'Pledges broken' over community care funding: All-party committee criticises failure by ministers

THE GOVERNMENT has failed to fulfil adequately its three key pledges on the funding of the community care policy which comes into force on 1 April, a report by an all-party committee of MPs concludes.

Despite pledges that the Department of Health's funding arrangements would be 'transparent, adequate and fair', the health select committee found that the commitment to transparency was partly unfulfilled, that the funding was inadequate in some areas and that the overall funding formula was unfair.

At a press conference launching the report yesterday, Marion Roe, the chairwoman, said that the committee had been unable to reach a 'definitive' conclusion about the adequacy of the resources overall.

This was because 'our efforts to reach a judgement between different views as to the adequacy of the sum available for community care have been hampered by a lack of transparency about the assumptions used by the Department of Health,' the report says.

The report, Community Care: Funding From April 1993, highlights a catalogue of problems which threatens the ability of local authorities to meet their new responsibilities under the NHS and Community Care Act 1990 for caring for the elderly, mentally ill and handicapped, and other vulnerable groups.

Because the needs of the most dependant will have to be met first - for instance elderly and ill or disabled people in need of permanent residential or nursing home care - and because the local authorities' resources are limited, many other people who are entitled to help will probably not receive it.

Those most likely to be neglected are elderly, mentally ill and handicapped people who want such things as a home help, day-care facilities or nursing at home.

People with a drug or alcohol dependency problem are also at risk because the Government has failed to 'ring-fence' funds for voluntary groups caring for such people, and local authorities may be forced to withdraw money to meet other more pressing priorities.

The report shows that at least 26 local authorities - one in five - are receiving less government money for community care for the coming financial year than they budgeted to spend this year.

It also reveals that another area of under-funding is the DSS's failure to pay the full cost of care home accommodation, leaving the home, resident, relatives or charities to pay the difference.

The report says this shortfall has not been made up in the transfer of money from the DSS to local authorities.

MPs also conclude that part of the funding formula is unfair. Half the amount of grant to local authorities is based on the number of residents on Income Support in care homes.

Many councils which have few homes of their own send clients to homes in another local authority. So the new system will disadvantage councils which have fewer homes, mainly in inner cities and particularly in London.

The report recommends that the Government monitor the changes closely to ensure that inequities are corrected.

Responding to the report, Tim Yeo, Under-Secretary of State at the Department of Health, promised to carry out extensive monitoring to look at progress on such issues as choice and service for users, development of the independent sector, the expansion of domiciliary care and whether resources were being used effectively.

David Blunkett, Labour's health spokesman, said: 'The report hints at the real dangers of a terrible mess being unleashed on 1 April.'

He added: 'It makes clear that we can have no confidence in the way the Government have prepared for community care. The Government's approach has left many key questions unanswered.'

Community Care: Funding from April 1993; HMSO; pounds 12.15.