Prevention is Better than Cure - Successful Council Day Centres Under Threat

12.00.00am GMT Mon 8th Sep 2003

The Council's "Day Care for Older People" consultation document includes proposals to develop further intensive day care services for older people who are mentally ill or who have severe physical disabilities, in collaboration with the Primary Care Trust.

This is welcome, as there is a growing need for specialist, therapeutic services for older people with dementia and those who are physically frail and recovering from illness or medical treatment.

At the other end of the spectrum, there is a proposal for a Community Support service, jointly funded with other partners, to help the more able older people to access community facilities with the help of volunteers - and this too would be a welcome addition to the work currently undertaken by various local charities.

Unfortunately, it appears that these services will be enhanced at the cost of day centres like Twickenham, Sheen, and Barnes Green, which currently provide practical and social assistance for over 150 members who would not meet the criteria for the intensive services.

These Council day centres, complemented by social day care centres run by voluntary organisations across the borough (many of which have been supported by grants and rent-free premises by the Council), enable many older people to maintain friendships and access activities, information and support which add so much to the quality of their lives - and you only need to speak to the people who use them and to their families and carers, to learn what a difference this makes.

But earlier this year, the new Tory administration raised the charge for social users of the Council day centres from just over £12 a year to £5 a day (including lunch), and now the proposal is to stop this Council service altogether in order to focus Council resources on those in greatest need.

However, there is clearly a false economy in the moves to higher charges and tightened eligibility criteria, because a comprehensive early intervention and preventative service is an integral part of the range of community services needed to support people to live independently and happily for as long as possible, and to reduce the much greater costs resulting from illness and injury.

The consultation paper talks glibly about transferring social day centre users to the voluntary sector, but is very thin on the detail.

For example Barnes Green Day Centre, which had already been marked down for closure in this year's Social Services savings programme, may now be offered to a voluntary organisation to run. And social users at the Twickenham and Sheen centres may be offered places in non-Council centres. But the consultation document has nothing more to say on how this might be achieved.

What about user choice? What about existing friendships? What about the specialist Council transport which many of the Council day centre users currently rely on? What about older people of differing abilities helping and learning from each other? What about the needs of carers? What about the impact on the existing voluntary sector centres? What about costs, funding and premises? The voluntary sector is not and should not be seen as just a delivery mechanism to get services provided on the cheap - if this Council is serious about partnership working with the voluntary sector, it must recognise the special nature of the relationship and the support needed.

This borough, almost uniquely in London, has benefited for many years from a range of preventative day services. Now, with the 2001 National Services Framework for Older People, the Labour Government has caught up with our thinking by recognising the need for seamless services between health, social services and other providers, with older people in the driving seat - a whole system approach which recognises the links with home care, housing, leisure and education, and promotes the health and well-being of older people and their carers.

I urge the Council to build on the strengths of this approach and of successful, well loved centres like Twickenham and Sheen - and to think again about the best way of planning and commissioning services which will meet the varying needs of older people in the borough, many of whom may not be using day services at all at present. These half backed proposals, which pre-empt the development of a proper strategy for services for older people, put the cart before the horse and do not bode well for process or outcomes.

Consultation finishes on 19 September, but I would encourage anyone with an interest in services for older people to write into the Council with questions, comments and suggestions whether by that date or afterwards. We must ensure that the Council's policies in this area reflect the real needs and wishes of those people whose lives will be affected.

Cllr Denise Carr

Liberal Democrat Spokesperson on Health & Social Services