Time for long-term, radical thinking
Everyone agrees that cuts will be needed, but the question is where? There is a great danger that the pressure on budgets will lead to short-term decision-making where the usual suspects – such as mental health services – get cut, instead of the focus being put on driving efficiencies in the acute and mainstream primary care sector or on reducing social care service bureaucracy.
People may keep their heads in the sand, recommissioning existing inefficient services rather than looking to new providers to do things differently. Commissioners should be making radical decisions, involving local people in designing and delivering the services they use.
Budget cuts shouldn't end up punishing those people already badly hit by the recession. Investing in preventive interventions, such as those that tackle unemployment, substance misuse or mental health problems, would short-circuit the intergenerational cycle of deprivation. The New Economics Foundation estimates the net return on full investment in these areas would be £269bn over 10 years.
Investing in personalised social care services for people with a learning disability, for example, cannot continue to be a "nice to have". I am hopeful that this time, at least, those who hold the purse strings will be able to make a real difference.
Victor Adebowale, chief executive, Turning Point, a social care provider