http://www.dh.gov.uk/en/SocialCare/index.htm
and
http://www.dh.gov.uk/en/Healthcare/index.htm
Health and Social Care Act 2001
http://www.opsi.gov.uk/Acts/acts2001/ukpga_20010015_en_1
Health and Social Care Act 2008
http://www.legislation.gov.uk/acts/acts2008/ukpga_20080014_en_1
Health and Social Care (Community Health and Standards) Act 2003
http://www.uk-legislation.hmso.gov.uk/acts/acts2003/ukpga_20030043_en_1
PDF version
http://www.hpa.org.uk/web/HPAweb&Page&HPAwebAutoListName/Page/1200660065903
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/119194217...
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/120109461...
http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/Page/1201094588891?p=12...
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/120343965...
http://www.hpa.org.uk/webw/HPAweb&Page&HPAwebAutoListName/Page/119194217...
Social care
If you’re new to using social care services, or are acting on behalf of a relative or a friend, get advice on where to begin.
This website is designed to be a resource on independent living, direct payments and individual budgets for disabled people and others working in the field who may find it useful.
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Directory of Local Support Services
http://www.ic.nhs.uk/statistics-and-data-collections/social-care
Social care
Adult social care information
A range of information on how adult social care is delivered across England.
Carer support
Support provided to carers by councils.
Learning disability
Services to support learning disability.
Older people
Information about the number of supported residents and what home care users think of their services.
Disability
How social care services for people with a disability are delivered.
Children's social care
Information on children's services.
User surveys
What service users think of the care they receive.
If assisted suicide currently commands the same media attention as sex, drugs and rock and roll, discussion of end of life care is still much more likely to be confined to the pages of professional journals and patients' newsletters. Yet the two are inextricably connected. Both are about trying to regain control of our lives – and deaths.
While the campaigning head of steam for assisted dying is growing – with, we are told four out five people supporting it – end of life care seems to be facing crises of its own. This will make if difficult for any of us to have the basis either for informed consent or truly informed choice about whether we wish to live or die.
While the government has produced its end of life care strategy, this has not been accompanied by significant money, and funds to palliative care have not been ring-fenced. Help The Hospices, the umbrella organisation of the hospice movement, recently found in a national survey that most primary care trusts were unable to identify additional funding for end of life care in their budgets.
However, the issues facing end of life care are much more far-reaching. People may need end of life care much longer, notably as cancer increasingly becomes a chronic condition, requiring ongoing support, rather than a terminal one.
People with complex and difficult conditions like Motor Neurone Disease (MND) are particularly identified as candidates for assisted dying.As yet, high quality care for them is far from the standard, and there can be enormous variation in outcomes. MND now affects more people as the population lives longer, and makes major new demands of end of life care. It requires skilled coordination of services and psycho-social support for both service users and their families.
In addition, new approaches to commissioning mean that private and third sector organisations are now competing with the traditional hospice movement for contracts, without a track record of expertise and under pressure to bid to the lowest price rather than ensure the highest quality.
Hospices are beginning to face serious financial problems, and the movement could be threatened with possible closures. The government highlights the gold standard of people dying at home, but at the same time, detailed research highlights that people's preferences – and what currently works – is much more complex.
All these changes mean that end of life care has increased in complexity and cost. It now needs to include help at home and day support, as well as income maintenance and social support. As pressure to introduce legislation for assisted dying grows, only a small minority of people receive high quality of end of life care. If choice is to mean more than a trip to Switzerland, then policy makers need to get much more serious about end of life care.
http://www.guardian.co.uk/society/joepublic/2009/jul/31/rethinking-palli...
Guidelines on assisted suicide will apply domestically as well as overseas, the Director of Public Prosecutions has confirmed.
Keir Stamer QC spoke after a woman with multiple sclerosis made legal history by winning her battle to have the law on assisted suicide clarified.
Debbie Purdy wanted to know if her husband would be prosecuted if he helped her end her life in Switzerland.
It was assumed that new guidance would affect only those who go abroad to die.
More than 100 people from the UK have gone to the Swiss clinic Dignitas to die, but no-one has been prosecuted so far.
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 This policy is going to cover all assisted suicides  Keir Stamer, DPP
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But under the 1961 Suicide Act covering England and Wales, those who aid, abet, counsel or procure someone else's suicide can be prosecuted and sentenced to serve up to 14 years in jail.
The law is almost identical in Northern Ireland.
Suicide is not illegal in Scotland but the law on assisted suicide is not clear and there is continuing uncertainty.
Ms Purdy, from Undercliffe in Bradford, West Yorkshire, took her case to the highest court in the country after the High Court and Court of Appeal held that it was for Parliament, not the courts, to change the law.
Broad principles
Last week the Law Lords agreed that changes were a matter for Parliament, but upheld Ms Purdy's argument that the DPP should put in writing the factors that he regarded as relevant in deciding whether or not to prosecute.
Mr Starmer told the Daily Telegraph: "This policy is going to cover all assisted suicides. The same broad principles will apply. They've got to apply to all acts, in the jurisdiction or out of it.
"We won't have separate rules for Dignitas."
He said a political decision had to be made on whether some assisted suicide is legal.
"That decision needs to be made by Parliament."
He denied that any new interpretation of the law would lead to a large increase in assisted suicides.
The leader of the House of Commons, Harriet Harman hinted on the BBC1's Andrew Marr show over the weekend that government may allow the Commons time to hear a bill to allow assisted dying, saying she would be very surprised if it was not debated further.
Last month peers voted against a move to allow assisted suicide.
The campaign group Dignity in Dying says parliamentarians will come under increasing pressure to provide a proper solution, which "doesn't involve exporting it abroad."
Who cares?
Who cares?
