NB Silver Voices Members can obtain back copies of specific briefings by e-mailing firstname.lastname@example.org
WHATEVER HAPPENED TO THE DEMENTIA CHALLENGE?
Our Briefing 24/17 queries what has happened to the Prime Minister's Challenge on Dementia 2020? No public updates since March 2016: is the current PM as committed to the issue as David Cameron?
POST-BREXIT STAFFING CRISIS LOOMS
Briefing 20/17 examines the looming staffing crisis in the social care sector; from a combination of high staff turnover, increasing demand and Brexit jitters amongst EU nationals. We suggest what needs to be done by Government to avert this crisis.
STATE PENSION AGE ON THE RISE AGAIN
Our Briefing 18/17, for members only, analyses two reports recommending that rises in the State Pension Age (SPA) are accelerated. One report suggests that the SPA should rise to 70 in less than forty years. The Government says it will take a decision in May.
Briefing 15/17 analyses the need for long-term funding solutions for the NHS and social care. Silver Voices argues that every attempt should be made to forge a cross-party approach to these deep-rooted problems.
Our Briefing 14/17 for members provides an analysis of the Budget. Silver Voices argues that the extra £2 billion for social care is woefully inadequate and will be gobbled up by the planned increases in the living wage for social care staff. There was no substantial injection of funding for the NHS.
Our Briefing 9/17 for members analyses recent research from the Nuffield Trust revealing that delayed discharges from hospital are running three times higher than the official (already disgraceful) figures. Also the NHS is responsible for more delays than the lack of social care.
HOUSING WHITE PAPER
Our Briefing 8/17 for members covers the Government White Paper on housing from a senior citizens' perspective. The economic case for investment in retirement housing is totally ignored. Platitudes not proposals is our general analysis.
NHS: STATE OF DENIAL OR DELIBERATE STRATEGY?
Briefing 5/17 on the NHS crisis debates whether the refusal of the Government to provide emergency funding for the NHS is due to indifference or lack of understanding; or whether it is a deliberate strategy to undermine public support for the health service.
BUSES: MORE POWERS BUT MORE CUTS
Silver Voices Briefing 3/17 for members only explained how the new powers being given to local government to set standards for local bus networks are being completely undermined by the huge cuts in funding for subsidised bus services over recent years.
CHANCELLOR TURNS HIS BACK ON SOCIAL CARE
Our Briefing 63/16 covered the Chancellor's Autumn Statement and highlighted the total absence of any mention of the social care crisis in his speech. Ignoring a situation where over one million vulnerable senior citizens are already being denied the social care help they need has been condemned from across the political spectrum.
STATE PENSION AGE ON THE RISE?
Silver Voices Briefing 58/16 reports on the latest review of the state pension age, expected to report in 2017. The UK already has one of the highest SPAs in the developed world but expect it to be hiked up again.
DISGRACEFUL WAITING TIMES FOR CATARACT OPS
Silver Voices Briefing 57/16 highlights the postcode lottery over waiting times for cataract operations. The average waiting between referral from an eye clinic to the actual operation varies from 467 days to 15 days depending on where you live.
BUSTING THE INTERGENERATIONAL MYTHS
Silver Voices Briefing 53/16 takes issue with the lies being peddled in the media about rich pensioners and the phoney war between young and old: a poorly disguised strategy to lobby for the abandonment of the pensions triple lock and the removal of universal benefits for senior citizens such as concessionary travel.
BEWARE OF SOCIAL CARE HOME TRUTHS
Silver Voices has criticised a report from the King's Fund and Nuffield Trust on the social care crisis. While correctly pointing out how profound the crisis is the think tanks let the Government off the hook: by refusing to call for significant extra funding and giving an unpalatable 'home truth'; that if government is unwilling to provide adequate funding it must tell the public that in future the primary responsibility for funding social care must sit with the individual and the family. (Briefing 51/16 for members only)
THE ECONOMIC CASE FOR MORE RETIREMENT HOUSING
Briefing 46/16 for members only reports on a study that reveals the huge potential savings to the state by developing more specialist retirement housing, to enable senior citizens to downsize. Only 2% of the UK's housing stock is specialist retirement housing, whereas over half of the 6.5 million senior citizens who own their homes would be interested in downsizing.
