Devastating cuts to Glasgow’s health and social care services
Chris Sermanni, Glasgow City Unison convener (personal capacity)
Health and Social Care in Glasgow was dealt a devastating blow on Wednesday 22nd March, when the voting members on Glasgow’s Integrated Joint Board (IJB), passed around £21m of cuts to services in Glasgow.
The IJB is the decision making board for Glasgow’s Health and Social Care partnership (HSCP), the integrated body that delivers health and social care services in the city.
The HSCP is funded primarily by a block grant from the NHS, and from Glasgow City Council (GCC). Both organisations passed cuts to the HSCP, around £13m from the NHS and £28m from GCC, leaving a gap of around £41m.
In order to partially mitigate cuts directly made to services, the proposed budget used reserves of around £20m to reduce this to £21m. The legislative framework for IJBs recommends that they hold around 2% of their budget in reserves, and using these funds reduced them from around 1.95% to 0.4%.
In delivering health and social care services, reserves are used as a buffer around external pressures such as prescribing costs. This leaves little to combat market changes in such pressures.
Furthermore, as reserves are non-recurring, the IJB will not be able to repeat this next year – where the financial forecast is even worse, with even more severe cuts expected.
root cause
The SNP administration set the council budget in February, which was the root cause of most of the cuts. It was clear that the administration did not see the cuts passed on to the HSCP as their problem.
An article in the Glasgow Times by council leader Susan Aitken quoted the total cuts for Glasgow at £61m, when the real figure was closer to £90m.
Nor was it possible to tell what the cuts to Social Work were from the council budget papers.
On top of this, GCC did not pass on Scottish Government funding for the recent pay uplift to the HSCP, which had to be funded from reserves.
It appeared that outsourcing the cuts put them out of mind with the administration at the City Chambers.
The IJB budget proposed a wide array of cuts to service including homecare, children/adult social work, addictions, homelessness, daycare and more. Around 202 full time workers are expected to go.
The officers on the IJB recommended that the voting members accept the proposals, on the basis there was no mechanism to question funding streams, and that this was the best the cuts could be managed.
Despite this, the officers were candid in their assessment that the budget was dangerous, carried risk and would most likely lead to the HSCP breaching their statutory obligations to provide services to the people of Glasgow.
Furthermore, they also warned that some of the measures proposed to save money were at the mercy of external factors beyond their control, and may not be deliverable. This could lead to the board convening later in the year to make even more cuts to services.
To say that health and social care services in Glasgow are in a perilous state is a gross understatement. Glasgow’s services were already underfunded, propped up by dedicated and committed workforce that delivers for the people of the city.
no cuts policy
The trade unions in the city have long held a ‘no cuts budget’ position on council funding, proposing setting a legal budget that does not cut, using various levers such as reserves and borrowing to launch a campaign with the unions to fight for appropriate funding for services from the Scottish and Westminster Governments.
This call was repeated to the HSCP, and a demonstration was held prior to the budget meeting, outside Commonwealth House on Albion Street, the HQ of the HSCP in Glasgow. Whilst the protest was outside the building, the budget meeting itself was held online.
Whilst this call was not heeded, an amendment to the budget proposal was tabled by one of the Green councillors which called for the voting members not to pass the budget, given the significant risk it posed, and to use the time and space (legislation stipulates that the IJB must meet within a week to try again if a balanced budget is not set) to campaign for more funds. In the end the choice was between accepting the budget as is, or voting for the amendment.
The IJB has sixteen voting members, 8 GCC councillors (3 SNP, 3 Labour, 2 Green) and 8 NHS Executive board members.
7 of the 8 councillors were in attendance, along with the NHS board members. In the end, the budget was passed by 9 votes to 6, with 6 NHS board members voting alongside the SNP councillors, against 3 Labour, 1 Green and 2 NHS Board members. More democratically elected members voted for the amendment, than against.
Of course, all of the parties with elected members in GCC have a track record of passing cuts budgets.
Whilst there was more visible protest this year with the council and HSCP budget, it was not enough and more needs to be done.
Councillors should refuse to meekly pass on the cuts handed down to them, and to stand up and fight for the people and the workers in the city.
Genuine socialist councillors would implement the trade unions’ no cuts demands and mount a fightback against the austerity that has crippled Glasgow and beyond for years.
A new worker’s party would draw mass support from those disillusioned by the traditional capitalist parties, and their obvious failure to address the devastating inequality that exists in Scotland. If these parties won’t fight for the workers in Glasgow, we need one that will.