While few Londoners currently seem to be planning for their own future care needs, the debate over how such care will be funded and delivered is one of the most important issues London boroughs face, says Marie-Louise Sharp
Fewer than one in ten Londoners are greatly concerned about who will provide care for them when they are older, a recent London Councils survey found.
And Londoners' apparent lack of concern regarding their future social care needs seemingly reflects a nationwide attitude that none of us are going to get old, or need someone to look after us.
But of course we are - and the issue of who and how we will be looked after is a very real and pressing debate.
One reason that so few people seem to consider any need to plan for their own care is that a significant majority, 65 per cent, believe such care is currently provided free on the NHS.
Many adults only find out at the point at which they need access to services, either for themselves or for a relative, that social care is actually means tested and most people will not be funded by the state.
Under the current system, if you are 65 or over and need social care and support, but have income and/or assets of more than £22, 500, you will have to fund your own social care until your income or assets are reduced to this threshold.
On top of this, most local authorities can currently only fund the highest need brackets with their limited resources, therefore the care system provides differing levels of social care coverage depending on where you live in England and what your council can afford.
Social care funding budgets in local authorities, which are made up from a mixture of central government funding, council tax and user charges, are already under strain. In 2008/09 London boroughs spent £2.4 billion on adult social care, of which £1.1 billion was on services for people aged 65 and over.
Ageing population
The government anticipates that between 2006 and 2035 the UK's over-85 population will double, meaning the ratio of working age adults supporting an older generation will change from 4:1 to 3:1 by 2029.
Today, London has around 900,000 residents aged 65 and over; by 2031 this number will have risen to around 1.25 million.
The government recently set out its thinking on how such looming challenges may be met in the Department of Health green paper: 'Shaping the Future of Care Together', and is encouraging people to give their views on the proposals via its Big Care Debate.
The green paper envisages a new National Care Service that is underpinned by the principles of prevention, national assessment, joined-up services, information and advice, personalised care and support, and fair funding.
The government is proposing three potential funding systems, all of which assume that those on the lowest incomes are paid for by the state and that attendance allowance is integrated into the funding pool (none of the proposals cover accommodation or living costs for those in care homes):
1. Partnership Funding Model - the state would fund a certain proportion of everyone's care and support costs, potentially up to a third. Above this, individuals would pay for their own care costs.
2. Partnership Model plus insurance - individuals would be able to purchase insurance for care costs above the minimum entitlement paid for by the state. They would therefore be able to protect their income and assets by insurance, should they need higher costing care in the future.
3. Comprehensive Model -a state mandatory insurance scheme, where all individuals would pay into a fund that would cover all of their basic costs for care and support if they needed it in the future.
Flexibility
The green paper also addresses the debate as to whether such a system should in future be funded by a part-national, part-local system, or by a fully national system.
This debate is especially important for London boroughs, who already face some of the highest costs in the country for staffing and social care services.
Under a part-national, part-local system, local authorities would continue to raise some of the money that goes into social care through council tax. People under this system would know what they are entitled to under the national assessment and a proportion of their care and support would be paid for by the state.
Local authorities would be responsible for deciding how much an individual would receive to spend on their care - giving local authorities the flexibility to take into account different local services and costs.
Under a fully national system, central government would decide how much funding people would receive for their assessed need - potentially giving out the same amount of money for the same levels of need, or weighted on the costs of services in different areas of the country. The funding would no longer come from council tax but would become part of general taxation.
A fully nationally funded system could fall into the trap of a one-price-fits-all policy, where local authorities could be told how much they could spend on services. Equally it could take away local accountability from councillors and boroughs to central government, where local communities could have less voice in what type of care is provided.
On the other hand, a national system may be perceived to be fairer, as councils would not be reliant on their different levels of resources to fund social care. A national system could also be easier for people to understand and plan for.
Delivery
London Councils' executive member for health and adult care Cllr Mike Freer says that there is a lot to be positive about in the green paper, but warns that the real test will be in how good principles are translated into reality.
"London boroughs must make sure that they are at the forefront of influencing the principles of this debate as they have been, and will be, the bodies on the front line in meeting all of the principles of the new system in prevention, personalisation, integration of services, advice, assessment, social care market development and commissioning."
Most people may not like to think about getting old and what services they might need, but this debate is one that is too important for anyone to ignore and one which it will be vital for London boroughs to shape.
You can read London Councils' briefing on 'Shaping the Future of Care Together' at:www.londoncouncils.gov.uk/healthandadultservices/briefings
You can read full results of our social care survey at:www.londoncouncils.gov.uk/healthandadultservices/consultationsandresponses
For coverage of the 'Big Care Debate', visit http://careandsupport.direct.gov.uk
http://www.londoncouncils.gov.uk/publications/lbm/2009/september/funding...
The TaxPayers’ Alliance and Institute of Directors have unveiled proposals to save £50bn a year through slashing public spending.
In a joint report, the two bodies propose:
- a one-year public sector pay freeze, netting £6,203m
- a one-year freeze of grants from the Department for Communities and Local Government to local and regional government saving £687m
- a rationalised framework of regional government and business support, saving £940m
- a “slimmed down” DCLG costing £1,317m less
The two bodies are also calling on the government to make its expenditure more transparent, in order to allow greater scrutiny of public spending.
Institute of Directors director general Miles Templeman said: “Businesses are right now making savings and cutting back on costs to get through the recession, and there is no reason why the public sector should not have to do the same.
“Any cut in spending naturally has the potential for some pain, but our list shows that large sums can be saved without hurting vital services.”
Responding to the report, Local Government Association chair Margaret Eaton said local government was the most efficient part of the public sector, achieving more than £3bn of savings between 2004 and 2007.
She said: “Thousands of council jobs have been cut in recent months and it is expected more will go over the course of the next year.
“Local government has delivered the lowest council tax rise for over a decade and is continuing to make big efficiency savings.