PARLIAMENTARY INQUIRY INTO SOCIAL CARE FUNDING
Silver Voices has made a comprehensive submission to the Parliamentary Inquiry on the social care funding crisis. Because this issue is so important we are making our submission publicly available below. You have to be a member to access our other briefings so please join on the Join Us page.
EVIDENCE FOR COMMUNITIES AND LOCAL GOVERNMENT COMMITTEE INQUIRY INTO THE FINANCIAL SUSTAINABILITY OF ADULT SOCIAL CARE
Silver Voices is a new national membership organisation for senior citizens, campaigning for a fairer society and stronger public services. We are non-profit-making and not affiliated to any political party. Our activities are internet-based and we provide members with regular policy briefings prepared by a team of policy experts. Policy priorities are set by the members and the social care crisis is one of our key campaign issues. We currently have almost 400 full members and further information can be obtained from our website www.silvervoices.co.uk .
There can be no doubt that funding for social care is in crisis and that social care services are in danger of meltdown. The question is: what is to be done about it?
2 The Social Care Crisis Illustrated
Funding for adult social care was cut by around £5 billion between 2010 and 2015, at a time of fast growing need as the age profile of the population changes. A recent ADASS (Association of Adult Social Services Directors) survey found that local authorities had cut adult social care budgets by a further £941 million (7%) in 2016/17. These swingeing cuts have had a dreadful impact on both the quality and quantity of social care provided to senior citizens. Eligibility criteria have been tightened up across the board and providers of both domestic and residential care squeezed. The much vaunted Government policy to permit local authorities to increase council tax by up to 2% to boost their social care budgets in fact only raised £380 million (ADASS) which was more than swallowed up by the costs of implementing the national living wage. Some of the effects of these policies are illustrated below:
It is estimated that up to one million senior citizens, who would previously have qualified for some social care support, are now being denied the help they need to live independently and with dignity in their own homes (Age UK). Again this year, ADASS admit that despite a growth of 3% in the number of senior citizens, the number receiving social care services will remain the same
The lack of social care in the community has an obvious adverse impact on delayed discharges (so-called bed-blocking). The National Audit Office reports that 1.15 million bed-days were lost because of delayed discharges in acute hospitals during 2015, an increase of 31% since 2013. 85% of delayed discharges concern people over 65
The Meals on Wheels service once formed a foundation stone of the Welfare State but is in danger of disappearing completely. The number of meals provided to senior citizens has been reduced by two thirds since 2010 and one third of authorities have abandoned provision all together (National Association of Care Catering)
The squeeze on fees for home care and residential care continues. In 48 councils at least one home care provider has gone to the wall in the last six months and at least one residential care provider in 77 councils (ADASS). Many other providers are handing back their contracts to councils as they can’t afford to run them.
Quality of services continues to suffer with fifteen minute ‘flying’ visits from carers commonplace. The National Audit Office has reported that nearly a quarter of a million homecare workers are being paid illegally below the minimum wage as providers are not paying their travel time between clients. Local authorities are turning a blind eye to this scandal, with only a quarter stipulating in contracts that travel time must be paid. Poor wages and lack of training and career progression in the home care sector has led to a huge turn-over in staff, resulting in an unsettling lack of continuity for the client. The Government Chief Inspector of Adult Social Care warned in 2015 that a “broken system is turning good people into bad carers” and revealed that there are more than 150 allegations of abuse against the frail and elderly every day
1.5 million senior citizens provide unpaid care to family members, saving the state £25 billion per year. The Care Act was supposed to provide a timely assessment of carers needs but one in three have to wait over six months for an assessment (Carers UK). The assessments often turn into tick-box exercises, as local authorities have no funding to help except in the most critical cases. Carers are often pointed towards whatever help can be provided through the voluntary sector
Even taking into account the austerity regime, social care has been disadvantaged compared to most other public services. £6 billion saved when the government deferred its manifesto commitment (in respect of the Care Act) to introduce a cap on individuals’ lifetime contributions to their residential care was supposed to have been diverted into the adult social care budget but disappeared into the Treasury. Unless immediate action is taken to resolve the funding crisis, tragedy beckons. As the Chair of the Care and Support Alliance has said “if we don’t do something, people will die”.
