For service users who rely on benefits, the Queen's speech brought no relief
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Version 0 of 1. If the Queen’s speech is anything to go by, the prospects for social care and its service users are bleak. But they may be even worse than expected, because we have been looking in the wrong direction. Attention has so far focused on how social care will fare under this government’s proposals for the NHS. Fears have been raised that it would stay the poor relation in the partnership, lacking the protection afforded the NHS by its public popularity. These are justified concerns. However, for social care service users, there may be even greater reason for concern. These arise out of the government’s continuing commitment to far-reaching welfare reform. Related: The Queen's speech must not treat social care as the poor cousin of the NHS The coupling that preoccupies policymakers and politicians is that of health and social care. The connection that more often troubles service users is that between needing social care support and relying on benefits. The political debate has been framed in terms of hard working people and even the Queen in her speech had to talk of “requiring young people to earn or learn”. Social care service users include high proportions of people who are not in paid work and government schemes to help have a poor track record. Disabled people, people with learning disabilities, mental health service users and people with chronic conditions all face barriers in the labour market. For some, employment may not be the answer even if it were made more accessible, flexible and supportive. As for older people, the biggest group of social care service users, they have no place in today’s political rhetoric once their working days are over – whatever contribution they may have made. So while talk about social care service users tends to highlight ideas of involvement, partnership, empowerment and coproduction, it is a different story when these same people come under the ministerial eye as benefit recipients. Then the subtext is of fraud, scrounging and dependence and the policy is one of draconian assessment. The failure of health and social care integration is associated with inefficiency and the lack of success of preventative policies. Benefit reform is associated with raised levels of fear, anxiety and distress for both service users and their families, suicidal thoughts and possible evidence of a link between benefit cuts and suicide. The Queen’s speech promises nothing to shift this direction of travel. The employment bill announced by the Queen reduces the household benefit cap from £26,000 to £23,000. There is a two-year freeze on most working-age benefits, including unemployment benefit, child benefit, tax credits and most of employment support allowance from 2016-17. Automatic entitlement to housing support for 18 to 21-year-olds will be removed. However, the bill’s proposals only add up to about £1.5bn of the £12bn that Cameron has promised to cut from welfare spending. We will only get a clearer picture of how these massive cuts will be implemented in the forthcoming budget. Meanwhile, we can expect a cash-starved and as a result more inefficient benefits system to take longer to make decisions and deal with appeals, making service users’ lives more and more difficult. Even more problems seem to be lying in wait for those who use social care services. Disabled people, mental health service users and others are particularly reliant on local public services, which will continue to be lost as cuts in council spending are maintained. How will the promised community-based system of healthcare survive, when this infrastructure of support is whittled away? Where will social care service users live as the already inadequate stock of social housing is reduced by new rights to buy? If we believe those such as the Institute for Fiscal Studies, who predicted that the Conservative manifesto would reduce the state and public services to pre-welfare state proportions, then it might be wise to consider social care service users as pathfinders for the rest of us. There is nothing in the Queen’s speech that offers any hope of long-term sustainability for social care, especially given the major demographic changes currently taking place. Social care service users are among the most disadvantaged and impoverished people in Britain. They are likely to be the best weather vane we have for assessing this government’s domestic policy experiment. The worry is that we haven’t seen the worst of it yet. |