Select Committee on Health Memoranda


Memorandum by the Department of Health

PUBLIC EXPENDITURE QUESTIONNAIRE 2001

Table 5.3.1

UNIT COSTS (£s) OF SELECTED PERSONAL SOCIAL SERVICES ENGLAND 1995-96 to 1999-2000



  Key .. = not available

  (1)  These unit costs have been calculated by taking gross current expenditure throughout the year on residential and nursing care as appropriate and dividing it by the average number of supported residents in such homes reported at 31 March in consecutive years. A supported resident is one who is supported wholly or in part by the local authority. Residents in local authority homes who are assessed to pay the full costs and residents in other homes whose fees are paid in part or through income support are not included.

(2)  From 1998-99 the definition of local authority care as reported on form RO3 has changed to exclude expenditure on people placed in the home of another local authority. This expenditure is now included in the independent sector expenditure.

(3)  This unit cost is calculated by taking gross current expenditure throughout the year on home care services and dividing it by activity data collected during a sample week in the Autumn.

(4)  This unit cost has been calculated by taking gross current expenditure throughout the year on foster placements and dividing it by the average number of children looked after placed in foster placements at 31 March in consecutive years.

(5)  From 1998-99 expenditure on foster placements also includes expenditure on lodgings, living independently, residential employment, children placed with parents or placed for adoption.

(6)  This unit cost has been calculated by taking gross current expenditure throughout the year on LA maintained children's homes and dividing it by the average number of children looked after placed in LA maintained children's homes at 31 March in consecutive years.

(7)  From 1998-99 expenditure on LA maintained children's homes is no longer separately identified.

(8)  Deflated using the GDP deflator at 1999-2000 prices.

















5.4  Independent sector provision

  Could the Department provide a table showing for each authority the latest information on the proportion of social services for adults which are purchased from the independent sector rather than being provided directly? Could the Department supply a commentary on these figures?

  1.  Table 5.4.1 shows for each authority the percentage contribution of the independent sector in respect of two main elements of community-based social services for adults (contact hours of home help/care and the percentage of local authority supported residents in independent sector residential care homes). Councils are continuing to make increased use of the independent sector.

  2.  For England as a whole, the independent sector provided 56 per cent of the total contact hours of home help/care in 2000, as compared with 51 per cent in 1999 and 2 per cent in 1992 , prior to the introduction of the Community Care Reforms of 1993. Use of the independent sector varies considerably between authorities and between services within authorities. 35 per cent of authorities have less than 50 per cent of their home help/care services provided by the independent sector and two authorities have all their provision from the independent sector. The variations in the use of the independent sector may reflect historical patterns of provision, local needs and local political priorities.

  3.  Local authorities place and financially support significant numbers of clients in independent sector residential care homes—73 per cent of all local authority supported residents in residential care (excluding unstaffed homes). This represents a slight increase on the 1999 figure of 71 per cent. Over the last few years a substantial number of authorities have transferred some of their homes to independent ownership. There is some variation in the use of the independent sector. Although there are no Local Authorities where all supported residents are completely in independent sector homes, just 3 per cent of councils have less than 50 per cent of their supported residents in independent sector homes.

  4.  Information on the total amount spent in the independent sector is not collected centrally.

Table 5.4.1

PROPORTION OF SOCIAL SERVICES FOR ADULTS WHICH ARE PURCHASED BY THE LOCAL AUTHORITY FROM THE INDEPENDENT SECTOR:













  Footnotes:

  1. Data collected on DH annual returns HH1 (home help) for a survey week during September 2000, and SR1 (supported residents) as at 31 March 2000. These figures do not include clients supported by local authorities in nursing care homes, which are all in the independent sector, or clients supported in any unstaffed homes.

  2. Includes residents supported in other authorities.

  .. not available.

  * in September week 2000.

  ** as at 31 March 2000.

5.5  Care for children

  Could the Department provide a table, by local authority, comparing the number of children fostered, with the number of children placed in community homes?

  Could the Department provide data on the number of children involved in schemes which are specifically designed to support families?

COMMENTARY

  1.  Table 5.5.1 headed "Children looked after by placement at 31 March 2000 by placement" compares the number of children fostered with the numbers placed in community homes. Community Homes refers to childrens' homes managed directly by Local Authorities and certain homes managed by Local Authorities in conjunction with Voluntary Organisations. These do not include homes run entirely by Voluntary Organisations or private "for profit" organisations. Children placed in these settings will be included "Other placements". This third category also includes children placed in residential schools and children on Care Orders but living at home with their families.

  2.  A second Table, numbered 5.5.2 has also been provided, comparing the number fostered with the number in all children's homes. This includes Community Homes, voluntary homes, and homes run by private "for profit" organisations. It is felt that the Committee might wish to see the data presented in this way, as it allows comparison between the number fostered and the total in all children's homes, rather than just the proportion in community homes. From 2001-02 onwards, the Department's placement statistics will be collected on this basis only and placements in community homes will not be separately identified.

  3.  There was a long term decline in the numbers of children looked after until 1994. This was accompanied by fewer and fewer children being cared for in residential care, so that the proportion of children in foster care increased correspondingly. Since 1994 the total number of children looked after at 31 March has increased by 17 per cent. However over the same period, the number of children starting to be looked after during the year ending 31 March has declined from 32,500 in 1994-95 to 28,400 in 1999-2000. The increase in the total looked after at 31 March, despite the decline in numbers who become looked after in the year, can be explained by an increase in the average duration of care periods.

  4.  The numbers of children in foster placements has increased over this period, from 32,000 (65 per cent of children looked after) at 31 March 1995, to 37,900 (65 per cent) at 31 March 2000, but the numbers of children in community homes has decreased over the same period, from 5,700 (12 per cent) to 4,800 (8 per cent). Over the same period, the number in all types of children's homes decreased from 6,900 (14 per cent) to 6,300 (11 per cent). These percentages show that the proportion of children placed in foster care remained constant, while the proportion who were in community homes decreased.

Table 5.5.1

NUMBER AND PERCENTAGE OF CHILDREN LOOKED AFTER BY PLACEMENT AT 31 MARCH 2000













  1.  Figures in this table exclude children who were accommodated under an agreed series of short-term breaks.

  2.  Where figures were unavailable they are represented by double dots (..).

Table 5.5.2

CHILDREN LOOKED AFTER AT 31 MARCH 2000 BY PLACEMENT













CHILDREN INVOLVED IN SCHEMES TO SUPPORT FAMILIES

  5.  For the purposes of this answer, we have interpreted "schemes" as all means, other than by providing care and accommodation, by which children and families are supported through social services departments.

  6.  The table shows the numbers of Children in Need receiving services from Social Services in the survey week. Children in Need comprise two broad groups; those children who are provided with care and accommodation (ie looked after) by local authorities and a much larger group of children who are supported in their families or independently through the work of fieldwork or centre based staff. In England as a whole, children looked after are typically about 25 per cent of the total children served in a typical week. There is variation in the figures by type of authority with children looked after comprising 30 per cent of the total in the metropolitan districts but only 19 per cent in London.


 
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