Health chief in funding warning as demand rises

Homes and health are our priorities but paying for them is becoming a headache. Picture: Getty
Homes and health are our priorities but paying for them is becoming a headache. Picture: Getty
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EDINBURGH’S health leader today called for a “national conversation” on public service funding as a rapidly ageing population leaves elderly care in the city facing crisis.

Ricky Henderson said the cash-strapped council had been forced to find £2 million which it is expected will largely pay for additional hours of home help.

However, he admitted that the “one-off solution” is not sustainable and that repaying the cash, found in the council’s reserves, in future years will present a “huge challenge”.

Outlining the impact of the council budget on his department, he said it was time for a debate about how services are funded.

Councillor Henderson’s department is perhaps the hardest hit of any within City Chambers, with budgets stagnating as pressure on services soars.

The number of older people supported by health and social care stood at 11,065 in January – an increase of almost ten per cent in 19 months.

In the same period, the number of people with learning disabilities using council health and social care services has gone up by 6.5 per cent, demand from those with mental health conditions went up 16.5 per cent while addiction services saw demand rise by almost 40 per cent, all at a time when the budget has barely increased at £198m.

Cllr Henderson said: “Demand for services is increasing and costs are increasing. Suffice to say, the council is living in a difficult financial climate, but we’ve put together the budget based on priorities and from a health and social care point of view, that’s caring for vulnerable people. We think we’ve put together a budget that protects those services as much as possible.”

He said that in light of the pressure being felt across local authorities – with the Capital needing to save £120m by 2018 while saddled with more than £1 billion of debt – he hoped the “national conservation” on public services would begin after the referendum on Scottish independence.

He said: “What sort of public services do we want in Scotland and how do we want to generate the funding? I think that’s a debate that’s not really been properly been had for a wee while. Hopefully, after September 18, there’ll be a bit more focus on it.

“It’s been tough. We don’t want to gloss over that in any way. I think there could be other ways of supporting public service expenditure. I think business rates should stay in the area in which they are raised and personally I’m still keen on a tourist tax of some description.”

Among the measures proposed by the council are an increase in prices for those using day centres and home care services who do not qualify for free help. From April, the cost of a session at a day care centre will go up 50p to £7, while care at home will increase by £1, to a maximum £13.50 an hour.

“It’s the first increase in four years, and we have to meet the savings targets,” Cllr Henderson said. “One of the ways of making savings is to increase your income. In this case those people who can’t afford to pay, don’t pay anyway because it’s means tested.”

Despite soaring bed-blocking levels in the city and a desperate need for new care home beds meaning Edinburgh pensioners are more likely to become stuck in hospital than in almost any other part of Scotland, a new £8m replacement for Silverlea Care Home at Royston is likely to be the last publicly-funded facility the Capital will welcome for several years.

But money has been found through savings on administration, and £8.7m from the Scottish Government’s Change Fund which will be ploughed into pursuing the agenda of helping the elderly and vulnerable stay in their own homes, while also negating the need for them to be treated in more expensive long-term facilities.

Another crisis facing the city is housing, with more homes needed for the Capital’s rapidly-expanding population. Edinburgh is to once again fall short of house building targets this year, as a short-term fix is applied to meet soaring demand in health and social care services.

While it is hoped that a £43.5m investment in 2014-15 will mean 1000 homes being built in the city – a higher figure then in previous years – by the latest estimate 16,000 are needed over the next decade to deal with a population boom, leading the city council to plead with the Scottish Government for more cash.

But with little cash to play with and many private developers still reluctant to commit to large projects, there are no easy solutions.

City housing leader Cammy Day said: “People are coming to Edinburgh and we don’t have enough homes. It’s not hitting the target yet, but it’s the highest we’ve had for a long time. We will continue to work with our partners to hit our targets.

“I’m in discussions with the Scottish Government, saying Edinburgh needs additional resource to meet its required targets. That is only going to increase to keep up with demand for affordable housing. We’re encouraging developers to kick-start their developments as well.”

