Charities short of evidence for claims on their ‘old-fashioned’ services


theweeksubFive of the big disability charities have been forced to defend a new report that claims to prove that investing in the services they provide could save the government millions of pounds.

The Economic Impact of Social Care Services report was commissioned from the consultancy giant Deloitte by Mencap, Leonard Cheshire Disability (LCD), Sense, Scope and the National Autistic Society (NAS).

The report says – uncontroversially – that investing in providing support for working-age disabled people with “moderate” care needs could save the government money.

Most councils now provide services only to those with “substantial” rather than “moderate” needs, with the government likely to introduce a national eligibility threshold set at “substantial” through its new care bill.

But the charities faced criticism this week because the five services selected for analysis in the report include three day centres – run by NAS, Scope and LCD – and do not appear to stress the need for choice and control for the disabled people who use them.

The report claims – apparently without any strong evidence – that for every £1 spent on support provided through the five service for people with “moderate” needs, an average of £1.30 will go back to the NHS, local and central government, and individual disabled people and their carers.

The report argues that service-users would find jobs, and so would provide greater taxation revenue for the government, reduce the need for local authority and NHS services, and cut the amount the government spends on out-of-work disability benefits.

But the report fails to provide any evidence that the five services detailed have managed to make any such savings, or have helped any of their service-users into work.

Deloitte admitted in the report that its research had been limited by the shortage of “robust primary evidence”.

Liz Sayce, chief executive of Disability Rights UK, supported the report’s conclusion that investing in support for disabled people was “an imperative”.

But she added: “We are also conscious that there are still a lot of old-fashioned services around, in the charity, private and public sectors.”

She said it was not clear from the report whether the five case studies were those that disabled people had chosen to use to meet their own support needs, with their own personal budgets.

She said: “Whilst some of the examples suggest individual support to enable independent living, others seem to be about offering separate ‘activities’ for disabled people – rather than the support we need to access opportunities right through the community.”

Simon Stevens, a disabled consultant and activist, was even more critical.

He said he could not see how “old-fashioned day services would be deemed a preventative service, as what would it do other than warehouse people”, and could even “cash in on keeping people dependent”.

He added: “Social isolation is a red herring, as we now have social networks, etc, and it would be better to get people online, interacting with other people, and blogging, which is more beneficial as work preparation.

“Direct services should be a last resort and while this applies to all service-users, those with moderate needs are most likely to have the flexibility for more deep-rooted solutions such as using new technology, further or higher education, and improvements to the disabled person’s community.”

Jane Young, an independent consultant and coordinator of the We Are Spartacus online network of disabled campaigners, said the Deloitte research “appears to show that services which support working-age disabled people with moderate needs can have a financially quantifiable preventative function”.

But she added: “Whilst the report provides some helpful evidence that meeting moderate needs prevents those needs escalating, it would be even better to undertake a similar exercise in relation to disabled people with moderate needs who use direct payments or personal budgets to enable them to live independently.”

None of the five charities were able to offer any firm evidence that the services picked for analysis had ended up saving the government money.

But Leonard Cheshire Disability defended the use of the case studies, which it said were “all examples of early intervention or rehabilitative care services and are used in order to examine the economic case for investing in social care, and particularly investing to extend eligibility so that more disabled people get the support that they need earlier”.

A Scope spokeswoman said: “The case studies selected to form part of this study were chosen as they are representative of a large proportion of services currently used by disabled people.”

A Deloitte spokesman was unable to point to any hard evidence that the services analysed in the report provided the kind of financial benefits claimed by the charities.

But he said Deloitte had “surveyed the available literature and determined the reliability of the evidence”, and used as many sources as possible to “cross-validate and challenge” the evidence.

He said: “Inevitably with this type of study and available evidence, a number of assumptions have been made and some degree of uncertainty therefore introduced into the modelling.

“We have been upfront about these challenges in the report and undertook a statistical simulation analysis to understand the potential impact of the key assumptions made.

“Through the combination of these approaches we have confidence in the results presented.”

6 June 2013