“Town halls make their own decisions about local priorities but all councils are committed to providing the best possible services to taxpayers, and that means ensuring as much money as possible is spent on the frontline services that millions of people depend on.”
http://www.lgcplus.com/news/recession/report-calls-for-local-government-...
Setting up a National Care Service would be equivalent to the creation of the NHS – now to tell the public what social care is
The brief announcement in Gordon Brown's speech that Labour will provide free home care for elderly people with dementia was a small glimpse of Labour's ambitious plans to transform social care.
Brown's big conference speech was not the time to go into the fine detail of the debate, but perhaps there could have been a little more honesty about the big issues – and the costs – involved.
The facts are stark: at present there are four workers for every person needing care, but demographic trends suggest that soon there will be only three and by the mid-century only two. There are more and more of us, and we are living longer, but often needing more care in the last years of life.
The health secretary, Andy Burnham, rightly identifies the problem with reform of social care. For too long, he told the Labour conference, politicians had ducked reform because the options were tough. The options are tough, and the obvious fact is that to provide adequate social care for all, someone will have to pay.
Labour has already dismissed the idea of its proposed National Care Service being paid for out of general taxation. Instead, it has suggested three options, and has started a national debate on which the public would prefer: either people pay for their own care; or the state pays some and some is funded through a voluntary insurance scheme; or the state compels everyone to take insurance to pay for social care, should they need it.
The third option – a mandatory insurance scheme – currently looks the most likely winner, with people having to pay between £20,000 and £25,000. One idea is that this money could be deducted from a person's estate once they had died, with the poorest paying nothing.
Ministers talk of their plans to reform social care as the next Big Idea, and are delighted that the prime minister told the conference that social care would be centre stage at the time of the next election. Yet a fringe meeting highlighted the difficulties Labour would face in winning this argument.
Dan Wellings, from the polling organisation Ipsos Mori, had some uncomfortable findings for those pushing for reform: two thirds of people wrongly believe that social care will be free for them if and when they need it, just like the NHS; 80% of people think they may need social care at some point; and curiously, half of people questioned don't really know what social care is. It is, of course, any type of care needed by elderly or disabled people that is not strictly medical: help with washing or toileting, help with mobility problems, help with getting meals prepared and so on.
It is, as Burnham said, the biggest unfairness of modern times that some people have access to good care and others to indifferent care or no care at all, depending on where they live or how clever they are at navigating the system. The establishment of a National Care Service would be truly revolutionary, equalling the setting up of the NHS all those years ago. Yet the level of public ignorance about this crucial debate is worrying, and if Labour is to persuade voters of the importance of its plans, it needs to get those facts and figures out there as soon as possible.
http://www.guardian.co.uk/commentisfree/2009/sep/30/labour-conference-na...
GPs need to realise these programmes exist and encourage patients to use them – they help you to take control of your life
"Self-care is one of the great ideas that the NHS has to grasp. At the moment they think too much that healthcare professionals should be looking after everyone all the time. But patients should be helped to do more for themselves." Safina Wahid is a tutor with the Expert Patients Programme Community Interest Company, a not-for-profit social enterprise that used to be run by the NHS. She teaches people in Yorkshire with long-term medical conditions such as diabetes, arthritis and heart problems, and their carers, how to better manage their situation.
Wahid, 32, began teaching after finding that an EPP CIC course called Looking After Me helped her to cope with the demands of looking after a husband with bipolar disorder, two young children and her own reliance on anti-depressants.
"On my course I learned about positive cognitive thinking, the reinforcement of action planning, better breathing techniques and guided imagery, in which you imagine you're somewhere you really love, with all your problems elsewhere locked in a box. All those can help you stay calm, reduce time off work, increase your energy and self-confidence, and make your pain seem less severe. They also reduce the demand on GPs, hospitals and rehabilitation services."
Co-production, as it is known in the jargon, involves the patient tackling the illness in partnership with their clinician, rather than being passive recipients of care. It is seen by its supporters as an innovative and cost-effective solution to rising levels of chronically ill people.
"Given the growing number of people with a long-term condition – 15.4 million in England alone – we need people to be able to self-care as much as possible. But to make that change the government and NHS need to become aware of the overwhelming effect that these self-care programmes have on patients' and carers' quality of life and put more money into them."
Behind the programme is the idea that patients can be as knowledgeable as clinical professionals in the day-to-day management of their condition. Wahid says: "GPs need to realise that these programmes exist and really encourage patients to use them, because they help you to take control of your life."
http://www.guardian.co.uk/society/2009/sep/30/self-care-expert-patient
Expert social support which could take much pain out of dealing with dementia should be more accessible to patients and their carers, a report says.
The Nuffield Council on Bioethics said such help often was unavailable until a crisis point was reached.
But access to holistic expert services in the earliest stages of the disease could make a real difference, it said.
Patients should not be written off, but involved in decisions about their care as much as possible, the report said.
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REPORT RECOMMENDATIONS
Services should be made available from an early stage
Families should be treated as 'partners in care' by professionals, helping to build trust
Introduction of 'risk-benefit assessments' to determine how best to protect patients without unnecessarily damaging their quality of life
Highlight legal duties of service providers - such as shops and restaurants - to ensure people with dementia can use their services
Abolition of the fee for people to register as welfare attorneys, who can make decisions on someone else's behalf about medical treatment
More guidance on how dementia patients can be actively involved in their care
More funding for dementia research
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The report authors said the flaws in providing dementia care were similar to those in providing cancer care 20 years ago when the patient was seen simply as a disease to be treated.
But since then cancer specialists had adopted a much more holistic approach, accepting that the patient's emotional and spiritual needs were also important.
Professor Tony Hope, a psychiatrist who led the working party which produced the new report, said people caring for somebody with Alzheimer's faced tricky ethical dilemmas on a daily basis.