One of the largest house construction projects in Scotland – in Muirhouse – is set to begin. New council housing developments to be completed in 2014-15 will include 60 affordable homes at Greendykes and 34 at West Pilton, while work on almost 100 at Leith Fort will also begin.

Efforts to offset the impact of the Westminster government’s welfare reforms will continue, with £665,000 set aside to deal with an increasing deluge of benefits applications. Awards of the discretionary housing payment, which offsets the impact of the bedroom tax, rose from 300 in April last year to 2100 last month.

Around £34m will be spent this year on improving homes, with £3.6m to go on environmental schemes. It is hoped that by replacing ageing heating systems, the council will reduce its carbon footprint while driving down bills for tenants.

Other initiatives include an £1m upgrade to council CCTV, which will become fully digital, giving clearer images which it is hoped will lead to increased conviction rates and deter crime, and the creation of an antisocial behaviour team to deal with persistent troublemakers.

City’s Greens offer their alternative

BEEFED-UP investment in school repairs, roads, pavements and cycleways form a central pillar of an alternative budget proposed by Edinburgh Greens.

The party would seek to plough £5 million into tackling fuel poverty, with the cash drawn from reserves generated through council tax paid by owners of second and empty homes.

As well as introducing a playground development officer, they would aim to create a wholesale food hub connecting consumers to agriculture.

The Greens argue to end planned six per cent rent rises for council house tenants and replace it with an inflation-only rise of 3.1 per cent.

To fund their budget, the Greens’ proposals include reducing landfill tax burden through minimising waste and charging more for parking permits for a household’s second car and high-polluting vehicles. Cuts include to the Lord Provost’s budget, public relations and Marketing Edinburgh’s £1m grant.

‘I welcome this budget’

Ricky Henderson

Health and social care convener, Edinburgh City Council

AS the convener responsible for services for older people, adults with physical disabilities, learning disabilities and other vulnerable groups, I welcome this budget, which will continue to focus on those who need support and on their carers.

Council budgets are reducing but demand for services is increasing. Despite this, the council has found financial headroom to provide additional resources, such as an

£8 million care home and an investment of £8.7m in new preventative services. A further £5.1m is also being invested in new services for older people, adults with learning and physical disabilities and an increased need for assessment and mental health services.

While increasing the supply of care in response to these pressures is essential, the council is also working with people to allow them to continue to live in their homes and communities as independently as possible. Key investments to achieve this include services such as re-ablement, which works with people to help them do as much as possible by themselves, and telecare to allow people to live safely at home.

Carers of older people and people with disabilities play a vital role in helping people to continue living in their community. I am delighted that the council is providing much needed support through its initiatives and, for the second year, making one-off payments of £250 to carers that recognises their huge contribution.

Strong communities will become increasing important as the number of older people living at home continues to grow, and I am pleased that the council continues to be able to fund initiatives and give grants aimed at supporting local volunteering activity.

‘Regenerating neighbourhoods’

By Cammy Day

Housing convener, Edinburgh City Council

THIS is a budget that underlines our commitment to delivering high-quality homes and services and to working in partnership with housing associations and the private sector to tackle the city’s acute shortage of affordable homes.

We are regenerating neighbourhoods and building affordable, cheap-to-heat homes, doubling the number to 1000 a year.

We are also continuing to invest in improving council homes, installing new kitchens, bathrooms, windows and front doors.

As a result, council homes are some of the best quality, most energy efficient homes in the city, with 93 per cent boasting an energy efficiency rating of Band D or above. Only 81 per cent of private market homes achieve this rating.

Our budget will deliver around 800 efficient heating systems, helping to reduce the burden of rising fuel prices, and adaptations to more than 500 homes, giving older and disabled people the opportunity to remain in their own homes.

It’s also vital that we strengthen and support our communities and continue to keep them safe. Over the last four years, Edinburgh has seen a 44 per cent reduction is antisocial behaviour.

The creation of an antisocial behaviour unit enables action against persistent offenders. Continuing to invest in community policing and upgrading our current CCTV system will also help us to reduce crime.