3 Funding Solutions
The Government appears to think that it is providing sustainable funding settlements for adult social care but no independent commentators hold the same view. Much faith is also being placed on efficiency savings arising from the integration of health and social care but there is no material evidence from the various pilots and local initiatives so far that major savings can be found by these means. The reality is that core funding for adult social care is billions of pounds short of meeting the minimum requirements for a dignified and supportive social care system. The social care system requires an emergency injection of funding of the order of that promised to the NHS (£8 billion up to 2020). Local government and the major charities supported the deferral of the residential care cap on the basis that the £6 billion saved would be reinvested in social care. Such an investment would at least restore the cuts that have been made to the system since 2010.
Full integration of health and social care is a desirable objective in its own right but in England the government has adopted a timid and disjointed approach. A number of low key and under-funded initiatives exist, some being driven by the health service and some by local government; including the Better Care Fund, ‘new care model vanguards’ and ‘integrated care and support pioneers programme’. The different programmes do not correspond geographically and the degrees of support from the Government and NHS England continually change. At least in Scotland constitutional change has taken place to set up new Integration Authorities and it will be useful to follow progress on integration there.
Silver Voices supports the formation of a national health and care service with an integrated budget but in doing so the anomalies between a health service free at the point of delivery and a means tested social care system must be rationalised. There is no logical reason why cancer care should be free and dementia care means-tested.
The Barker Report of 2014 pointed the way on many of these areas but has largely been ignored. Barker called for a single-ring fenced budget for health and social care, with a single commissioner, and recognised that substantial extra funding was required to resolve the social care crisis. Furthermore, Barker argued that a start should be made in resolving the eligibility anomalies between health and social care by making care free for those with critical or substantial needs, at a cost of about £3 billion a year. Silver Voices members have been surveyed on their preferred options for finding the extra funding required for the NHS and social care system and increased general taxation and/or national insurance was preferred by 68% of our members. High quality public services have to be paid for and the Government has the responsibility to make this positive case to the electorate. In such circumstances we believe an increase in general taxation would be supported.
Silver Voices as an organisation run by senior citizens for senior citizens, would be delighted to give oral evidence to this Inquiry if requested by the Committee.
Dennis Reed Director Silver Voices
SOCIAL CARE AT TIPPING POINT
Our latest briefing 40/16 for members only, reveals how social care is facing further huge cuts during this financial year. The increase in council tax was swallowed up by the costs of introducing the living wage, so local authorities will be forced to make cuts of nearly £1 billion this year. These cuts will directly reduce services for senior citizens, such as home care support, and increase charges.
Briefing 33/16 for members only provides a carers' update, including a survey showing that the Care Act is not delivering. Carers are having to wait many months for the assessment to which they are entitled under the Act; and often the assessments turn out as 'tick box' exercises as local authorities don't have the resources to help.
THE SILENT GENERATION
Briefing 32/16 for members only covers a report revealing the comparative poverty of the Over 75s, the generation who lived during the Second World War. Their income is on average £59 per week less than younger pensioners.
DELAYED DISCHARGES CRISIS
Briefing 31/16 reveals the latest shocking figures on delayed discharges (so-called bed-blocking). Briefing for Silver Voices members only.
