WMWI The National Federation of WIs campaign to improve women’s and family’s lives

Monthly Newsletter: April 2015: No 116 www.womens-institute.org.uk/oxfordshire www.freewebs.com/wmwi

every Month at 8pmPresident Lynn Coleman - Tel: 557226 Secretary Sue Field - Tel: 557843

Next meetingApril 14th: 8pm

How I cast away 50 influential

peopleSylvia Vetta

Journalist at the Oxford Times

Next month, we will be voting on the Resolution. In preparation for this, please reading the briefing paper on pages 9-17.

The wmwi Website Sue Mannifield has updated and re-organised our website. Do take a look. The Website address is at the top of the first page of this journal; just hold your ‘Control’ button and click on the address. Sue has added the new programme and a ‘suggestions’ tab. The committee welcomes all feedback and suggestions.

New committee After the WMWI Annual Meeting last month, our committee now stands as following:

Lyn Coleman PresidentSue Field SecretaryDamaris Darby TreasurerHilary Godfrey ProgrammeHannah Hirst Dunton Trip AdviserSue Mannifield WebsiteAnne Wiles Newsletter

Wmwi DatabaseDamaris Darby kindly maintains this database of our membership, which talks to NFWI. However, she can only do this if we keep her informed, so please tell her if you change your address or email.

Walton Manor WI Registered charity 1119651

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Last Meeting: March 10th 8pmLyn opened the meeting by introducing Amanda Ponsonby. Amanda worked for Geoffrey Howe for 5 years, from 1975, during which time he was both Shadow Chancellor and Chancellor of the Exchequer. After a break 2 years, she returned to parliament as a researcher. She then became Press Secretary and, from 1983, Personal Assistant and Diary Secretary to Margaret Thatcher. She described the latter as being akin to a lady-in-waiting; male Prime Ministers usually have wives to attend to matters of dress and personal care, but a woman is without that support.

Mrs Thatcher lived in Number 10 for eleven and a half years. This residence has a small living space; subsequent Prime Ministers have chosen to live at Number 11, which is more spacious. Mrs Thatcher changed the artwork and made it more homely. She spent only one day a month in her Finchley constituency.

Amanda worked on the speeches for Conservative Party conferences, producing a 1st draft four days before the event. This was invariably rejected and had to be re-worked. One of these was prepared for the 1983 Blackpool conference, which was totally overtaken by the news of Cecil Parkinson’s affair and child with Sara Keays. The 1984 Brighton

conference was memorable for the bomb which was detonated in the centre of the hotel on the last night. Mrs Thatcher had not yet retired to her room and so escaped injury, unlike many others. Amanda’s memories of that night include a Special Branch officer clad in green long-johns.

A typical day in Number 10 would start with Mrs Thatcher listening to ‘Farming Today’. She would then tackle the red boxes; five of these would arrive each night, she being very disciplined about going through them. Her first meeting was at 9am; she was always very well briefed, more so than the ministers who she would correct. They did not like this.

Margaret Thatcher loved clothes and had flair. She could always be cheered up by a collection of clothes to try on. From 1987, she was dressed by Aquascutum.

With the relaxation of relations with the USSR, Mrs Thatcher visited Russia. She got on well with President Gorbachov but found Moscow to be under curfew. On a visit to the Kremlin, they arrived to find it deserted and in darkness; it was necessary to search for their hosts. Mrs Thatcher resigned just as the Cold War ended.

Dennis Thatcher was renowned for his sense of humour. Although a great support to the Prime Minister, he had his own life and did not want protection for his personal safety.

Amanda felt that Meryl Streep portrayed Margaret Thatcher very well; she adopted her walk and her mannerisms. However, the film contained some inaccuracies.

Whether one agreed with her policies, it has to be appreciated that

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Mrs Thatcher had had to fight for all her achievements. An official car took her to the palace to tender her resignation but she immediately lost all her privileges. There was no car to take her home, no office and no staff. She did, however, have protection for life. She retired to Dulwich and continued to correspond, secretarial services being given to her by business. Amanda remained on friendly terms with her for her remaining years. This was a fascinating insight into the life of our first and only female Prime Minister from one who saw it at first hand. Thank you, Amanda.

Lyn then reminded us of the Resolution Debate on April 29th and the Group Meeting on April 8th. The Fashion Revolution photo-shoot on April 24th will be attended by Jean Geary and Jean Hammond.

Anyone who wished to enter the Denman Dip was invited to give £1 in an envelope to Lyn. These will be taken to the OFWI Annual Meeting. We also collected small change for ACWW.

After a break, we moved on to our Annual Meeting. The reports of our Secretary and Treasurer had been made available and were tabled at the meeting. These reports were accepted. John White was approved as auditor. Lyn gave her report and thanked the committee, particularly Caroline and Liz who are standing down. She then handed over to Jane for election of the new committee.

Nominations for President were taken by Jane and Lyn Coleman was duly reinstated for the next year. The meeting was followed by an opportunity to socialise. We were also reminded about the cake and washing-up rota. If all of us contribute to this occasionally, it

should not prove to be a burden, and we all enjoy the cake!