He said often it was the little things that most distressed families.
"A common problem is being worried that a person will hurt themselves, for example by slipping in the bathroom.
"But going into the bathroom with them and intruding on their privacy can be, understandably, very upsetting."
"There will rarely be a straightforward answer to these problems, but we want carers to have better access to support and advice to help them work out what is best in their particular situation.
"Things are starting to change but dementia still carries a stigma.
"Dementia needs to become an accepted, visible part of our society, and people with dementia should be able to take part in the activities they enjoy."
The report also praised the establishment of Alzheimer Cafe schemes, where people with dementia, their carers and health professionals can meet to talk through problems.
More respect
Dr Rhona Knight, a GP and another author of the report, said: "People with dementia also need more respect.
"We heard one person describe having dementia as being 'like a non-person'. We have to challenge these kinds of attitudes.
"People with dementia are often capable of doing much more than we think, and even if they can't make big decisions, they may be able to make smaller ones, such as what to wear or eat."
The report said health professionals needed more information and training to help them deal with dementia, and the difficult situations it could create.
Rather than starving carers of information for fear of breaching confidentiality, they should be encouraged to share details which could be of great practical help.
Neil Hunt, chief executive of the Alzheimer's Society, said: "This report provides compelling evidence of the need for better public understanding of dementia, more support and greater investment in research."
A Department of Health spokesperson said careful account would be taken of the report's findings when implementing its new dementia care strategy.
"We are committed to improving early diagnosis and directing people to the right support, information and advice as soon as possible.
"We also want to see the stigma attached to dementia tackled at every level, from GPs to friends and family."
About 700,000 people in the UK currently have dementia and this is likely to increase to 1.7 million by 2051.
http://news.bbc.co.uk/1/hi/health/8278557.stm
The brief announcement in Gordon Brown's speech that Labour will provide free home care for elderly people with dementia was a small glimpse of Labour's ambitious plans to transform social care.
Brown's big conference speech was not the time to go into the fine detail of the debate, but perhaps there could have been a little more honesty about the big issues – and the costs – involved.
The facts are stark: at present there are four workers for every person needing care, but demographic trends suggest that soon there will be only three and by the mid-century only two. There are more and more of us, and we are living longer, but often needing more care in the last years of life.
The health secretary, Andy Burnham, rightly identifies the problem with reform of social care. For too long, he told the Labour conference, politicians had ducked reform because the options were tough. The options are tough, and the obvious fact is that to provide adequate social care for all, someone will have to pay.
Labour has already dismissed the idea of its proposed National Care Service being paid for out of general taxation. Instead, it has suggested three options, and has started a national debate on which the public would prefer: either people pay for their own care; or the state pays some and some is funded through a voluntary insurance scheme; or the state compels everyone to take insurance to pay for social care, should they need it.
The third option – a mandatory insurance scheme – currently looks the most likely winner, with people having to pay between £20,000 and £25,000. One idea is that this money could be deducted from a person's estate once they had died, with the poorest paying nothing.
Ministers talk of their plans to reform social care as the next Big Idea, and are delighted that the prime minister told the conference that social care would be centre stage at the time of the next election. Yet a fringe meeting highlighted the difficulties Labour would face in winning this argument.
Dan Wellings, from the polling organisation Ipsos Mori, had some uncomfortable findings for those pushing for reform: two thirds of people wrongly believe that social care will be free for them if and when they need it, just like the NHS; 80% of people think they may need social care at some point; and curiously, half of people questioned don't really know what social care is. It is, of course, any type of care needed by elderly or disabled people that is not strictly medical: help with washing or toileting, help with mobility problems, help with getting meals prepared and so on.
It is, as Burnham said, the biggest unfairness of modern times that some people have access to good care and others to indifferent care or no care at all, depending on where they live or how clever they are at navigating the system. The establishment of a National Care Service would be truly revolutionary, equalling the setting up of the NHS all those years ago. Yet the level of public ignorance about this crucial debate is worrying, and if Labour is to persuade voters of the importance of its plans, it needs to get those facts and figures out there as soon as possible.
http://www.guardian.co.uk/commentisfree/2009/sep/30/labour-conference-na...
The social work "model" used by Birmingham Social Services is not fit for purpose, a report has found.
Birmingham Social Services department is heavily criticised in the report.
The inquiry team expressed concern that child referrals were screened by "inexperienced staff with insufficient management oversight".
The inquiry was commissioned after it emerged at least eight children known to social workers had died in the city in the past four years.
The report, led by former city councillor Len Clark, said the current model of service delivery "is patently not working" and added that urgent investment was needed to address immediate and short-term issues.
Accommodation criticised
Members of the inquiry committee, who visited all the council's principal social care establishments, also said they were "shocked and dismayed" at the standard of accommodation at some sites.
The inquiry was commissioned after government inspectors found weaknesses in the care offered to children at risk of serious physical or sexual abuse.
Among the cases the inquiry focused on was that of seven-year-old Khyra Ishaq, from Handsworth, who was allegedly starved to death.
Her mother and stepfather, who have denied killing her, are due to stand trial for her murder next year.
Ofsted inspectors previously criticised Birmingham's Safeguarding Children Board after finding the level of care offered to children at risk of serious abuse was "inadequate".
That criticism came after the death of Baby Peter in Haringey, north London, in August 2007, which led to an urgent review of children's services across the country.
The 17-month-old boy died after sustaining more than 50 injuries, despite having been seen by child support professionals 60 times.
The country-wide review highlighted weaknesses at six authorities, including Birmingham.
http://news.bbc.co.uk/1/hi/england/west_midlands/8289954.stm
Large sums of money could be saved and put back into front-line services by cutting back on NHS bureaucracy, the Conservatives will say.
