Health and social care services are at ‘breaking point’

Independent councillor Andrew Rodger has warned health and social care services are at “breaking point” due to lack of funding.

A huge – and rising – demand for care services has left Fife Council facing another multi-million-pound overspend of its social work budget.

Cllr Rodger, co-chair of Fife’s health and social care partnership, stressed Fife wasn’t the only local authority facing major financial difficulties, with most of Scotland – and, indeed, the UK – facing the same problems.

He insisted there was an urgent need for more government support and that it couldn’t simply be left to local authorities to foot the bill.

But he was also adamant that those most in need of care must always come before balancing the books.

Cllr Rodger highlighted a letter to Prime Minister David Cameron, and the leaders of the Labour and Liberal Democrats, signed by leading figures in the British Medical Association, Royal College of Nursing, Alzheimer’s Society, Teenage Cancer Trust and the Faculty of Public Health, amongst others.

They stated that the NHS had been through its “longest and most damaging budget squeeze” and that an NHS deficit of £30bn was predicted by 2020.

Cllr Rodger said: “Our health and social care staff – from the management to those on the frontline – are working their socks off to provide the best possible services for the people of Fife, and I would like to pay tribute to them for that.

“They want to be able to care for their patients to the best of their abilities, but financial pressures are making this increasingly difficult.

“We need the proper funding to deliver services.”

Cllr Rodger continued: “We’re trying to integrate health and social care services, and I’m all for that.

“However, we need money to transfer from the acute sector to the community, but that’s a tall ask for the people at NHS Fife considering the pressure they are under.”

He said the NHS in Fife was already dealing with an overspend, and issues such as a lack of hospital consultants, and the need to bring in locums to cover shifts, was putting further strain on its budget.

“Demand for care packages is increasing, and it’s going to continue as the number of older people in Fife is rising,” he said. “Three quarters of councils in Scotland have overspent their social work budgets. The Scottish Government needs to recognise the difficulties we are all facing.”

The Scottish Government said it had increased the budget for NHS Fife from £557.3m to £571.4m, a rise of £14.1m (2.5 per cent).

A spokesman added: “We’ve also increased the funding available nationally to the integration fund, from £120m to £173.5m, which will support the development and delivery of new models of care in local areas, including those for the elderly.”

Demand for care services outstrips extra investment

Fife Council invested an additional £12 million to meet the rising demand for purchased places for children being taken into care and for care packages for adult and older people.

But that’s not been enough, with these services running at a £10m overspend.

Council leader David Ross said the increase in demand had been greater than anyone had anticipated – and backed calls for more funding from the Scottish Government.

He also criticised the previous SNP-led administration for budgeting for “unrealistic savings” in social care and children’s services.

Cllr Ross said: “It is evident that health and social care services across Scotland have been badly under-funded by the Scottish Government.

“This isn’t about blame, it’s simply recognising the realities of the situation. Officers are quite clearly telling us that the position is the same across most of Scotland. NHS boards and council social care services are struggling to meet increases in demand for care with inadequate budgets.”

Cllr Ross has written to health minister Alex Neil MSP setting out the position in Fife, and said the Council was working closely with NHS Fife to find the best way of dealing with these challenges at a local level.

He warned that without a significant injection of additional funding on a long term basis, health and social care services in Fife and across Scotland would seriously struggle to meet the needs of their communities.

Cllr Ross added: “Thanks to the prudence and professionalism of our officers, the Council continues to meet its social care responsibilities and to manage its budget well in difficult financial circumstances.

“However, in the longer term, we still face a huge financial challenge.

“Unless something happens at central government level it is inevitable that the savings we are being forced to make will have a real damaging impact on services and staff.”

Focus is on those in ‘critical’ need


Due to the rising demand for care services, Fife’s under pressure social work staff are only able to focus on those whose needs are assessed as ‘critical’.

That means those who have major health problems which could be life-threatening, and those suffering – or are likely to suffer – neglect or abuse.

However, Sandy Riddell, director of health and social care, acknowledged this approach did little to prevent escalation of need.

Waiting lists

Mr Riddell predicted there was little prospect of the situation improving over the winter months, and that waiting lists would get longer. In a report to councillors, he said: “This year has seen an exceptional increase in the volume of referrals from both within the community and across the hospital sectors for all types of care, particularly services provided for older people. Historically, the service tends to see a reduction in demand for services over the summer months. However, the current demographic pressures have resulted in increased demand across the year to date.”