KNITting & stitching group

WMWI Knitting Group continues to thrive. Knitting or stitching may befor charity, for family, or for self. Everyone is very welcome, including new members; just turn up. If you want to learn to knit, then we can help you. The next date is:

Wednesday, April 22nd at 7pm

PLEASE NOTE CHANGE OF DAY

Lyn’s address is 33, Victoria Road in Summertown. 01865 557226 or 07836 687457. lyn.coleman@btopenworld.com

Fashion revolution day‘Who made your clothes?’ April 24th: 7pm

On the anniversary of the tragedy in Bangladesh, which saw loss of life in a garment factory, campaigners are remembering the victims, and highlighting lack of acknowledgement and exploitation within the fashion industry. Come to Oxford Lord Mayor’s parlour at the Town Hall for a photo-shoot, wearing a garment inside-out. We are

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planning to have supper somewhere afterwards. If you are interested, tell Lyn.

Wi centenary

THE BATON! - an update from Lyn

Thursday, 16 April - Afternoon event:Anne Welding and Jean Field are our members who will be on the Vintage bus trip travelling from Long Hanborough Bus Museum to Wolvercote where the baton will be handed over to our group. They will also be enjoying a cream tea at The Plough that afternoon. ( Anne and Jean, we hope you have a wonderful time and that you have a photo taken for the record. The bigger the hat, the better for an occasion like this.)

Thursday, 16 April - Evening event:The pageant at Henry Box School. I must be mad, but I am on stage for this. Thank you to all of you who are coming along. Please do let out a cheer for Walton Manor when it is mentioned.

However, it’s not just me who has

been involved. Cat Hayer is  working away making a cake for the Cherwell Group, Hilary will be helping her cut this on the night, Damaris has been arranging photos and helping with some sound for the Cherwell part of the pageant, Caroline has been dealing with all the income and payments for all the groups and Anne’s nephew Ed will be playing the piano for us all. Well done Walton Manor. We are doing our bit.

Friday, 17 April - Lunch time event:I have contacted those who have signed up to have lunch at the Anchor that day when the baton visits our WI. The lunch is at 1.15pm. It’s not too late to sign up if you want to come along. Please just let me know so I can amend the booking.

Later that afternoon, the baton will be handed over to the next group. There will be a picnic in The Leys Park in Witney, but we would not be able to get from The Anchor to that in time. However, if you are not coming to the lunch and have now decided you want to go to Witney, it’s not too late as this is an open event to which you can just turn up. Just let me know.

Please could we have offers of help from 3-4 people, to assist with washing-up at the end of each meeting? If everyone lends a hand, this will only be an occasional duty. Also, please replace your own chair in the store; this makes tidying of the hall so much easier.There is also a rota for tea and cakes. We hope that many of you will feel able to contribute to this. Just once a year is enough.

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Annual Council Meeting

OFWI’s Annual Council Meeting was held on Tuesday, March 24th at the Oxford Town Hall. A group of WMWI members attended, including Lyn as WMWI delegate. As usual, this meeting was well-supported; the hall was full, with many of us taking to the balcony. The sound system was found to be much improved this year.

The business meeting was completed with efficiency and humour, even the lengthy financial report proving to be entertaining. All the committees gave a report on their activities. The new Board of Trustees was announced, including our Lyn Coleman. Another of our members, Jane Finnerty, was declared to be a new WI Adviser. Denman bursaries were then announced, extra being given this year in honour of the anniversary. We were not lucky. In the midst of the business meeting, a reading of ‘When I am old, I shall wear purple ……’ was accompanied by actions from a group of ladies, not all wearing purple, but all adorned with red hats.

The morning ended with a moving presentation by Julie Summers, who is well known to WMWI. Julie talked of her grandfather being a Japanese prisoner of war for 6 years, working on the infamous bridge over the river Kwai. During that time, his wife both joined the WI and worked. When he returned, he was a changed man; she had also changed, as she had been

independent and active in the war effort. They both found life very difficult.The WI was pacifist but involved itself in feeding the nation. Tons of sugar was bought up by the government in 1940. This was sold by the hundredweight to WIs, who used it to make jam and preserve fruit which would be otherwise wasted as male allotment holders left for war. They also canned vegetables. An American association of business women donated canning vans for this purpose. In addition, there was a pie scheme for rural workers who did not have access to a canteen. Members were given meat, with which they made literally millions of pies. On a different tack, herbs were collected for drugs, in particular digitalis from foxgloves.

Julie’s book on the WI is being adapted for television. A series will soon be shown which, although a drama, is an accurate and serious portrayal. This is entitled ‘Home Fires’. We thoroughly enjoyed listening to Julie.

The awards to members included Barbara Gray of Wolvercore WI, who has been a member of most committees and a Denman representative. She is also a very entertaining racconteur.

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The final presentation was by Lucy Worsley who is probably known to most of us. As a historian and keeper of some of the Queen’s stuff, she is responsible for five unoccupied palaces, including Hampton Court and the Tower of London, and is often to be seen on BBC4 presenting programmes on historical clothing and living conditions. As a demonstration of her work, she showed a slide of herself wearing a crown and robe.

