The BBC reports that the English Community Care Association, a representative body for charity and private sector care providers, has criticised local authorities for 'appalling' behaviour in seeking to reduce what they pay for care home services.
This can be read two ways. Firstly, it is clearly the case that local authority funding is being reduced significantly in cash terms over the next few years, and since social care is the largest area of local authority expenditure which is not directly funded by the Government (as is the schools service), many authorities have little choice but to bear down on costs. There are only two ways they can do this, either by reducing entitlement to services, which is clearly difficult when we are talking about highly vulnerable people and in some cases almost certainly unlawful, or they can try and reduce prices.
Since the private and voluntary sectors are now major providers of care services, the only way this can be done in a lot of cases is to reduce fees paid to these providers, and inevitably some of those providers will be more easily able to bear the reduction than others. For local authorities, this is no more than doing to their suppliers what the Government and, to some extent, the taxpayer does to the local authorities. Even before the current economic crisis, more was expected for less on a year-by-year basis.
The other way of looking at it is that if you are a care provider, and you have already driven down costs as far as they will go, it is impossible to go on providing the same services for less money- just as it is impossible for local authorities to do so for services they run, for all the exhortations of Ministers. Furthermore, some local authorities seem to have been a little high handed in the way they have sought unilaterally to reduce fees which, if I recall from ancient days my studies of commercial law, is not strictly allowed.
The Government's reaction has not yet become clear but I have a shrewd suspicion - based on track record- that they might take the part of the private and voluntary sector, if they say anything at all, although perhaps they would be wisest to stay out of it.
Let it not be forgotten in all of these high handed rows between funders, commissioners and providers that the people who suffer at the end of the day are the residents of care homes, among the nation's most vulnerable citizens. Thus every time a decision is made to cut public expenditure rather than to put up taxes, the pain of public sector cuts finds its natural level. In many cases, as in this one, this is at a level of accountability many steps removed from the original decision- a process which, if I was being cheeky, I might be tempted to call the 'Trickle Down Effect'.
