“It will be more difficult to cope.”

City 20th February, 2017

Lorna Stephenson

Disabled people and carers speak out on Bristol cuts impacts.

Photo: kimba Howard, Flikr CC.

Adult social care is a national crisis: with an ageing population, and progressively reduced funding from central government, councils are being forced to cut services to the bone.

Bristol is no different. The over-65 population is predicted to rise by 13% by 2024, and the general population growth will increase demand on all public services. Meanwhile, the adult social care budget has shrunk by 26% in real terms in the last four years. The proposed budget, to be passed by councillors tomorrow (Tuesday 21st), incorporates at least £7million to be cut from social care alone.

Bristol, like other cities around the country, is taking up the option of increasing its ‘social care precept’ on council tax. An increase of 2% on council tax bills will provide new ringfenced funds for care. But the precept won’t plug the gap – and there’s still no long term strategy for a sustainable care system.

Paying ‘due regard’?

The budget cuts have prompted people to wonder whether the council is fulfilling its duties to protect vulnerable groups.

Under the Equalities Act, local authorities must show that they have given ‘due regard’ to the impact of service changes on groups with protected characteristics, including disability. However, judgements on cases brought under the Act have used increasingly loose understandings of what ‘due regard’ involves. Evidence of a consultation period is usually seen to be enough, particularly as it becomes more and more difficult for people to fund court cases.

Laura Welti, spokesperson for Bristol Disability Equality Forum (BDEF) and a social care user, argues that the consultation the budget proposals underwent was inadequate. Instead of supplying a full equalities impact assessment before or during the consultation, for many proposals there was only an ‘equalities relevance check’ which simply assessed whether the measure should undergo a full impact assessment, leaving the affected groups of people in the dark until their chance to participate in the consultation was over.

Further complicating the issue of consultation is that the figures given for proposed savings lack any detail in how exactly the saving will be made. The Corporate Strategy outlines the ‘whats’, the general amounts earmarked for savings under each spending area, without going into the ‘hows’: how exactly ‘reviewing’ or ‘reducing’ services will achieve the desired outcomes.

“You couldn’t really give an informed response to the consultation, because it didn’t really give you the information on how that was going to impact on the coalface as it were, of those services,” Welti says.

In response Cllr Estella Tincknell, Deputy Mayor and Cabinet lead for equalities, said: “As a council we recognise how important it is for us to understand the impacts of what is a very challenging budget, especially as council services largely serve the most vulnerable in society.

“We are confident that the individual EQIAs and the cumulative impact assessment, which takes into account all proposals together, give us the best information we can have at this moment in time to enable us to make these difficult decisions.”

She added that the equalities impact assessment were ‘not static documents’ and that they will be continued to be developed as the process continues and as the Cabinet decides on how the savings will be implemented in each area.

“Many in caring situations will reach breaking point.”

Nothing about us without us

Nevertheless, BDEF is hoping for more inclusion of disabled people in decision-making moving forward, not least because they are uniquely placed to advise on service reconfigurations from knowledge and experience, as well as the cumulative impact.

It was concern over the cumulative impact which shone through in the responses to a Bristol Cable survey of disabled people and carers on the Corporate Strategy. On the question of which proposals were the most concerning, two respondents replied simply, “All of them.”

Laura Welti points out that some proposals were removed after a public outcry, such as blue badge charges, the end of concessionary companion travel, and the imposition of prepaid cards for all recipients of direct social care payments.

She points out that more thorough consultation could avoid unnecessary anxiety and wasting money through the turmoil of perpetually changing services without allowing time for the new configurations to bed down and adapt. Yet, compared to other authorities, Bristol council does listen, as evidenced by the retraction of some suggestions – “They’re better than pretty much any other authority,” she says.

“Mayor Rees clearly does not understand and has limited interest in disability.”

Welti suggests that a large part of the problem with the council under Rees is a lack of awareness around disability issues which led to disability being left out of the general ‘equality’ theme running through the administration – such as the confluence of disability with other forms of disadvantage like poverty. (Other anonymous survey respondents were less polite: “He clearly does not understand and has limited interest in disability,” one commented.)

Keith Sinclair, CEO of the Carers Support Centre, further emphasised the short-sightedness of proposals which will cause carers to ‘pick up the pieces’, because, he says, this group provides already provides in excess of £700million of voluntary care to the health economy.

“We fear that, with reduced support, many in caring situations will reach breaking point and the impact of this will be much more significant for health and social care providers, and more importantly, the lives of carers and the people they support,” he said.

He added that some of the most common questions they fielded were around day service and respite availability, and any cut back or rationing of these services would have a direct impact on carers, who struggle to get a break from their responsibilities.

Empowerment – or shifting responsibility?

The council is pushing forward with a plan to reconfigure social care into a three-tiered system whereby those with the lowest needs get temporary support to regain independence, and intense or permanent support is reserved for those with the highest needs. However, critics say the system is open to abuse: Rather than genuinely empower service users, the financial bottom line becomes more important.

One anonymous social care worker responded to the Cable survey: “We support several people who would come under the lower umbrella, they already receive far too few hours and we spend much time outside of their funded hours supporting them.”

When the budget is voted through tomorrow, the council is going to have a hard time reconciling the numbers in the ‘savings’ column of a spreadsheet with the reality of implementation, and safeguarding vulnerable people from the fall out. As one survey respondent put it, “It will be more difficult to cope.”