Lucy cut an impish figure as she talked of her latest interest, that of murder. She discussed the history of the public’s fascination with the murder mystery, and noted that many authors of this genre were women. She is contributing to this body of work; could be well worth a read.

Although this event is a requirement of the Charity Commission, and was a highly efficient business meeting, it was also very entertaining. We can thoroughly recommend it.

Moodle - online training There are a number of online courses available, for example in preparation for taking on the role of treasurer. The Denman website has more information. If you are interested in being an online

learner, email Damaris as she can enable this.

Associated country women of the world (Acww)

OFWI is a member of this, the largest international organisation for rural women, active in over 70 countries. It aims to raise the standard of living of rural women and their families mainly through education, self-help schemes, and by giving them a voice at international level through links with UN agencies. OFWI has raised many thousands of pounds to sponsor projects in South Africa, Colombia, India and Uganda, through the collection of small value coins.

If you would like to contribute to this initiative, please bring any spare change to the meeting. Thank you.

fund-raisingIn order to continue with our activities and invite speakers, etc., we need to constantly raise funds. Subscriptions do not cover our expenses.

To boost funds, Lyn is planning two Sunday afternoon tea parties, to be held at her home on July 5th and the 19th from

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3-5pm. These are for members and guests at a modest cost. Details in due course.

news and ViewsWe buy a copy for each member. Please collect yours as it will contain up-to-date information about OFWI. A number of events are advertised in each edition. Please take a little time to scan your copy and see if anything is of interest to you. Take good note of the closing date or you might miss the boat.

Booking procedureThere will be booking forms available at the meetings, one for each event. If you are interested in attending any event, please inform the secretary or Hannah, who will enter your details on the form; you will be able to see who else will be going. You must also provide a cheque for Liz Jennings, made out to WMWI. We are not permitted to buy tickets until we have received your cheque. For this reason, it is easier if you bring your cheque book to meetings.

CAMPAIGNS ‘Help for Bees’ Action Plan

Bees pollinate up to 75% of agricultural crops around the world. Last year, the WI joined forces with Friends of the Earth to call on the Department for Food, Environment and Rural Affairs to follow Wales' lead and introduce a comprehensive

bee action plan. The WI responded with thousands of postcards which were presented to the Environment Minister, and responses to a government consultation. The National Pollinator Strategy has been launched and the WI recognised through a campaign award from the Third Sector Excellence Awards, for best Charity Partnership. However, we all need to continue to support bees through our garden choices.

End Violence against WomenThe UK Government has a declared commitment to an integrated strategy for tackling violence against women (March 2011).

Over 1 million women experienced domestic abuse in the last year, and over 60,000 women are raped each year; it is important to

ensure that the Government continues to prioritise this issue.

Food Security FOOD FOR THOUGHT Global and National Challenges of Food Security. During 2013, WI members were invited to hold a nation-wide series of debates that will help get to the crux of some of the questions the global food system faces and build understanding about the role that we all can play. Current discussion appears to be heavily focussed around the concept of 'sustainable intensification' which is effectively using GM crops and large scale intensive farms to increase yields and productivity. Whilst this will necessarily inform part of the debate, what other issues should be explored? Considering ways to cut down on food waste, ensuring we have the right policy environment for

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agriculture to flourish and confronting consumer attitudes to food and sustainability are just a few of the issues that the NFWI believes warrant further exploration. If you would like to help get the debate underway then get in touch. Jane.finnerty@ntlworld.com Telephone 01865 553304 Banana Price Wars

A low price for bananas is only achieved through poverty wages and living conditions for the farmers. Help to combat this trend by buying only Fair Trade bananas.

Support dairy farmers

Milk prices paid to farmers are falling. Global demand has fallen and there is now a worldwide glut. British dairy farmers are losing their businesses. Please help them by buying dairy products made with British milk. Look for the Red Tractor logo, which indicates strict standards and UK produced milk.

Organ donation – make your wishes known

Following the over-whelming support for this year’s resolution, we are all urged to make others aware of our wishes regarding organ donation. No one should be left to guess. 7000 people are awaiting the gift of an organ, but this is a personal decision. We are also asked to encourage friends, family and members of our community to make their wishes known to others. It has been shown that donations increase with the raising of awareness.

Action against Plastic Bags

Plastic bag use in England is 6 times bigger than in Wales. A 5p charge instituted by the Welsh Government in 2011 has led to an 81% reduction. Voluntary agreements have had little effect and very few plastic bags are recycled. The NFWI is calling on members to contact their MP and ask them to push for a charge on plastic bags. An action pack and template letter is available from the public affairs dept. or at www.thewi.org.uk

Care not CustodyNHS England has announced a fresh wave of pilot projects that will seek to bring about a change to the way that mental health services are delivered within the justice system. These projects are a boost for the WI’s Care not Custody campaign. Theresa May praised the WI’s campaign at an event, last July, to review progress on the government’s promise to develop appropriate services for the

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mentally ill or learning disabled persons who come into contact with police, courts or prisons. Pilot services and early intervention have shown promising results.