Shadow health secretary Andrew Lansley will make efficiency a central theme of his speech on Monday to the Manchester conference.
The party believes a third could be shaved off the annual £4.5bn cost of quangos and NHS management in England.
Mr Lansley will say bureaucracy has spiralled out of control recently.
The Tories are also expected to set out proposals to allow all patients to decide which doctor or surgeon treats them in hospital.
They want to see performance tables published for every doctor in the country.
So far the medical profession has been fairly resistant to the idea as they argue the best and most experienced doctors tend to take on the most complex cases that by their very nature have the worst outcomes.
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Labour has allowed wasteful spending on bureaucracy to spiral. We are determined to shift NHS funds from the back office to doctors and nurses on the front-line Andrew Lansley, shadow health secretary
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Data is already published on a hospital-by-hospital basis, with some specialisms such as heart surgery giving data down to a unit level, which incorporates groups of doctors.
On spending, Mr Lansley will point out that running costs for primary care trusts, management bodies which oversee services locally, have risen from £1.43bn to £2.14bn in the past four years.
In particular, he will say money could be saved by cutting back on the use of management consultants.
NHS quangos are another source of spending that could be curbed, he says.
Nearly £2bn is spent each year on the arms-length bodies.
Other budgets that could be looked at would be the £200m cost of running the Department of Health as well as the £100m spent on the 10 strategic health authorities that oversee care on a regional basis.
Mr Lansley will say over the course of four years the £4.5bn bill in this area could be cut to £3bn, freeing money to be spent on front-line care at a time when more and more pressure is being put on NHS funds.
The health service has its funding guaranteed until 2011, but after then it may face a freeze or even cut in spending.
Mr Lansley will say: "To make the NHS successful, we must devolve decision-making closer to patients. In doing so, we'll save substantial sums of money.
"Labour has allowed wasteful spending on bureaucracy to spiral. We are determined to shift NHS funds from the back office to doctors and nurses on the front-line."
http://news.bbc.co.uk/1/hi/health/8290861.stm
Chancellor Alistair Darling has recommended a pay freeze for 40,000 senior public servants in 2010/11.
He has written to salary review bodies calling on them to freeze the pay of judges, senior NHS managers and GPs.
In addition, about 700,000 middle-ranking public servants, including doctors, dentists and prison officers, will get a rise of between 0 and 1%.
Unions said they were disappointed by the news and the Tories questioned the announcement during their conference.
Mr Darling's move breaks the convention about avoiding big policy statements during rival party conferences and a Conservative spokesman said people would "question his motives".
Shadow Chancellor George Osborne is due to deliver his keynote speech to the Conservative Party conference in Manchester on Tuesday.
The spokesman said the move "comprehensively shows that the Conservative party is setting the terms of the political debate on the economy.
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People are having to manage the reduction in budget and potentially great change in the public services and frankly a nought percent increase is no way to either motivate or reward anybody. Jonathan Baume, First Division Association
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"It is surprising that the Labour Chancellor chose to make this announcement - which affects hundreds of thousands of people - in the middle of a Conservative Party conference."
If it is fully implemented, the pay freeze will be the toughest public sector pay deal in 30 years.
No recommendation about pay for the armed forces has been made.
And Mr Darling's announcement does not affect teachers, nurses and police officers who are still subject to three year pay deals which come to an end next year.
A Treasury source told the BBC
the pay freeze will override the final year of a three-year pay deal for senior public sector workers.
This means the salary rise expected next summer by GPs, judges, NHS managers and the heads of quangos will not now go ahead.
And according to the BBC's political correspondent Ben Wright, the Treasury have also said the pay freezes are devolution sensitive.
So the freeze for GPs applies to England and Wales, and senior civil servants who work in national organisations - such as a HM Revenue and Customs worker in Scotland - are also subject to the restriction.
But if someone works in the Scottish health department the pay freeze does not apply, our correspondent added.
'Better ways'
Jonathan Baume, general secretary of civil service union the First Division Association, said a pay freeze was not the right move.
"For the senior civil service, we were about the enter the third year of a three year settlement which we had entered into in good faith...
"These are staff who are doing very demanding jobs at the moment.
"We recognise there is a very difficult fiscal situation - there is a crisis in the public finances - but people are having to manage the reduction in budget and potentially great change in the public services and frankly a nought percent increase is no way to either motivate or reward anybody."
The British Medical Association said it was not right to penalise frontline NHS staff "especially as many of them are under the pressure of more work during the recession.
"There are other more effective ways of making savings in the NHS."
Meanwhile, the ongoing debate over public spending has seen the Conservatives announce plans to make millions of people now in their fifties work for an extra year before they get their state pension.
Mr Osborne is expected to say during his speech that he would raise the state pension age from 65 to 66 from 2016 if the party wins the next election to help tackle the UK's debts.
http://news.bbc.co.uk/1/hi/uk_politics/8291810.stm
Senior civil servants, top NHS managers and judges will get a lower than recommended pay rise of 1.5% next year, Gordon Brown has announced.
The prime minister said the economic crisis meant the 2009-10 rises had to be lower than suggested by the Senior Salaries Review Body (SSRB).
However, all military personnel were awarded the recommended 2.8% rise.
Senior public sector staff should lead by showing "restraint," Mr Brown told MPs, who will get a pay rise of 2.33%.
Doctors and dentists will also receive a pay rise of 1.5% for 2009-10, which is in line with the proposals of their pay review body, the Doctors' and Dentists' Remuneration Review Body (DDRB).
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The amount of money saved is very small but it will be a slap in the face for senior civil servants who are working extremely hard to support ministers Jonathan Baume, general secretary, First Division Association
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The news follows the announcement that MPs' salaries are to increase by 2.33% from 1 April, to an annual salary of about £64,766, and amid rows over their expenses.
