Tag Archives: National Health Service

Autumn Statement – what’s in it for social care?

Guest post from Megan Cleaver, Parliamentary Officer at Scope.

Today’s Autumn Statement was the last big political announcement of 2013. But what was left out of the Chancellor’s speech this morning was just as revealing as what was included.

The A&E crisis has dominated the headlines over the past few months, with investment in social care seen as one way to ease the pressure on hospitals. But despite rumours overstretched social care budgets would be given a boost today, on this the Chancellor was silent.

Such a commitment to extra funding would have been especially welcome given the second reading of the Care Bill in the House of Commons was also announced today. The Care Bill contains the biggest ever reforms to the social care system, and its debate on 16 December will be the first opportunity for MPs to debate changes to social care which will affect over half a million disabled people.

And providing good quality social care can bring huge economic benefits. George Osborne spoke at length in the Autumn Statement about the need to get the benefits bill down and get people working. For disabled people, social care is the cornerstone of their independence- the support they need to both seek and stay in employment.

Indeed, recent research by Deloitte has shown that investing in social care for disabled people with ‘moderate’ care needs – who the Government have stated they intend to shut out of the social care system by tightening up eligibility for care – creates considerable savings for the public purse. Deloitte found that for every £1 that is spent on moderate social care needs, £1.30 is saved through increased tax revenue to the Treasury and a reduction in welfare spending as a result of disabled people and informal carers entering the workplace, not to mention the significant savings to local authorities and the NHS from ensuring disabled people’s needs do not escalate to crisis point and therefore require more expensive medical treatment at a later date.

And when George Osborne states that the job of getting rid of the deficit ‘is not yet done’, these are financial savings that cannot be ignored.

What is Britain saying about disability? Part 1: the dominant story

The game changers

Scope summary of research by Linguistic Landscapes. linguistic logo

With our next campaign we want to work with others to begin shifting attitudes towards disabled people for the better. Recognising the power of language and its influence on how people think and act, we wanted to build a comprehensive picture of how people – both disabled and non-disabled – are talking around disability.

As well as our research into public attitudes towards disabled people, we worked with Linguistic Landscapes (who have previously partnered with organisations including Oxfam GB, Prostate Cancer UK, the NHS and various companies) on a ‘discourse analysis’ – basically an analysis of how people talk and write about disability. They analysed over 500 texts from 2010 to now across the media, companies providing disability services, disability charities (including Scope) and campaigners, the Government, blogs, social media and elsewhere on the internet.

In this first summary of their research, it shows there is a dominant way of talking about disability that’s entrenched in Britain today. The main narrative that’s out there – accidentally or intentionally – says that disabled people are seen as passive, homogenous not individuals, separate from ‘normal’ society, hopeless and voiceless.

Passive

      • Things happen to disabled people by others. Movement is a common metaphor and also disabled people being described as recipients: “changes to social security aren’t helping disabled people, they are pushing them into poverty” ; “how on earth they had justified throwing disabled children to the wolves”
      • Many tend to talk about rather than to disabled people:
        “they/them” not “you”
        “more than 100,000 disabled people are or risk soon being denied vital care and support”
        The voices of disabled people themselves are less evident in the mainstream than voices speaking about disabled people.
      • Where disabled people do themselves speak, there is often limited visibility of their impairment
        Disabled people’s voices appear mainly in writing, on the radio and only more recently on TV. This is partly why Paralympics was so radical by showing disabled people visibly and prominently.

‘Other’: separate or different from the mainstream 

      • Disabled people are often put with other marginalised groups
        “Sick and disabled”, “Old and disabled”, “The poor and disabled”, “Women, children and disabled people”, “BME, women and disabled (students)”.
      • This powerfully sustains an invisible norm that’s taken for granted, the ‘normal’ are the able-bodied, the unimpaired, men, straight people, white people, the non-poor etc.
      • Disabled people are overwhelmingly featured as the exception
        “Those with a disability are twice as likely to live below the poverty line – and more likely to be victims of crime”
        “Disabled people are more likely than non-disabled people to experience material deprivation”
      • Common metaphors of war and survival reinforce the sense of difference
        “parents battling for support”, “barely surviving”, “war on welfare”

 Homogenous: a mass group 

      • Stripping away people’s individuality – when terms like “disabled people” are used a lot, the person is defined only by their disability and they can lose individual characteristics , even as to whether the disabled person is an adult or child. There is very little about important aspects of pleasure, like humour, relationships and sex.
      • Stories of individuals are powerful but unfortunately too often these are negative, e.g. individual ‘benefit scrounger’ stories. These have particular power when people have little understanding of the wider group of ‘disabled people’. 