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National Federation of Women’s Institutes2015 Annual Meeting Resolution Briefing NotesOverviewThe NFWI Public Affairs Department has compiled these notes to facilitate members’ discussions on the resolution that will be voted on at the 2015 AM.The notes outline the key issues addressed in the resolution, the current status and policy environment on the issues raised, and the main groups already working on the subject.Please use the notes to inform your further research.

2015 ResolutionFailing to care – assessment of need in long term care

This meeting calls on HM government to remove the distinction between nursing care and personal care in the assessment of the needs of individuals, in order to advance health and wellbeing.North Duffield WI, North Yorkshire East federation

These briefing notes are available online at www.theWI.org.uk/resolutions and on the Moodle. For further information contact:NFWI Public Affairs Department104 New Kings Road, London SW6 4LYTel: 020 7371 9300 ext 212Fax: 020 7736 3652Email: publicaffairs@nfwi.org.uk

Proposer’s PositionThe proposer is concerned that ‘inequality in how needs are assessed’ is leading to ‘vulnerable patients being denied their right to NHS Continuing Care’ resulting in an unfair system, in which many families are having to rely on local authority social care, to which they may have to contribute financially.

OverviewSome people need practical or emotional care or support to lead an active life and do everyday things. In England and Wales this is called social care. Having meals delivered, help with washing, dressing, feeding or using the toilet, can make a big difference to people’s lives. Social care is also about giving help in the home with things like cleaning and shopping; adaptations to make the home safer; day centres and care homes; and financial support.’1 An estimated 2 million older people in the UK have social care related needs.2 Local authorities delivered £19 billion worth of social care services in 2012-13,3 and over 1.5 million people work in the social care sector (employed by localauthorities, independent providers, the NHS or directly by those needing care).4 About 420,000 people are currently living in care and nursing homes across the UK, while about 1 million get help in their own home.5 There are another 1.5 million people who rely on friends and family for support. This unpaid care equates to £119 billion every year.6

In England and Wales there is a NHS funding package, called ‘NHS Continuing Care’. This is arranged and funded by the NHS for people that are not in hospital but have complex ongoing healthcare needs requiring full time care. This may include services from a community nurse or specialist therapist, and help with bathing and dressing for example. To be eligible for NHS Continuing Care individuals must have a medical

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condition which often involves complex, ongoing and significant care needs. A person must have a ‘primary health need’, which means that your main or primary need for care must relate to your health. Patients receiving NHS Continuing Care do not pay any fees.7

58,809 people were listed in receipt of NHS Continuing Care in England at the end of 2013.8

The resolution concerns the uneven access to NHS Continuing Care, despite a National Framework being in place to guide England and Welsh authorities. The Framework is designed to guide clinical commissioning groups in assessing people for eligibility to access the fund. In order to assess eligibility, a ‘Decision Support Tool’ which considers needs across a range of areas from breathing, to skin (including ulcers and wounds) continence, mobility and nutrition, is also in place to help ensure national uniformity in the award of NHS Continuing Care. Despite these levers being in place to help with consistency in decision making about eligibility, concerns have been raised by health groups and campaigners about fair and consistent access to NHS Continuing Care and poor public awareness about the package. Individuals that are assessed as having ‘personal’ caring needs as opposed to ‘health’ care needs, may have to pay for their care as part of the local authority care and support system. This can have significant financial implications for individuals. The local authority care and support system is often referred to as ‘in crisis’. There have been several successful court cases where people have fought for access to the free NHS Continuing Care they need to meet the physical and mental health care needs resulting from disability, illness or injury.

However, there are millions of people in Britain who have social care needs that NHS Continuing Care will not fulfil. Cuts to local authority social care budgets have had severe consequences. A recent study by the Strategic Society Centre estimated that 1.4 million older people ‘who struggle to look after themselves do not receive community support’.9 Richard Humphries, an expert in social care policy at the King's Fund think tank, believes the current outlook is far bleaker than most people realise.10 The NFWI’s own Social Care Conference in 2013 discussed the massive impact on society and the economy when a person is diagnosed with dementia every three minutes in Britain.

Focussing on making sure a limited number of individuals get access to the free NHS Continuing Care that they need does not necessarily address these wider, systemic challenges which are also having a tremendous impact on WI members and their families, as well as the wider public, today, and will continue to do so in the future.Recently, more and more health organisations, think tanks and health experts have come to the conclusion that only a radical change to health and social care in Britain can ensure that we have a care system which is financially sustainable and delivers care with dignity and compassion into the 21st century.

