have restricted funding to only those in the severest need, leaving many others to do without help or to try to pay for it themselves. David Walden is the commission's director of strategy, he joins us now. So many, many people David are now finding themselves ruled out of getting state help to live on at home?

WALDEN
Yes that's quite right. Our report published today says that a 100 of the 150 councils across England, so that's two thirds of all councils, are now restricting the help they provide to the two highest levels of need - people who have, what are called, critical or substantial levels of need.

WAITE
Can you tell us a little bit more about that, about the criteria, I mean how do they judge who is in the most need?

WALDEN
Well there's a government framework of guidance about four levels of need but it's for local determination precisely who falls into which category. But clearly the lowest levels, what are called moderate and low levels of need, are things, as you say, like help with washing, shopping, cleaning and so on, the things that actually help people to maintain independence, family and social networks and really contribute to their quality of life.

WAITE
Mundane things but crucial things?

WALDEN
Absolutely.

WAITE
So are you reporting on this or are you alerting on it, I mean how concerned are you saying we should be?

WALDEN
We're doing both I think. This is our second annual report looking at the whole of social care across England, both for adults, older people and for children. And we're pointing out what's going on in those services and for people who are getting those care services we are saying they are getting a better quality, so there is improvement out there but we're also highlighting this point that increasingly councils are restricting the people - the sort of people they will help and that means that people really have three options, firstly they can pay and find for the care themselves, secondly it puts more pressure on informal carers such as family and friends to support them or thirdly they - some people have to just do without any support and often what happens is that their situation worsens, they might have a fall or something like that, and then they find that they're getting into a crisis situation where the help unfortunately is then forthcoming.

WAITE
Well with me in the studio here in Manchester is Anne Williams, from the Association of Directors of Social Services. What do you make of this Anne and what will the consequences be do you think?

WILLIAMS
Well this is an excellent and well research report and we really welcome the report raising the reality of what's happening to people out there and local councils do not want to restrict services, in fact it's the absolute opposite of what councils and the government want to do and we're acutely aware that it means that potentially more people come to us at a time of crisis, that it leads to more inequalities in who can purchase care and that there is less chance for us to do anything at an earlier time in people's lives.

WAITE
But this is, you're saying, the new reality?

WILLIAMS
It is the new reality.

WAITE
We have to expect now, people should expect, that many more of us will have to either pay for help to live at home or rely on family and friends?

WILLIAMS
Yes. And that's in stark contrast to what people expect. We're - 10% only of people expect to pay for their own care, the reality is much closer to 100%. And people's expectations of what they may get from the state are going to be a lot less, will not be met, given what the state can provide.

WAITE
And it's not just the elderly is it, it's also children who may be affected by this?

WILLIAMS
Children and people with physical disabilities and mental health problems, so learning difficulties, physical disabilities. We've been advocating for some time now that there needs to be a national debate on what people can realistically expect to pay themselves and what the state should pay and we really welcome a recent announcement now by the minister Ivan Lewis from the Department of Health to say he is calling for that because without that awareness raising and a national debate we will continue to have to restrict eligibility.

WAITE
But on this subject of economics, if someone with support can live independently at home but without that support then has to go into hospital or wherever that will work out won't it more expensive, I mean you'll save money on the one hand by withdrawing support only to have to pay it out with the other later on?

WILLIAMS
Yeah, yeah we totally agree. And actually given the level of funding that goes to the NHS, compared to the level to social care, actually a tiny percentage taken out of the NHS would be a huge percentage increase for social care. And the White Paper last year did advocate a move but you're aware that there are many pressures on the National Health Service but that is part of the debate that needs to happen also.

WAITE
David Walden, I'm taking it you're agreeing with all of this?

WALDEN
Yes, one of the main things we're trying to highlight really is the fact that this shift from state to individual responsibility is not happening openly, if you like, that people do need to know what to expect in the future, that there isn't clarity about what they may have to pay for themselves and that the sort of infrastructure of the systems to help them find information about what might be available and to support them and to support their carers is underdeveloped in too many places.

WAITE
But I mean what happens to your report - you are the regulator, but will it just be read or do you hope it will be implemented, what's next?

WALDEN
Well a number of things. It will inform the way we carry out our jobs, so we regulate all care services and we assess the performance of local councils and these are important issues in those processes. Obviously we want to influence government and opinion formers more generally about some of the issues we've raised. And finally we've highlighted in this report today that we want to look next year at what happens to the groups who are falling outside the net - either those who are having to pay for their own care, as I said, or having to rely on family and friends and so on. So we're going to follow this up ourselves in our State of Social Care Report for next year.

WAITE
Well Anne Williams it sounds like the situation is pretty bad and getting worse, is there anything that can be done finally?

WILLIAMS
Well I think councils are constantly working with their communities, voluntary sectors, providers, to do as much as we can with the money we've got but we welcome a national debate.

WAITE
Anne Williams and David Walden thank you very much.



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