Examination of Witnesses (Question Numbers
436-439)
MS SHEILA
SCOTT OBE, MR
MARTIN GREEN
AND MR
COLIN ANGEL
19 NOVEMBER 2009
Q436 Chairman: Good morning and welcome
to our fourth evidence session on our inquiry into social care.
I wonder if I could ask you, for the record, to give us your name
and the current positions you hold.
Mr Green: I am
Martin Green and I am the Chief Executive of the English Community
Care Association.
Ms Scott: I am Sheila Scott, Chief
Executive of the National Care Association.
Mr Angel: I am Colin Angel, Head
of Policy and Communication at the United Kingdom Homecare Association.
Q437 Chairman: Thank you and welcome.
I have a question for all of you to start this session. Obviously,
we have been hearing about projections of demand for social care
in the future. What assumptions are you making about demand in
the coming decades and what are you basing these assumptions on?
Mr Green: From my point of view,
I think what we are basing our assumptions on are the assumptions
that you are basing your position on, which was outlined in the
Green Paper. Part of the problem about developing any assumptions
is that there are great regional and local differences around
how services are developed, so it is very difficult to come up
with a national view other than the demographic issue, which will,
obviously, produce more people needing care.
Ms Scott: Just to add to that,
I think we are assuming that the estimates are an underestimate
rather than an overestimate. My members primarily provide residential
care and right now there are large waiting lists in some areas,
so we have to get it right by area and region as well as nationally,
and we think that the figures that we see, whether that is from
the National Statistics Office or from the Government itself,
are generally an underestimate, but that is a belief; it is not
founded on fact.
Q438 Chairman: Colin, would you agree
with that?
Mr Angel: I would not disagree
with my colleagues. For the homecare sector, particularly, we
expect a considerable increase in demand given recent policy announcements.
The other thing, I guess, is our caution that the homecare sector
is largely limited by the supply of recruits and surety of supply.
Those are issues that are going to be concerns for us for some
time over the next few years.
Q439 Chairman: We are going to go
into some detail about that. We have heard of projections of future
costs as well. What assumptions are you making about unit costs
in the coming decades and what are you basing those assumptions
on?
Mr Green: Again, I think it is
very difficult. What we would like to see is an independent cost-of-care
exercise used as the benchmark for defining costs. Unfortunately,
what we have is a monopsony position in terms of the way in which
the Commission has managed the market. The costs, as they stand
at the moment, are very much costs defined by local authorities
rather than costs that are real costs for services and there are
issues around cross-subsidy in that.
Ms Scott: I think one of the key
things that the public debate that is going on needs to look at
is are we looking for providers to supply a five-star service
to everybody, not just in the care that is delivered, but (for
residential care) in the accommodation that is provided, or does
the Government truly mean what it says about a National Care Service
that will provide basic care? There is a huge difference. Providers
are expected by the regulator to provide that five-star service
across the board, but our members have to take into account not
just what we aspire to, but what is the available cash, and the
available cash at this time cannot provide that five-star accommodation
as well as a five-star service.
Mr Angel: We certainly would agree
with Martin's point that the local authority is a local monopsony
and has a critical impact on the costs and, indeed, what is paid
for care at home. We just observe, with a couple of figures, that
when councils provide a homecare service they are currently doing
that at a gross average hourly rate of £22.30. The same figure
for the independent sector is £12.30. So we are operating,
we believe, in a situation where costs are at an absolute minimum
and we do not think there is much to squeeze. However, we are
facing a restriction in the next spending round which is going
to leave local authorities even more cash constrained than they
currently are.
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