About NHS Continuing CareIndividuals over the age of 18 must have complex and significant health needs over an extended period to be eligible to access NHS Continuing Care. A National Framework is in place which sets out the process which clinical commissioning groups must follow when assessing a person for eligibility. There have been several court cases in England and Wales that have influenced debates around NHS Continuing Care eligibility, such as that of Pamela Coughlan who decided to go to court following an attempt by the NHS to move her from an NHS-funded residential facility to a social services-funded facility. Cases such as this have provided a landmark, establishing how access should be granted and leading to the development of the National Framework, and the accompanying ‘Decision Support Tool’, used to help with consistency in decision-

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making. Yet campaigners and advocates claim many authorities do not acknowledge these cases and carry out the assessment improperly, denying people access to the free health care they are entitled to.11 There has also been speculation that because ‘Decision Support Tool’ thresholds are higher than those set out in case law, should Pamela Coughlan be reassessed under today’s thresholds, she might not receive Continuing Care, despite the importance of her case in establishing the legal precedent.12 Recently in Wales, a court case over access to Continuing Care has ruled a family was unfairly denied, and those who had paid for nursing care between 1 April 2003 and 31 July 2013 were encouraged to register their intent for reimbursement by the end of July 2014. But only 93 families had made enquiries by the end of that period despite a Welsh government advertising campaign, suggesting that public understanding of the case or the system is poor.13

In March 2013, the All Party Parliamentary Group on Parkinson’s, a cross-party group of MPs and Peers, with an interest in the condition, launched a unique inquiry into NHS Continuing Care. The Group’s report, Failing to Care: NHS Continuing Care in England was based on evidence from 12 organisations and 41 individuals. It found the system was not fit for purpose, and abandoned people at their most vulnerable. Particular problems with the assessment process and the complexity of the system were highlighted. Based on the report’s recommendations, in November 2013, thecharity Parkinson’s UK launched its ‘Failing to Care’ campaign.14 It has since worked closely with NHS England, the Department of Health, the Parliamentary and Health Service Ombudsman and Healthwatch England to examine ways to improve the system. As part of its campaigning it has established the ‘Failing to Care Coalition’ which brings a range of organisations together to campaign for improvements to NHS Continuing Care. The Alzheimer’s Society, MS Society, MND Association and several others are part of the Coalition. The Alzheimer's Society believes that there are many more people who should be getting NHS Continuing Care but are not because they do not know how to apply or have been wrongly denied funding.15 They are calling for health authorities to promote public awareness of NHS Continuing Care and increased knowledge of the scheme among health and social care professionals. They have set up a NHS Continuing Care Volunteer Support Group which offers advice to people whohave been turned down for NHS Continuing Care funding and want to challenge the decision.16

The NHS Continuing Care system is not designed to replace the social care system; the court cases which patients have won have not concluded that social care should be free for everyone on the NHS. It is purposefully designed to help a small section of people with severe and enduring health problems. The Money Advice Service advises that ‘most people with long-term-care needs don’t qualify for NHS Continuing Care: ‘There's no clear-cut list of health conditions or illnesses that qualify for funding and not everyone with ongoing health needs will be eligible. The assessment is quite strict, and being frail isn't enough.’17 While a small section of people battle for access to NHS Continuing Care, millions of other people are living with social care needs in a system that is being stretched to breaking point, and where there is almost universal agreement that major change is necessary.

The NFWI may wish to look at the resolution more widely to encompass how we assess and meet the health and care needs of people throughout their lives, whatever frailty or illness they face.

What’s wrong with social care in Britain?

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As the demands for social care increase as the population ages, over a third of local government spending goes on social care. Local authorities have long complained that social care is chronically underfunded - over the last five years, local authorities have been given 37% less money to deliver social care services.18 In the past 10 years, the number of people aged 65 and over in England has increased by 1.4 million, a 17% rise.19 The result is a “ridiculous situation,” according to head of the Local Government Association, David Sparks. “It’s basic arithmetic. If you freeze local council spending and the population is increasing all the time and the demand for services is increasing, itmeans other people will suffer. There’s an inadequate amount of funding going in for a civilised level of care in the 21st century”.20

Age UK research shows the impact of the cuts between 2010-11 and 2013-14. The overall number of people getting social care help from councils has dropped by one fifth. 185,000 fewer people are getting help at home for tasks such as washing and dressing, and the number of people getting meals on wheels fell to 29,500 - a decline of 64%.21

Research by the BBC shows the average amount of care spending per person over the last 10 years has dropped by 20%.22 Age UK director, Caroline Abrahams said: "Our state-funded social care system is in calamitous, quite rapid decline. Hundreds of thousands of older people who need social care are being left high and dry. The lucky ones have sufficient funds to buy in some support, or can rely on the goodwill of family,neighbours and friends. But there are many who are being left to struggle on entirely alone”.23

The passing of the Care Act 2014 and the Well-being of Future Generations (Wales) Bill has helped to standardise who gets Local Authority social care and who doesn’t. The Westminster Act creates a national minimum eligibility threshold across England. Where an adult’s or carer’s needs reach this threshold, the local authority has a legal obligation to consider how these needs can be met and, depending on their financial means, the local authority may be under a duty to provide services to meet these eligible needs. By creating a new national minimum threshold the Act aims to ensure that there is clarity and consistency around local authority determinations on eligibility.24 Similarly in Wales, the new Act provides a single statutory framework covering local authorities’ responsibilities in relation to all those who need care and support, and including their carers.25 The government in Wales says the new system will focus on people's wellbeing and the prevention of problems.26 However, Richard Hawkes, chair of charity coalition the Care and Support Alliance, said that the threshold had been set too high, leaving too many people without access to Local Authority help. He argued that the “only long-term solution to the crisis in care” was an increase in funding.27 Similarly, the Public Accounts Select Committee was concerned the government “do not fully understand the scale of the challenges facing local authorities, or the costs associated with implementing the Care Act”.28

