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20 Aug 2012
Helen Baker, chair, Advance Housing and Support

Housing is high on the white paper’s priority list

At long last the government is saying loud and clear what housing providers have been shouting about for years – that having somewhere secure to live is fundamental to both health and well-being. The new white paper on care and support rightly insists that the kinds of transformational change it advocates will only be delivered by bringing together the knowledge and resources of local authorities, the NHS - and housing .

helen bakercaring for our futureThere may not be a lot which is really new about the white paper’s proposals, but the overall vision is ambitious and impressive. It is built on principles that immediately resonate with housing associations across the country – personalised services, promoting rights, choice and independence, offered within active and engaged local communities.

Housing associations have long been committed to finding ways to make legally complex opportunities such as tenancies and shared ownership accessible even to those whose capacity, disability or circumstances might otherwise exclude them. The housing sector has experience of consumer-led regulation which would be of particular relevance in a system committed to strengthening entitlements to individual budgets and where commissioning is positively driven by community rather than institutional priorities. And it is already recognised for its ability to build the skills, resilience and engagement of local neighbourhoods to transform lives.

It is an irony then that housing moves centre stage just at a point when it faces particularly severe financial challenges. These include substantial reductions in the traditional routes to publically funded housing development finance and widespread cuts to housing related support. Other concerns include the proposed reforms to housing benefit and wider welfare reforms that have the potential directly to undermine the security of both housing providers themselves and of the most vulnerable individuals supported.

The government’s decision to postpone a resolution of the Dilnot proposals to beyond the next spending review makes it even harder to accept the claim of those in power that there is enough money in local systems to meet current needs at least if we just work harder at using our resources more effectively together. There is no doubt that local, national and global economies are under extreme pressure, and that far more imaginative integration of capacity across sector boundaries is now essential. However, a bit more openness about the negative as well as the positive impacts of government interventions would provide more straightforwardly positive motivation to get on with it.

Again, whilst new or continuing sources of funding are identified against many of the white paper proposals, the scale of investment sometimes falls far short of the scale of both recognised and growing  need. Housing associations would, for example, strongly agree with the drive to deliver a much greater diversity of specialised housing options for older and disabled people, but the £200m of capital funding to be allocated over five years from 2013/14 can have no more than minimal impact on the efforts already being made to extend developing models such as extra care or transitional housing.

Housing associations are highly experienced at attracting commercial and charitable sources of finance to complement public sector investment. Cap Gemini research carried out in 2009 showed that £1.6bn annual investment in housing related support services led to cost savings to the public purse of £3.41bn. Why then the failure to protect proper investment in services which so evidently align with the defining commitment to early intervention and prevention?

One real strength behind this white paper is the government’s determination to make access to quality services across the country more reliable and equitable. The drive to simplify and unify is  welcome as is the coordination of the priorities of the care and support white paper with other strategic measures such as the revision of the National Planning Framework and a comprehensive modernisation of care and support law. Standardisation can also have unintended negative consequences however – benefit changes undermining the viability of long fought for shared ownership schemes for those with disabilities for example – and should not mean that systems just settle for the lowest common denominator.

The white paper is right that, with NHS budgets again under increasing pressure, serious concerns about caring for the most frail and vulnerable and mounting numbers of delayed discharges, the NHS and housing organisations have a responsibility to find more powerful ways to work together. Housing needs to be high on the priority list for emerging clinical commissioning groups and must be fully engaged through JSNAs and health and wellbeing boards. Commitments to invest more in adaptations, small repairs and assistive technologies through to far more imaginative and personalised  packages of support combining housing, health and social care to prevent or minimise hospital admissions have the potential to be transformational.

The case for the white paper proposals is strong and there is unlikely to be opposition to the idea of shifting the focus from acute and crisis care to early intervention and prevention from any of the players. It is after all a very familiar argument and one we can all comfortably get behind.

The real and unaddressed challenge, however, remains how to achieve equally comfortable agreement about what we will all STOP doing now to release the capacity to fund that transition? What immediate investments are we prepared to sacrifice? Perhaps the real need is for a new white paper to make all the players tackle that one together?

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