NHS DISCRIMINATION ON DEMENTIA
Briefing 28/16 provides details of a survey exposing how badly people with dementia are being discriminated against when they need health support.
FINANCIAL ENGINEERING IN THE CARE HOME SECTOR
Briefing 27/16 for Silver Voices members only illustrates how the big residential home chains have siphoned off public money through financial engineering.
SHELTERED HOUSING UNDER THREAT FROM BENEFIT CAP
Silver Voices briefing 14/16 reveals how the proposed cap on housing benefit for rented social housing has already resulted in the development of thousands of much needed extra care homes for the elderly and other vulnerable groups, being shelved.
GOVERNMENT GUILTY OF DIGITAL EXCLUSION
Silver Voices recent briefing (11/16) covers the trend of government agencies to provide public services almost exclusively through the internet, thereby increasing digital exclusion of older people.
CARE HOMES HORROR STORIES
Silver Voices recent briefing (10/16) shows how the squeeze on local authority social care budgets is starting to have a severe impact on standards of care in residential homes.
FREE TV LICENCES
Silver Voices recent briefing (8/16) for members outlines all the arguments in favour of retaining the free TV licence for the over 75s, at a time it is under attack.
Silver Voices recent Briefing 7/16 provides an update on the problems with the new state pension and also shows how badly retired workers in the UK fare compared to other developed countries (briefing available for members only).
SHOCKING HOSPITAL CARE FOR PEOPLE WITH DEMENTIA
Silver Voices recent Briefing 6/16 covers a survey exposing how badly some hospitals treat patients with dementia, leading to worse health outcomes for them (briefing for members only).
Silver Voices recent briefing on so-called 'Intergenerational Fairness' exposes this attempt by Government to put one generation against the other over resources and to justify pension and benefits cuts for senior citizens in the name of fairness. The House of Commons has set up a loaded Inquiry into whether senior citizens are getting an unfair share of resources. Briefing 5/16 for Silver Voices members only.
ATTENDANCE ALLOWANCES UNDER THREAT
Silver Voices recent briefing (Briefing 2/16 for members only) reports on the apparent Government intention to devolve the £5 billion attendance allowances budget to local authorities. The danger is that the benefit will be merged with the social care system and will be severely restricted by means testing and more rigid eligibility criteria.
WINTER DEATHS DISGRACE
Silver Voices recent briefing exposes the scandal of excess winter deaths at a time when the Government is cutting subsidised insulation in homes. Nearly 41,000 senior citizens died from the cold last winter (Briefing 66/15 for Silver Voices members only).
AUTUMN SPENDING STATEMENT
Silver Voices has issued a series of briefings unpicking some of the nasty small print of the Chancellor's autumn spending statement. The briefings have covered the lack of funding to resolve the social care crisis, a pensions update and how the spending statement affects local government and the NHS.
RESIDENTIAL HOMES MARKET IN STATE OF COLLAPSE
This briefing from Silver Voices outlines the facts about the collapsing residential homes market with many private operators facing bankruptcy because of the social care cuts. This situation proves what folly it has been for local authorities to close so many of their own homes and rely on the private market; soon residential care will be the preserve of the wealthy self-funders and many more older people will end up in hospital beds because there is nowhere else for them to go. Briefing 60/15 for Silver Voices members only.
MEALS ON WHEELS FACING EXTINCTION
This briefing from Silver Voices outlines the savage cuts to meals on wheels services over the last five years. The physical and psychological benefits of receiving regular hot meals from trained staff are being ignored, leaving hundreds of thousands of housebound and often confused people to fend for themselves. Briefing 58/15 available to Silver Voices members only.
NEW STATE PENSION TOP-UP SCHEME
This briefing from Silver Voices exposes the new state pension top up scheme as a scam. The lump sums required are so big that many people would have to live beyond the average life expectancy in order to recoup their investment! Briefing 57/15 available to Silver Voices members only.