The government has also introduced a ‘cost cap’ following on from the Dilnot Commission on social care finance. From April 2016 the government is capping care costs after the age of 65 at £72,000 over the rest of a person's life. However, concerns about shortcomings with this system have been raised. Only when an individual is deemed to be eligible for care does their spending count towards the cap. But ‘eligibility’ is only rationed to people with high care needs. More than 4 million people aged 65 and over - about one in two - have what could be classed as a care need, according to thecharity Independent Age. For half, it will be a pretty low level need. But of the remaining 2 million, only between 500,000 and 1 million older people - the estimates suggest - would qualify for help in the new system. “It means there will be an awful lot of people

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paying for care or relying on friends and family who are not even classed as being ‘in the system’. Any expenses they incur will not even count towards the cap.”29

The care sector also suffers from a crisis in employment. Flagged by the Low Pay Commission as a sector of concern, the pay of a typical direct care worker hovers not far above the national minimum wage. Alongside low and sometimes illegal pay levels, one-third of social care workers are employed on zero-hours contracts. Training is infrequent and basic, lacking a focus on common job requirements such as caring for those with dementia.30 Increasing demand for services may create close to 1 million additional jobs in the next decade, but commentators say pay must improve to ensure people have more incentive to work in the sector; low pay threatens the viability of a service that “we or our loved ones will probably require at some point.”31

What can be done?By December 2014, accident and emergency units in England missed their waiting time targets for the 80th week in a row.32 Similarly, only 81% of patients were treated within four hours at A&E units in December in Wales when the target is 95%.33 Part of the reason for these failings was the situation with social care. Charities say that wards are full because a lack of social care in the community means far too many elderly people remain in hospital when they could have been sent home, with the right support.34 The example of the pressure of A&E units this winter shows how social care and the NHS are inexorably linked in people’s lives and the way the systems work together impacts their overall wellbeing. NHS England is hoping local clinical commissioning groups will begin to use their ‘NHS’ spending for innovative, preventative social care that stops costly NHStreatment down the line35 – funding home improvements to keep people safe and warm in their homes, for example.

On a grander scale, Carers UK, the King’s Fund, Age UK and many other expert groups and charities believe a radical new way of jointly approaching health and social care is the only way Britain will be able to care for its elderly population sustainably, with compassion and dignity.36 They believe the distinction between the entire NHS and social care budget isn’t working for service users and isn't the best use of scarce public resources. Carers UK says:In the current system the distinctions between what are health needs and what are social care needs are often arbitrary, contested by professionals on both sides and incomprehensible to families and service users. Carers UK firmly believes in the principle of equal support for equal need and that the needs of older and disabled people and carers should be the priority – not how those needs are viewed through the different prisms of the NHS and social care). We are not yet convinced that case for the structural reorganisation which this would entail has been made) but in line with our members’ views, believe that risk should be shared - with general taxation providing the right mechanism for funding both health and social care. 37

Age UK says, NHS and social care, often perceived as a single service, cannot be fully fit for purpose until they work effectively together). Age UK believes there must be a singular focus on delivering a seamless service that maintains wellbeing and independence. Better coordination of health and care is a long-standing priority for Government, regardless of which party is in power .38

The independent Commission on the Future of Health and Social Care in England (the Barker Commission) concluded in its September 2014 report that moving to a single,

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ring-fenced budget for the NHS and social care, with a single commissioner for local services was appropriate for a health and care system fit for the 21st century.39 The Commission, ‘recommends a focus on more equal support for equal need, which in the long term means making much more social care free at the point of use.’ Because of this, the Commission estimates that an extra £5 billion will be needed and so a ‘comprehensive review of various forms of wealth taxation needs to be undertaken.’40

Carers UK has also identified the need for better information and support for people and their carers in the current system. 1 in 5 carers receive no practical support, an estimated £1 billion in carers’ benefits go unclaimed each year and 42% of carers have missed out on financial support as a result of not getting the right information and advice. Many people do not know about the benefits they could get to help them, or feel demonised if they claim because of a culture of ‘benefits scroungers’.41 17% of carers report being treated negatively because they received benefits and a shocking 14% had been victims of crime like damage to property or verbal abuse.42 Similarly, Age UK point to recent changes with pensions and the legal system making access to information andadvice even more important. ‘For many older people, face-to-face advice is also important, but the local voluntary organisations that provide such services struggle to maintain stable funding.’43

The NFWI’s work in the 1990s with the Caring for Rural Carers project focussed on information for those with caring needs and their carers, using the network of WIs as a support system across England and Wales. With the passing of care legislation in England and Wales and the new ‘care cap’, the situation for health and social care has changed and the NFWI could be well placed to help WI members navigate new territory with confidence.

