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Regional variations in social care

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I woke this morning to a story in the news that the Labour Party have published some figures about the fees charged for social care.

The Labour Party appear to be using this to make a party political point that there is something wrong with the social care system. Well, they are probably right about that, but I think the way they've used the figures is silly and disingenuous.

I should make clear that I'm relying on the way this story has been reported by the BBC. I can't find anything about this story on the Labour Party website (that's a bit fishy, wouldn't you say?) so it's possible that I'm misunderstanding what Labour are actually saying if the BBC haven't reported them correctly.

Anyway, one of the criticism is that prices have risen sharply in the last 2 years. Well, duh. Inflation has been running at about 5% for the last 2 years, so we'd expect them to rise. The statistic that charges for home care have risen by 6% over that period shows that they're actually decreasing in real terms. And even the 13% increase in the fees for meals on wheels isn't exactly way out of line with general inflation.

But what I find really annoying is we are told that there are substantial variations in the fees charged to service users in different part of the country as if this were some kind of terrible scandal.

Guess what, Labour: social care is administered by local authorities. Local authorities make decisions based on the views of voters in their own areas about what kind of social care provisions are appropriate. If different voters in different parts of the country value these things differently, there will be differences. It's called democracy.

Actually, that last paragraph is pretty much bollocks. That is of course how it works in theory, but I seriously doubt that it really works that way in practice. Voters in local government elections don't, on the whole, think about things like what fees are charged to users of social care services when they cast their vote. In the main, they vote for the party they always vote for and their parents before them always voted for, without really thinking about the reasons why. Not everyone votes in such an unthinking way, of course, but enough voters do that any notions of true democratic accountability when applied to the effect of local democracy on setting levels of social care spending seem hard to justify.

So decisions about how social care services are run are made by council officials, and if you're lucky, with some guidance from elected councillors. I doubt that elected councillors have too much say, however. I remember a story my father once told of a local government council meeting when he was a district councillor many years ago. He attended a 2 hour meeting of the full council. There were 2 items on the agenda: the annual budget, and whether council vans should be painted green or yellow. Apparently they spent about 10 minutes discussing the budget and the rest of the time having a deeply passionate debate about what colour to pain the vans. One doesn't have to look very far to read other stories of local government council meetings behaving in inappropriate ways that completely lack any pretence at democratic legitimacy.

All in all, I don't have a lot of faith that variations in social care costs are decided in a legitimately democratic way, so the criticism of wide variations is probably reasonable.

But for the Labour Party (or indeed any politician, I'm really not trying to bash one particular side in the political debate here) to make this argument is deeply hypocritical. Local government is a fundamentally flawed system, because the idea that it results in local accountability is a myth. But politicians from all the main parties have supported local government and allowed it to proliferate to the point where it has become a vast and expensive empire. Politicians like it, of course, because it provides more opportunities for politicians to do political stuff. But allowing local government is bound to lead to regional variations in any service provided by local government, so politicians really have no right to complain when that happens.

In my humble opinion, we should do away with local government altogether. The only justification for having it is that it allows local democratic control, but I'm pretty sure that that's a myth. Yes, local governments have considerable powers to organise their own local areas differently, but most councillors don't understand how that actually needs to work to be meaningful, much less the average voter. All that happens in practice is that council officials get to make arbitrary decisions about what happens.

Of course, local government provides important services, social care being an excellent example, and I'm not for a minute suggesting that we do away with that as well. But I don't see why things like social care couldn't be run from central government, and I'm pretty sure it would be a lot more efficient to do it that way as economies of scale kick in.

On the other hand, there are other things local government does that we could quite happily do without, and which no doubt only exist in the first place because people in local government enjoy building their own little empires and politicians let them. Would the world really come to an end if we suddenly found ourselves unable to call on the services of Diversity and Community Engagement Officers?

Local government costs us billions. In return, we are supposed to get local accountability, but in practice, we don't. We just get another reason for the government to suck money away from hard-pressed taxpayers to feather the nests of the political classes. In the current economic climate, can we really afford to spend all that money on a failed political experiment?

 

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