Spending on adult social care has fallen by more than 12% in the North East of England over the last decade, with northern and midlands regions bearing the worst of swingeing council cuts, exclusive analysis shows.
New health secretary Sajid Javid claimed last month that fixing social care remains an “absolute priority” for the Government, when he took over office from disgraced former minister Matt Hancock.
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But new analysis of 10 years’ worth of NHS data by NationalWorld has revealed the reality of stark spending reductions in communities up and down the country – despite our ageing population – with the North East bearing the worst of the cuts outside London.
NHS Digital figures show councils in England spent £19.7 billion on adult social care in 2019-20 – that’s all support, whether long or short-term, for people aged 18 or over with physical or learning difficulties or ill health.
Councils are responsible for commissioning the bulk of social care in England, mainly from independent providers. Where people have a ‘primary health need’, requiring support from the NHS rather than social care providers, that care will be funded by the NHS alone.
Cuts of almost £0.5 billion
While in cash terms council spending has risen from £17 billion in 2010-11, after adjusting for inflation it represents a real terms cut of more than £0.4 billion, or 2.1%. That is the equivalent of £41 less per person.
But the national figure hides huge inequalities between the regions.
Across the North East, the analysis shows spending fell by a massive 12.4%, or £145.3 million, over the same 10-year period. Only London saw a steeper fall, with cuts of 13.5%.
In total, northern regions saw cuts of 3.4% and the midlands regions 5.9%. That compares to a rise of 4.8% across the South East, South West and East of England regions.
The figures refer to gross current expenditure. It only includes day-to-day spending on care, excluding capital spending such as on buildings or other physical assets, and includes the contributions made by clients towards the cost of their council-arranged care.
A recent report by the government spending watchdog the National Audit Office (NAO) found spending had fallen by 4% since 2010-11 (3.9% by NationalWorld’s calculations).
That uses a measure known as net current expenditure – the same as gross current expenditure except it excludes client contributions, to only look at the cost burden on councils.
Here too NationalWorld’s analysis reveals huge disparities – the North East was worst hit, with a drop of 16.4%, followed by London on 15.5%.
Again, the southern regions (excluding London) saw a rise in spending of 3.8%. Northern regions experienced a cut of 5.1% and the midlands a cut of 9%.
Liverpool, Calderdale, Derbyshire and Wiltshire have all been removed from the regional figures – but not national – as 2010-11 data was not available.
‘Austerity can’t continue’
IPPR North, a public policy think tank for the north of England, said the central government’s programme of austerity since 2010 had hit the north disproportionately hard.
“It had a huge disproportionate effect on local government and public sector spending,” said campaigns manager Rosie Lockwood.
“Austerity can’t continue and we can’t continue to see capacity taken out of local authorities, in order to be able to support the social care sector in the future.”
Council-arranged social care is funded through a mix of central government grants, general council tax and the social care precept portion of council tax, as well as means-tested fees for those receiving care.
The NAO report said central government funding to local authorities had been cut by 55% since 2010-11, which had reduced their spending power by 29%.
IPPR said this likely meant that social care provision had been stripped back by councils trying to balance their books.
“People with lighter touch needs might not be getting the support they need,” said senior research fellow Erica Roscoe.
“There is a finite amount of support the council can offer, whether that’s staff or funding.”
The dramatic reduction in spending in the North East and wider northern region comes despite the fact that there is greater demand for support there than in other parts of the country.
In 2019-20, councils in Yorkshire received 6,307 requests for support per 100,000 adults, the highest rate in England and far above the national average of 4,362. The North East was next with 5,694 requests.
The North East also had the most people receiving support per head of the population – 2,549 per 100,000 compared to England’s figure of 1,894. It was followed by the North West (2,246) and Yorkshire (2,007).
Figures from Public Health England show people in the North East have on average a shorter healthy life expectancy than any other English region.
Shorter healthy life expectancy in the north
Healthy life expectancy at birth for men across the region is 59.4 years and for women 59 years. That is 5.9 years and 6.9 years shorter respectively than the healthy life expectancy in the South East – 65.3 years for men and 65.9 for women.
They also can expect to live a shorter time before developing disabilities. Men in the North East have a disability-free life expectancy of 57.3 years, the lowest in the country and 7.3 years shorter than top-of-the-pack London, at 64.6 years.
For women, the North East’s figure is 56.7 years, compared to 63.1 years in the South East – a gap of 6.4 years.
Ms Roscoe said the low-wage economy and resultant increased poverty levels in the north impacted the need for care.
“Health and poverty are inextricably linked, so of course with that comes higher levels of poor health and greater demand on the health system,” she said.
IPPR senior research fellow and health and care expert Chris Thomas said the new health secretary needed time to demonstrate his commitment to social care.
He said: “Hopefully it will be taken forward now in tangible action but I think the proof of the pudding is basically the Government has a commitment to bring forward a proper reform plan for social care by the end of the year.
“If the plan is either weak or delayed, as we know social care plans are very liable to be delayed from recent experience, that will be a very bad sign in terms of, ‘is their commitment there?’”
The Department of Health and Social Care was approached for comment.
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