Points to considerRecent court cases have found that people have been incorrectly denied access to NHS Continuing Care. In calling for more uniform assessments, and publicising NHS Continuing Care, the NFWI could help make sure more people get the care they need when suffering from illness.As the population ages and people’s needs bisect the arbitrary health and social care divide, the arguments for merging health and social care are more compelling than ever. An integrated health and social care system could benefit millions of people and safeguard the care system for generations to come. The resolution is concerned with ending the blurred boundaries between nursing and personal care for a relatively small, yet vulnerable, section of society, but does the solution lay in ending the distinction between ‘NHS health care’ and ‘local authority social care’ for all of us, for the future?The resolution does not address the wider problem of finding a sustainable solution to shore up social care funding for the future; is there a risk that some people could consider the NFWI looks out of touch by having such a narrow focus on a major issue and calling for an impractical ‘solution’ to the funding crisis?If more people are granted access to the NHS Continuing Care fund, that simply places the burden of cost onto the NHS instead of social care, and the NHS is facing its own £20 billion funding problem. More money must be put into both systems if demand for complex, multifaceted health and care demands are to be met.44

Existing NFWI mandates on the issue

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That it be the recognised policy of the National Federation of Women’s Institutes to take full advantage of all existing health services and to do all in its power to secure such further development, both practical and educational, as may help to improve the standard of health of the rural population. NFWI Executive Committee, 1928.This meeting urges all WI members to press for the provision of more Day Hospitals, Day Centres and ancillary services, thus enabling older members of the family to share the home without undue hardship and stress for the younger generation. Sonning Common WI, Oxfordshire Federation, 1967.That this meeting urges the government to provide a sufficient allowance for a housewife disabled by chronic illness, injury or congenital handicap, to remain in her own home and so enable the family to live as a unit. Newham WI, Gloucestershire Federation, 1968.This meeting of Women’s Institutes urges its members to promote and support the provision of hospice care for those patients who desire it. Stockland WI, Devon Federation, 1983.This meeting urges HM government to ensure that full support is available to assist schoolaged children who are carers in order that their welfare and education are protected. Broughton Pastures WI, Buckinghamshire Federation, 1998.This meeting calls upon HM government to take urgent action in order to ensure that the necessary facilities and services are provided to enable older people, irrespective of their means, to spend their remaining years in comfort and dignity, whether this be in their own home, or in a nursing or residential home of their choice. Sheringham Evening WI, Norfolk, 2003.

Other campaigns and further informationParkinson’s UK215 Vauxhall Bridge Road, London, SW1V 1EJTel: 020 7931 8080Web: www.parkinsons.org.ukAge UKTavis House, 1-6 Tavistock SquareLondon, WC1H 9NAE: http://www.ageuk.org.uk/contact-us/T: 0800 169 6565W: http://www.ageuk.org.uk/Care and Support AllianceHosted at the National Autistic Society391 City RoadLondon, EC1V 0EPE: csa@nas.org.ukT: 0207 923 5723W: http://careandsupportalliance.com/Carers UK20 Great Dover StreetLondon SE1 4LX8E: info@carersuk.orgT: 020 7378 4999W: www.carersuk.orgCare to be DifferentSuite 10, Unit 3, Blackhill Drive, Wolverton Mill South,

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Milton Keynes MK12 5TSE: http://www.caretobedifferent.co.uk/contact/T: +44 (0)1908 582231W: http://www.caretobedifferent.co.uk/The Kings Fund11-13 Cavendish Square,London W1G 0ANE: enquiry@kingsfund.org.ukT: 020 7307 2400W: http://www.kingsfund.org.uk/