Rules introduced last year fixed the pay increase at the average received over the previous year by 15 different groups of public sector workers.
BBC political correspondent Carole Walker said senior civil servants were "disappointed" with the news, and said comparisons with the MPs' rise would "increase resentment".
Bonus pots
"This is just about people at the top of public life setting an example and joining in the wider job that we've got to do which is about making sure that every penny of public spending goes to where it's really needed," said Cabinet Office Minister Liam Byrne.
In Tuesday's announcement Mr Brown also revealed plans to "fundamentally reform" early retirement and severance terms for all civil servants.
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This pay rise is... appropriate acknowledgement of the burden our people are carrying on behalf of the nation Air Chief Marshal Sir Jock Stirrup
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"The current arrangements have been in place since 1987 and are inflexible and expensive," he said.
He said the new rules would require departments to cut costs, saving up to £500m over the next three years.
The move is part of a plan to reduce the real-terms cost of running government by 5% in each of the next three years.
On civil servants' pay, the SSRB had suggested that pay for senior staff should go up by 2.1%, but that was rejected in favour of 1.5%. Its recommendation that the bonus pot should be frozen was accepted.
The government also appears to be "unpicking" a three-year pay deal, our correspondent added.
Strikes
Jonathan Baume, general secretary of union the First Division Association - for senior managers in public services - said the rise was disappointing and added up to "gratuitous gesture politics".
"The amount of money saved is very small but it will be a slap in the face for senior civil servants who are working extremely hard to support ministers."
Corin Taylor of the Institute of Directors said compared with the current state of the private sector, a 1.5% rise "actually seems quite good" and should have instead been frozen.
In the other part of its review, the SSRB said the judiciary should get 2.6%, and NHS managers 2.4%, but in both cases it was again cut to 1.5%.
The bonus pot for NHS managers will also be frozen.
The head of the Armed Forces welcomed the decision to award military personnel a 2.8% rise, saying it reflected the "burden" they carried for the nation
The Ministry of Defence said the rise, proposed by the independent Armed Forces' Pay Review Body (AFPRB), would give an Army private on operations a basic pay of between £16,681 and £25,887.
Air Chief Marshal Sir Jock Stirrup, Chief of Defence Staff, said: "This pay rise is welcome and appropriate acknowledgement of the burden our people are carrying on behalf of the nation, and of their remarkable achievements in the face of great adversity."
The government and some public sector trade unions have been clashing over plans to reform public sector pay.
There has a series of strikes by workers angry at a 2% cap on public sector pay.
http://news.bbc.co.uk/1/hi/uk_politics/7974470.stm
David Cameron says he does not back a freeze on all public sector pay - but says it cannot be "independent" of pay restraint in the private sector.
The Tory leader told the BBC it was "right" to leave pay levels to the independent pay review bodies but they would be "much tighter" in future.
Audit Commission boss Steve Bundred has said all public sector pay should be frozen to rebalance public finances.
TUC chief Brendan Barber said an across the board freeze was not realistic.
On Sunday Mr Bundred told the Observer politicians had to admit that "severe pay restraint" was one of many measures needed to rebalance the public finances - particularly if pay in the private sector was falling.
'Much tighter'
"At a time when inflation is likely to be between 2% and 3%, a pain-free way of cutting public spending would be to freeze public-sector pay, or at least impose severe pay restraint," he said.
Asked whether he supported a freeze, Mr Cameron said: "I don't think that is the way we do pay in this country.
"The way we do pay in this country in the public sector, rightly, is we have independent pay review bodies."
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The prospect of a real living standards being cut for public service workers will obviously provoke a very strong reaction Brendan Barber
TUC |
Those bodies already took account of pay in the private sector - because they had to consider how to recruit and retain public sector staff, he said.
"Everybody knows public sector pay is going to have a much tighter than it has in the past. Here we are in 2009, we don't know exactly what inflation will be in the future so I don't think it's the right time to make this decision."
In his article Mr Bundred said public sector workers had "done well" in the past 10 years and would "tolerate" modest reductions.
But Brendan Barber, general secretary of the TUC, told the BBC millions of public sector workers had seen "real cuts" in pay over the last three years.
"It's not that long ago that inflation was 5% and the government had a pay policy of 2%, so the prospect of more suffering to come is not an attractive one," he said.
Prevailing conditions
He said it was not "realistic" to suggest an across-the-board freeze as public sector workers ranged from very low paid employees to high court judges.
He said there seemed to be a mindset that there should be an "equality of misery" between the public and private sectors. He called this "absolutely wrong" and said it was "astonishing" Mr Bundred had suggested a freeze would be a "pain free option".
"The prospect of a real living standards being cut for public service workers will obviously provoke a very strong reaction."
On Sunday Chancellor Alistair Darling said pay policy would be decided over the next few weeks adding: "Public sector pay obviously has got to reflect prevailing conditions, and in particular inflation has come way down."
He added: "It has got to be fair to people who work for the public sector just as we have to be fair to the private sector."
Gordon Brown faced union anger in 2007 when he said public sector pay rises had to be held down to prevent inflation, as did a 2% cap on pay rises last year.
Liberal Democrat Treasury spokesman Vince Cable has said an "absolute across-the-board freeze" in public sector pay did not make a "great deal of sense" because of different contractual obligations but bonuses should be stopped.
http://news.bbc.co.uk/1/hi/uk_politics/8135828.stm
Public sector pay should be frozen or at least subject to "severe" restraint to help rebalance the public finances, says the head of a spending watchdog.
Audit Commission chief Steve Bundred told the Observer public sector workers had "done well" in the past 10 years and would "tolerate" modest reductions.
Chancellor Alistair Darling said public sector pay had to be "fair" to private sector employees as well.
Last year a policy to limit public pay rises to 2% prompted walkouts.
