Solace Blog

The Future of Health and Social Care Funding

By Mike Suarez, Chief Executive, Cheshire East Council and Solace Spokesperson on Local Government Finance

The social care funding question is now one of the biggest issues facing all world leaders. It is, therefore, positive at least that a structural mechanism is now in its second year in local government which recognises explicitly that additional funding for a maturing population is essential to help balance the books. In all partners, a realisation of the profound service delivery issues facing is now getting the recognition it deserves from a maturing prison population to the developing market for products and services to support the quality of life into our later years.

Whilst I believe local government will and must contribute strongly to the Brexit debate and inevitable reformation of our trading with Europe, we can as an economy get a leading market advantage if we address further structural reforms ahead of other world economies with regard to an older and maturing population. The way some councils have transformed services, recognising the vital economic contribution a maturing population can give from volunteering and other inter-generational learning and training, is positive and welcomed. The link between social care and health is now well evidenced and reported on. However, the idea of the gearing relationship between the two areas is perhaps less so.

An NHS-funded out of kilter to social care creates tensions and bottlenecks which we often witness. The system is connected so more resources in one without a profound understanding of what that will do to the other can lead to unintended consequences.

The STP has been a difficult process – trying at a principle level to build collaboration when the health system is still built on a market mechanism is not an overnight change to overcome, yet local authorities have shown the strength of putting local democracy at the centre of local reform working with local partners to discuss and understand the system and how it relates to each other. It is noteworthy that at the time we are trying to build collaboration, many indicators like hospital discharge do not exemplify this or the steps being taken to co-produce solutions. Additionally, the STP for LAs used to local and regional priorities has felt top down with a focus on structures like accountable care organisations rather than say system resilience overall.

Local authorities have a profound understanding of sustainable budgets and understand a win/win strategy. So the realisation that long term social care funding must have an equivalent status to NHS funding issues is at least welcomed, albeit one falls on local tax payers and the other still retains central support that is significantly greater and more geared than just about every other partner – who are also addressing, as it happens, the consequences of a maturing cohort of our population.

Addressing this matter will help sustain the UK as an economic global competitor. Local authorities are place-shapers, and helping partners focus more on a "wellbeing" service, incorporating both mental health and physical wellbeing, and less on an "ill health service" will, I hope, better support the economy as a whole sustainably.