MALNUTRITION AND DEHYDRATION
This briefing from Silver Voices reveals some shocking statistics on the extent of malnutrition amongst senior citizens and the large number of unnecessary deaths due to dehydration taking place in hospitals and care homes. Briefing 49/15 available to Silver Voices members only.
CARE ACT 2014
This briefing from Silver Voices (46/15) provides a detailed implementation update on the Care Act. It covers the implications of the Government's decision to defer the cap on lifetime contributions to residential care until 2020, despite a manifesto commitment.
Silver Voices briefing (45/15) covers the numerous warnings over the summer that the social care crisis is getting worse and faces financial meltdown. Other recent briefings from Silver Voices include a Government response to Silver Voices on dementia (42/15), the shocking Government u-turn on the Care Act (43/15) and Digital Exclusion (44/15).
A TWO FACED SUMMER BUDGET
This briefing from Silver Voices exposes how two-faced the recent Budget was. Major welfare cuts while corporation tax was reduced to the lowest level in the developed world. And the much trumpeted living wage announcement being far out-weighed by huge cuts in tax credits. Silver Voices is most worried about the forthcoming cuts in health and social care which will be announced in the autumn. The social care crisis means so little to the Chancellor that he failed to mention social care at all in his lengthy speech!
This briefing from Silver Voices (40/15) shows how the so-called bed-blocking crisis in NHS hospitals is getting worse as more and more patients languish in hospital waiting for social care packages to be arranged so that they can return home. The Briefing suggests that Silver Voices members find out what the situation is in their local hospital and publicise it.
Silver Voices briefing 37/15 provides statistics on the poorly reported outrage of elder abuse and covers the new adult safeguarding measures that can be used by members of the public if abuse of senior citizens is suspected.
WHAT PRICE CARE?
Silver Voices has issued two briefings written by one of our members providing a powerful description of the unsatisfactory care received by her Mum at the end of her life. The care home is run by a large company and although it keeps getting unsatisfactory reports from the Care Quality Commission it continues to operate without sanctions. The briefings also point out the limitations of existing complaints procedures for residential care. Silver Voices uses real life experiences to illustrate our campaigns.
THE QUEEN'S SPEECH
This Silver Voices Briefing (33/15) describes the Government's legislative programme for the next parliamentary year. Senior citizens are largely ignored.
DEMENTIA: THE MIND KILLER DISEASE
This Silver Voices briefing (32/15) provides statistics on the numbers of elderly people suffering from this cruel disease and calls on the Government to make good on its promises to make the UK "the best country in the world for dementia care and support by 2020".
GENERAL ELECTION: WHAT THE THE PARTY MANIFESTOS SAY TO US
Silver Voices issued a series of briefings for members over the General Election period, analysing what the political party manifestos say on key senior citizen issues, including Social Care, the NHS, universal benefits, pensions, energy policy. We have also highlighted how senior citizens have largely been ignored during the general election campaign in favour of "hard working people" !
NEW STATE PENSION
This Silver Voices members' briefing exposes the new state pension coming in from next year as a complex con trick. Briefing 20/15 explains in detail how the new single tier pension affects new and existing pensioners.
This Silver Voices briefing describes the dire shortage of specialist retirement homes in the UK and explains what needs to be done about it. Briefing 19/15 for Silver Voices members only.
END OF LIFE CARE
This Silver Voices briefing explains the findings of the Health Select Committee on the problems with end of life care: most people would like to die at home but the majority of us die in hospital. Why is this? Briefing 17/15 for Silver Voices members only.
OLDER CARERS: THE SILENT ARMY
Silver Voices has issued three briefings on the plight of older carers: the extent of the crisis and the human toll exacted, the benefits maze which older carers face and an agenda for positive support for older carers for the next government to implement. Briefings 12/15, 14/15 and 16/15 for Silver Voices members only.