'Shroud-wavers'
Mr Bundred wrote: "At a time when inflation is likely to be between 2% and 3%, a pain-free way of cutting public spending would be to freeze public sector pay or at least impose severe pay restraint.
"This is especially true if real wages in the private sector are still falling."
He said it could provide £5bn of the £50bn that would have to be found through tax rises or spending cuts.
He said health and education spending should not be shielded as efficiency savings could be made in both.
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We have got to be fair with regard to people who work in the private sector, many of whom have seen their pay conditions somewhere near freeze Alistair Darling
Chancellor |
"Don't believe the shroud-wavers who tell you grannies will die and children will starve if spending is cut. They won't. Cuts are inevitable and perfectly manageable," Mr Bundred said.
Asked about his comments, Mr Darling told Sky News: "Public sector pay obviously has got to reflect prevailing conditions, and in particular inflation has come way down.
"Of course we have got to be fair with regard to people who work in the private sector, many of whom have seen their pay conditions somewhere near freeze."
He said pay policy would be decided "over the next few weeks".
"It has got to be fair to people who work for the public sector just as we have to be fair to the private sector."
Bonuses
Public sector pay has proved a contentious issue for the government. Gordon Brown faced union anger in 2007 when he said public sector pay rises had to be held down to prevent inflation.
A 2% cap on public sector pay rises in 2008, at a time of rising living costs, was criticised as "morally bankrupt" by the Public and Commercial Services union and prompted walkouts.
Responding to Mr Bundred's comments, Unison general secretary Dave Prentis, said the government should be cracking down on rich tax evaders and City bonuses.
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Looking for constraint, you have got to decide whether that is really the best and fairest way of going about it Ken Clarke
Shadow Business Secretary |
He said: "Freezing public sector pay during a recession is not the way to steer people through it.
"Let's be clear, the recession was caused by bankers and speculators and the lack of regulation.
"Low paid public sector workers, who will be helping communities through the recession, shouldn't be expected to pay."
Shadow business secretary Ken Clarke said public sector pay had to reflect "the current low level of inflation".
He told Sky News: "When that is put to you by somebody like the head of the Audit Commission, you look at it as an option but you have got to put it alongside other options.
"Looking for constraint, you have got to decide whether that is really the best and fairest way of going about it."
Liberal Democrat Treasury spokesman Vince Cable said an "absolute across-the-board freeze" in public sector pay did not make a "great deal of sense" because of different contractual obligations.
But he told Sky News there should be "an absolute and complete stop immediately to bonuses".
http://news.bbc.co.uk/1/hi/uk_politics/8135020.stm
The social work model in a city where eight children known to social workers have died in the past four years was branded unfit for purpose by a damning official inquiry today.
The report into Birmingham city council's children's services department, commissioned after inspectors found weaknesses last December in care for children at risk of serious physical or sexual abuse, found that a lack of senior management was a "major risk" and a shortage of experienced staff continued to "hamper progress".
"Our findings demonstrated an extremely fragile management structure and the inevitable conclusion is that the current social work model is not fit for purpose," the report said.
Members of the inquiry committee, led by former city councillor Len Clark, were "shocked and dismayed" at the standard of accommodation at some of the council's social care sites.
The report ruled that current social work structures were "patently not working", adding that urgent investment was needed to address immediate and short-term concerns.
It found that the screening of child referrals was carried out by "inexperienced staff with insufficient management oversight" and discovered a lack of clarity about contacts and referrals.
Overall, the quality of case files for children in care was not adequate, the scrutiny committee's report said.
In the wake of the case last year of Baby Peter in Haringey, north London, who suffered horrific abuse at the hands of his parents despite being on an at-risk register, it emerged that at least eight children who were already known to social workers in Birmingham had died in the city in the past four years.
Among them was seven-year-old Khyra Ishaq, from Handsworth, who was allegedly starved to death last year. Her mother and stepfather, who deny killing her, are due to stand trial for her murder next year.
An urgent review of children's services across the country last year, prompted by the death of Baby Peter, highlighted weaknesses at six authorities, including Birmingham.
Ofsted inspectors said the level of care offered to children at risk of serious abuse by Birmingham's Safeguarding Children Board was "inadequate".
The council said it accepted the findings of the report, which it said was a "serious examination" of the challenges facing children's social care in Birmingham.
"Our focus remains fixed on putting in place the changes needed to ensure the most vulnerable young people in our city get the care and support they need," Mike Whitby, the leader of the council, said.
Les Lawrence, the council's cabinet member for children, young people and families, said: "While recognising there is still work to do, I am pleased that we are starting to see substantial improvements already coming through.
"There is no quick fix to the problems highlighted, some of which affect all councils nationally, such as the recruitment and retention of social workers."
Birmingham city council looks after 2,400 children and supports a further 1,400 through child protection plans.
http://www.guardian.co.uk/society/2009/oct/05/birmingham-social-work-wea...
Pensioners and public sector workers were on Monday warned they faced a tougher financial future as both the Conservatives and Labour began to match rhetoric on curbing the £175bn deficit with action.
George Osborne, shadow chancellor, will on Tuesday set out plans to save £13bn a year by raising the state retirement age for men to 66 in 2016 – 10 years earlier than planned – in a statement of intent at the Tory conference in Manchester.
Meanwhile, Alistair Darling, chancellor, has called in submissions to pay review bodies for a wage freeze for senior public sector workers including judges and family doctors, heralding an expected across-the-board crackdown on pay.
With an election only months away, both Mr Osborne and Mr Darling risk alienating important sections of the electorate, but calculate that voters and markets need reassurance that the deficit is under control.
Mr Osborne’s conference speech will be sober in tone as he prepares his party for what he expects to be a bloody first Budget, if the Tories win the next election.