Work and individual responsibility: a massive topic

      • Not working is immoral – A recent and now major context for many conversations related to disability is work, for example in politics and the media. It is a moral discourse where you are only valuable – and ‘normal’ – if you are in employment.
      • The ‘benefit scrounger’ narrative fits within this, where being passive (not working) combines with being separate (different from the majority of hardworking people), combines with individual stories.

Some of the other findings showed that disabled people are often described as special and vulnerable, in an inevitably negative situation and permanently disabled with little understanding of the nuance of people’s impairments.

What do you think? And what are the alternatives?

The end result of the language we all use isn’t necessarily intended – often it can just be unthinking.  Because there is such an established way of talking about disabled people, most people won’t question it most of the time. But seeing it laid out here sparks thinking: is this the picture we want to paint or a different one?

Please comment below or tweet with the hashtag #ScopeGameChangers.  

We have now published the second part of our findings – some of the alternatives to the dominant narrative and hope for change. Let us know what you think.

Six talking points from the Spending Review

Young disabled man outdoors with personal assistant

1. Do you want the good news or the bad news first?

Good news? Okay… the Chancellor has announced a £3.8 billion investment – including £2 billion of new money – in social care: the support disabled people get from their council to get up, get washed and dressed, and live independently.

The official document says, “This shared pot includes an additional £2 billion from the NHS and builds on the existing contribution of around £1 billion in 2014–15, with the aim of delivering better, more joined-up services to older and disabled people, to keep them out of hospital and to avoid long hospital stays”.

Here’s why this cash is welcome. The social care system is on its knees. Cash-strapped councils have been upping the bar for support eligibility, with 83% of councils now setting the threshold at a higher level. According to London School of Economics 69,000 disabled people have been pushed out of the system.

At the same time councils are squeezing the support for those that are in the system. A Scope survey found almost 40% of disabled people who continue to receive social care support are not having their basic needs met including eating properly, washing, dressing or being able to get out of the house.

Take away the preventative support and people fall into crisis. Have a listen to Angela Murray explain why social care is so important to her.

2. The ‘how’ is really important

Given that we now also know that councils are facing a further 10% cut in their budgets, a crucial piece of detail is how the cash gets to frontline social care. ADASS have said that previous injections of cash have instead disappeared into the black-hole of council budgets.

The documents talk about pooled budgets and NHS money being made available to councils through ‘local health and care systems’, which – in an exclusive for the HSJ – Jeremy Hunt explains will be achieved through Health & Wellbeing Boards. A cross-part panel of MPs and Peers recently argued that this would give it a better chance of reaching the people that need it. The official document explains that the Government is “putting £3.8 billion in a single pooled budget for health and social care services to work more closely together in local areas, based on a plan agreed between the NHS and local authorities”.

3. Britain Cares about social care

Today’s spending review announcement follows six months of campaigning. The innovative Stephen Fry-backed Britain Cares campaign, has seen over 25,000 people contact their MP about social care for disabled people – a thousand of who have sent personalised photos to show they care.

At the same time a young disabled woman from Luton – and former volunteer of the year – Angela launched a petition on Change.org which has received more than 45,000 signatures. She handed it in to 11 Downing Street on Monday.

4. But don’t celebrate just yet

The crucial question is now who gets care and who doesn’t. The announcement comes as the Care Bill is debated in the Lords over the coming week. The reforms seek to tackle the crisis in care by introducing a cap on costs, a new means-testing threshold and national eligibility to end the postcode lottery in care.

But under the current  plans – reiterated in the Spending Review – the Government will raise the bar for eligibility to social care to a level which London School of Economics (LSE) says will leave 105,000 disabled people with significant needs outside of the system altogether. They need that support to live independent lives. Without it, they are left isolated and in crisis.

5. And the really bad news…

The Government was briefing that there would be no further cuts on welfare. But that’s exactly what a cap on so-called Annually Managed Expenditure could mean. AME is Government spending which includes welfare and state pension bills. The Government is capping about half the budget. The Chancellor confirmed this will definitely include benefits for disabled people.

This means that regardless of how many disabled people need financial support, if the public finances take another nose dive, the Government could pull the plug on support for disabled people just when they really need it. This is ludicrous. Some disabled people will always need financial support. It doesn’t make them scroungers or skivers.

6. But let’s end on a positive note

The Chancellor committed to continue to spend £350m on employment support for disabled people. This mainly funds Access to Work and Work Choice. This support is especially important when you consider the growing consensus that the Work Programme (not linked to this funding) isn’t effectively supporting disabled people and ESA claimants. This will come to a head when the DWP publishes performance statistics for the Work Programme on Thurs June 27th.  It’s becoming ever more clear we need new solutions for getting disabled people into work.

With every Spending Review there’s is a lot to take in. But at a time when the Government is bringing in £11.5bn of cuts, an investment of £3bn into local support for disabled people is certainly good news.