There's more than enough space taken up by reviews of the last year, and life is for living forwards. So as time moves into 2012 heres a view on what the year to come may hold, with the knowns, the unlikely and the complete unknowns all getting a show.
Three certainties to show up in the year ahead:
The White Paper
The Government entered power with a promise to reform care for adults in the lifetime of this parliament. It has completed the reviews by Dilnot and the Law Commission. The engagement process which reported just before Christmas developed some new lines of thought, and we turn the year with the prospect of reform still alive.
In 2012 this becomes a matter for the whole Government - it will need to set out its policy response in the White paper and its response to how care will be funded in the specific financial response to Dilnot. One way or the other it will be a definitive moment in meeting the promise set out in the coalition agreement.
Its also an issue for the sector. The sector has shown through the engagement exercise that it is ready to work with reform, but that it cant do this without funding and policy change. If that change isnt forthcoming, then the sector will have some serious thinking to do about the nature of the relationship with Government for the rest of this parliament.
ADASS's resource survey showed a billion pounds came out of adult care in 2011/12 despite the protections offered to adult care by both central government money and priority setting by local government. More to come in 2012 is inevitable, with uncertainty about how this will look.
The predictions post 2013 also worsened at the end of the last year. Given the extent to which local government copped for large reductions in the last spending review, adult social care needs to find a voice to make its case. Doom-mongers can contemplate the scenario of no reform and further cuts in 2013, optimists will see added urgency to the need for the settlement on how care is paid for.
Fees and providers
2012 sees more cost pressure for providers while council budgets enter year two of the three year reductions. Of course, expect more noise about this being all the fault of directors for not having the alchemy to make this work.
Relationships maybe strained, but there are signs of emerging solutions sometimes the providers are ahead on the need to recraft the way care is done to get to grips with these issues. Open book and transparent arrangements offer some solutions but are not yet secure enough in all places as ways forward.
Post Southern Cross, new providers will show their hands and ADASS has welcomed the responses of Four Seasons and HC-One to new ways of working through open and transparent processes. The whole market shape will need to adjust and settle in new patterns and in some places that will mean tough conversations about new types of supply, reducing over-provision or attracting investment into poor quality stock.
Three things that we can hope for in the season of goodwill, but that probably wont show up:
- Workforce: this is a sector that has 1.7 million people, and is growing. I have been struck during my year as president by how few members of that workforce enter the policy debate and how weak its voice is. A stronger voice and greater attention to the employment and wealth creation opportunities that come from care would be good signs in 2012,
- Good practice: We all know that there is no place for poor practice. But at times in 2011 it sounded like all our staff spent all their time harming, abusing or failing to plan for the needs of the people that they care for. We cannot allow the work of all staff to be characterised in these ways. There is much that is good and life-changing about great social care.
If the case for reform was to be made by poor practice, something would have been done a long time ago. We need to raise our game to show why reform can achieve something positive in peoples lives and some of that practice is there now despite the many fractures in the system of care.
- Recognition of leadership: Of course 2011 had its challenges but councils met the budget tasks, cracked on with personal budgets and on the way met the challenges posed by Southern Cross. All this and the day job of meeting the needs of growing numbers of people living with needs and levels of vulnerability that require some support. The sector is under pressure, locally and nationally, yet leaders have put huge amounts of commitment into shared work regionally and nationally.
Directors and other leaders in this system are, in my view, public sector heroes. It would be good at some point to see that get recognised by something more than unreported ministerial thankyous.
Just as the last group got more extreme and unlikely, I thought I would leave space for the three things that we cant guess. Parts of 2011 were nothing if not unpredictable so I think we should all have three personal wild guesses at what lies ahead These are best left as work related (although England finally beating Ireland at rugby would allow much personal happiness into my family life!).