“Our aim is to bring forward the date when the pension age rises,” Mr Osborne will say. He will argue that the move will help fund the commitment to restore the link with earnings for the basic state pension.
A review by Lord Turner, now head of the Financial Services Authority, had proposed raising the state pension age, starting with a rise for men from 65 to 66 in 2026; Mr Osborne intends to bring that forward to 2016.
Mr Osborne will announce a review on how to implement the plan – Lord Turner is deemed to be “a good candidate” for the job – and whether further to adjust the state pension age for women, already scheduled to rise to 64 by 2016.
The shadow chancellor, who on Monday announced plans for “national insurance holidays” for start-up businesses, hopes his speech will quell accusations from his political opponents and some in the City that he is not up to the job.
Mr Darling’s unveiling of proposals for a public sector pay squeeze – almost certain to be endorsed by a Tory government – recommends a freeze in wages for judges, doctors and senior NHS managers. He has indicated he will not break three-year pay deals for teachers, nurses and other frontline staff – some of which run until 2011 – but they will now be bracing themselves for very small future rises.
The debate on the public finances, though painful, was seen by David Cameron’s allies as preferable to further headlines about splits over Europe.
Mr Cameron made an impromptu conference appearance, warning delegates that this should not be a week when “we talk to ourselves”.
http://www.ft.com/cms/s/0/24d5a0fc-b1ea-11de-a271-00144feab49a.html?ncli...
Policy Context for the Tools
To support Primary Care Trusts and local authorities, the Association of Public Health Observatories and Department of Health have developed the Health Inequalities Intervention Tools. These tools are designed to support evidence-based local service planning and commissioning, including Joint Strategic Needs Assessments.
The tools show the causes of death which are driving local health inequalities, with breakdowns by gender and age. They also show the impact evidence-based interventions can have on local health inequality gaps.
We are producing a new, enhanced intervention tool, with improved ease of use and presentation of information. As new data, and other improvements, become available they will be posted on this page. We welcome feedback, including any changes or enhancements you would like to see, by e-mailing us here
Health Inequalities National Target
The national health inequalities Public Service Agreement target is to: "Reduce health inequalities by 10% by 2010 as measured by infant mortality and life expectancy at birth."
This target is underpinned by two more detailed objectives:
- starting with children under one year, by 2010 to reduce by at least 10 per cent the gap in mortality between the routine and manual group and the population as a whole;
- starting with local authorities, by 2010 to reduce by at least 10 per cent the gap in life expectancy at birth between the fifth of areas with the worst health and deprivation indicators (the Spearhead Group) and the population as a whole.
Tackling health inequalities and achieving the PSA target remains a key priority for the NHS as set out in the NHS Operating Framework 2009-10, and for local authorities as part of Local Area Agreements.
The Spearhead group provides a focus on those areas with, on average, the worst health, mortality and deprivation. However, health inequalities exist within all areas, not just Spearheads and all areas have a role in tackling them.
The Tools
There are currently two tools, one for Spearhead areas only and one for all areas. To assist Spearhead Primary Care Trusts and local authorities in planning to meet the life expectancy element of the national target, the Spearhead area tool addresses the life expectancy gap between a whole Spearhead area and the England average. The tool for all areas provides all English local authorities, and the PCTs that map to them, with information on within, as well as between, area inequalities. The tools can also be used to support planning to meet local targets set within Local Area Agreements, or as national priorities within the 2007 Operating Framework, particularly the Vital Signs and LAA National Indicator Set indicator for reducing All Age All Cause Mortality.
New Spearhead Tool
The Spearhead Tool has been revised and enhanced for 2009, and now includes the latest data for 2005-07. This provides updated information on gaps in life expectancy between Spearhead areas and England as a whole.
The earlier version of the Spearhead Tool, released in 2007, remains available. This provides information on gaps in life expectancy based on data for 2003-05, allows users to compare changes over time and also allows Spearhead areas to model the effect of specific interventions on their life expectancy gap. Please note that the information on interventions has not yet been updated in the 2009 tool.
Click here to access The Health Inequalities Intervention Tool for Spearheads and supporting documentation
Health Inequalities Intervention Tool for All Areas
The existing Health Inequalities Intervention Tool for All Areas (2008) covers all local authorities in England, Spearhead and non-Spearhead, and provides information on within, as well as between, area inequalities. The tool provides data on gaps in life expectancy between the most deprived quintile of each local authority and a range of comparator areas, including an analysis of the causes of death which contribute most to these gaps.
The tool also allows local authorities to estimate the effect on their life expectancy if certain evidence based interventions are increased.
Click here to access The Health Inequalities Intervention Tool for All Areas (2008) and supporting documentation
Coming soon: planned developments
The Association of Public Health Observatories is currently working with the Department of Health to produce an enhanced intervention tool, with improved ease of use and presentation of information and combining all elements of the previous tools into a single interface. Planned enhancements include:
- Adding latest 2005-07 data to the Spearhead Tool [Completed]
- Incorporating new evidence-based interventions for increasing life expectancy [expected winter 2009/10]
- Adding new data for the All Areas Tool [expected spring 2010]
A new element to help tackle inequalities in infant mortality [expected autumn 2009] which will:
- Identify risk factors contributing to infant deaths in the Routine and Manual group in local populations and quantify their contribution to infant mortality
- Help tackle individual challenges in reducing inequalities in infant mortality
- Examine trends in infant death rates in the population as a whole and in the Routine and Manual group
Your views
We would welcome the opinions of users as the new intervention tool is developed. Please send us your views, including on changes or enhancements you would like to see, by e-mailing us here
The Health Inequalities Intervention Tools were developed by the Association of Public Health Observatories, working in partnership with the Department of Health.
http://www.lho.org.uk/LHO_Topics/Analytic_Tools/HealthInequalitiesTool.aspx
http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/Publicati...