SOCIAL CARE CRISIS LATEST: SIGN THE SILVER VOICES PETITION
As well as calling for signatures on the Silver Voices petition this briefing reveals shocking new statistics on the impact of the social care crisis on elderly people and the direct links with the bed blocking emergency in NHS hospitals. Briefing 11/15 for Silver Voices members only.
THE SCOURGE OF LONELINESS IN OLD AGE
This briefing from Silver Voices analyses the most recent statistics on the rise of loneliness among senior citizens and the measures to combat this major societal issue. Nearly 3 million older people feel they have no one to turn to for help or support and everyone can help to combat social isolation. Briefing 9/15 for Silver Voices members only.
FREE NATIONAL CARE SERVICE: IS IT AFFORDABLE?
This briefing from Silver Voices examines the costs of providing a free national care service alongside the NHS. Such a service would remove the glaring anomaly of free cancer treatment but costly dementia care. Silver Voices argues that the funding must and can be found in a civilised society. Briefing 8/15 for Silver Voices members only.
SUBSIDISED BUS SERVICES AXED ACROSS THE COUNTRY
This briefing from Silver Voices reveals the extent of the cuts to subsidised bus services in England and Wales over the last year. There is a league table of shame of those local authorities who have cut the most and a link to protest to your MP. Briefing 7/15 for Silver Voices members only.
36 YEARS A PENSIONER
This briefing from Silver Voices outlines the importance of the state pension and other state benefits in ensuring the well being of the mother of a Silver Voices member, now aged 100, since she retired. We allow these benefits to be diluted at our peril as many future senior citizens will not have occupational pensions when they retire. Briefing 6/15 for Silver Voices members only.
THE BETTER CARE FUND: PAPERING OVER THE CRACKS
This briefing from Silver Voices analyses the likely impact of the BCF and whether the fund represents new money. Briefing 5/15 is available to Silver Voices members only.
TAKING THE SHAME OUT OF DEMENTIA
Silver Voices has published a powerful article by a member on the impact of advanced dementia on a family. The article calls for a more honest approach to the challenging behaviours often exhibited with this disease and the development of expertise, training and strategies for caring for people with this condition. Briefing 4/15 for members only.
HOME CARE WORKERS: LIFTING THE LID ON AN EMPLOYMENT SCANDAL
A new briefing by Silver Voices exposes the appalling pay and conditions of home care workers: around 200,000 of whom are illegally paid less than the minimum wage. Local authorities and the NHS bear direct responsibility for this state of affairs as these workers are usually working under their contracts. Find out the full facts of this employment scandal and what you can do about it by joining Silver Voices today. Briefing 3/15 for members only.
An analysis by Silver Voices reveals that 1.6 million pensioners are officially in poverty. This situation is made much worse by the fact that many senior citizens do not claim the benefits to which they are entitled e.g 2.2 million are not receiving the council tax benefit they are due. Briefing 1/15 for members only.
SOCIAL CARE CRISIS: THE FACTS
As part of the Government’s austerity measures nearly £3 billion has been cut from the adult social care budget over the last five years. Millions of older people now receive a worse domiciliary support service than they did in 2009, or none at all.
Download the Briefing here
NHS FUNDING ON A CLIFF EDGE
NHS finances are in a critical state today and the situation is predicted to get much worse over the term of the next Parliament. Most commentators and think tanks believe that unless extra funding is committed there will be a £30 billion black hole in funding by 2020/21. Trust failures, like the recent Colchester case, may become commonplace. The responses of the main political parties have been limited and inadequate so far.
Download the Briefing here
CARE ACT 2014: SMOKE AND MIRRORS
This Act was supposed to prevent many old people from being forced to sell their homes and use up their savings to pay for residential care in their last years, after having paid income tax and national insurance throughout their lives. Does it do the job intended?
The Act also places many extra responsibilities on local authorities.
Download the Briefing here