Health and Social Care – More for less

I met the head of Adult Learning Disabilities and mental health at Dudley Council for a briefing on services and current issues.

With the economy in a state of near ruin it is especially important that we protect what the media call ‘front line services’ for such vulnerable groups of people. Sadly if we are not very careful, such groups will suffer a disproportionate share of the cuts that are now being discussed by all political parties.

In just over an hour with the excellent head of service, Mr Richard Carter, I identified three areas where we could make substantial savings without affecting the quality or extent of the service received by those with learning disabilities.

1. Dudley Council employ 70 social services staff ‘seconded’ to the Walsall & Dudley Mental Health Trust. Such large scale secondments are always problematic. Who are such staff accountable to? We have three bodies, the Local Authority, the Walsall and Dudley Mental Health Trust AND the Primary Care Trust all trying to manage parts of a service that clients and carers assume is coming from one source. Try being the carer going between all these organisations – I’ve done it myself with older people and its almost a full time job! We should consider merging all three groups under one management structure and budget. Definite savings at no detriment to service – in fact in my view such a move would enhance the service.

2. Out of a total budget of some £24m for learning disabilities within the Local Authority, some £10m is spent on residential care. The cost of caring for some of the clients with more complex needs can reach £3000 per week. These are private homes charging the taxpayer a great deal of money and their books should be scrutinized. Local Authorities account for almost 100% of their income. The Councils should work together to drive down costs whilst maintaining standards.

3. Now this idea is doing the rounds. And it came up in another context when I visited the Worcester Street GP Practice in Stourbridge the other day. What is it that Primary Care Trusts do that cannot be done either by Local Authorities or GP Practices? If these two arms of government were merged when it comes to health and social care there would be tremendous savings on back office costs.

These policy decisions will be made by the Shadow Secretary of State for Health, Andrew Lansley, and his team, not by me. But I will certainly feed ideas in from the grassroots.

The sheer incompetence of this government and the byzantine systems of public service management at least mean, that with proper government, I have no doubt that we could deliver the same, or even a better standard, of care to many groups of vulnerable people for less money.