Endnotes1 NHS Choices. Guide to Social Care Services. July 2014. http://www.nhs.uk/nhsengland/aboutnhsservices/social-care-services/pages/social-careadults. aspx2 Age UK. Policy Position Paper: Health and care integration (England),http://www.ageuk.org.uk/PageFiles/21016/Health_and_care_integration_%28england%29_March_2014.pdf?dtrk=true3 Public Accounts Committee. England faces great adult social care squeeze. 10 Jul 2014.http://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/adult-social-care-substantive/4 Skills for Care. The size and structure of the adult social care sector and workforce in England, 2013. http://www.skillsforcare.org.uk/Document-library/NMDS-SC,-workforce-intelligence-and-innovation/Research/Size-and-structure-2013-vweb2.pdf5 BBC News. Care spending 'cut by fifth in 10 years', 28 January 2015 http://www.bbc.co.uk/news/health-310158076 Carers UK. Is 2015 the year when carers’ rights will catch up with carers’ responsibilities? 16 Jan 2015‘http://www.carersuk.org/for-professionals/policy/expert-comment/4696-is-2015-the-year-when-carers-rights-will-catch-up-with-carersresponsibilities7 NHS Choices. What is continuing healthcare?’ [no date]. http://www.nhs.uk/chq/Pages/2392.aspx?CategoryID=688 Individuals in receipt of NHS Continuing Care, June 2013. https://www.gov.uk/government/publications/nhs-continuing-healthcare9 Nuffield Trust blog. Fact or Fiction? Social care cuts are to blame for the 'crisis' in hospital emergency departments. 29 Jan 2015.http://www.nuffieldtrust.org.uk/blog/fact-or-fiction-social-care-cuts-are-blame-crisis-hospital-emergencydepartments?utm_medium=email&utm_campaign=Monthly+update+January&utm_content=Monthly+update+January+CID_76e0bfa669ef20d009792ca477087a8c&utm_source=Email%20marketing%20software&utm_term=Read%20Ruths%20blog10 BBC, Why the rising cost of social care cannot be ignored, By Alison Holt Social Affairs Correspondent, BBC Newshttp://www.bbc.co.uk/news/health-3100115111 See Care to be Different, http://www.caretobedifferent.co.uk/12 See: https://www.youtube.com/watch?v=GGI73tv-qaQ13 Wales Online. ‘Only 29 people come forward to claim wrongly-paid care home fees - leading to fears families will lose out’. 15 July 2014,http://www.walesonline.co.uk/news/wales-news/only-29-people-come-forward-742085414 APPG on Parkinson’s, Failing to Care: NHS Continuing Care in England, November 2013 15 Alzheimer’s Society. NHS Continuing Healthcare. April 2013, http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=132116 Alzheimer’s Society, ‘NHS Continuing CareVolunteer Support Group’ (no date),http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=39817 Money Advice Service. Are you eligible for NHS Continuing Carefunding? https://www.moneyadviceservice.org.uk/en/articles/are-you-eligible-fornhs-continuing-care-funding18 The Guardian. Social care funding in a ‘ridiculous situation’, says LGA head. 28 January 2015,http://www.theguardian.com/society/2015/jan/28/social-care-funding-ridiculous-situation-local-government-association19 BBC News. Why the rising cost of social care cannot be ignored. 27 Jan 2015 http://www.bbc.co.uk/news/health-3100115120 The Guardian. Social care funding in a ‘ridiculous situation’, says LGA head. 28 January 2015,http://www.theguardian.com/society/2015/jan/28/social-care-funding-ridiculous-situation-local-government-association21 BBC News. Social care cuts 'major cause' of A&E problems. 21 January 2015 http://www.bbc.co.uk/news/health-3090255522 BBC News. Care spending 'cut by fifth in 10 years'. 28 January 2015 http://www.bbc.co.uk/news/health-3101580723 BBC News. Social care cuts 'major cause' of A&E problem. 21 January 2015 http://www.bbc.co.uk/news/health-3090255524 Carers UK. Eligibility for care and support. National minimum eligibility threshold - what it means for carers and the people they care for. Summary www.carersuk.org/for-professionals/policy/policy-library?task=download&file=policy_file&id=504925 King’s Fund. Integrated Care in Northern Ireland, Scotland and Wales: lessons for England. July 2013, Chris Ham,http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/integrated-care-in-northern-ireland-scotland-and-wales-kingsfund-jul13.pdf

26 BBC News. How the care system works across the UK. 21 January 2015. http://www.bbc.co.uk/news/health-3090255227 Community Care. Care Act 2014: Government tightens national minimum threshold. 23 October 2014.http://www.communitycare.co.uk/2014/10/23/government-publishes-final-care-act-guidance/

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28 Public Accounts Committee. England faces great adult social care squeeze. 10 Jul 2014.http://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/adult-social-care-substantive/29 BBC News. Does the (care) cap fit? 27 January 2015 http://www.bbc.co.uk/news/health-3098454930 The Guardian. Better pay for care workers: up-front costs but long-term gains. 20 January 2015, http://www.theguardian.com/social-carenetwork/2015/jan/20/care-workers-better-pay-conditions31 The Guardian. Better pay for care workers: up-front costs but long-term gains. 20 January 2015, http://www.theguardian.com/social-carenetwork/2015/jan/20/care-workers-better-pay-conditions32 BBC News. A&E waiting is worst in a decade. 6 Jan 2015. http://www.bbc.co.uk/news/health-3067994933 BBC News. Long waiting times in Wales ‘affecting policing’. 16 Jan 2015. http://www.bbc.co.uk/news/uk-wales-3084247634 The Telegraph. A&E Crisis: Hospitals again fail to meet waiting target. 16 Jan 2015. http://www.telegraph.co.uk/news/nhs/11349844/AandE-crisis-Hospitals-again-fail-to-meet-waiting-time-target.html35 Carers UK. NHS Five Year Forward View, 4 Dec 2014www.carersuk.org/for-professionals/policy/policy-library?task=download&file=policy_file&id=504836 Including but not limited to, The King’s Fund (e.g. http://www.kingsfund.org.uk/blog/2013/05/beyond-dilnot-need-wider-reform) , The Nuffield Trust (e.g. http://www.nuffieldtrust.org.uk/publications/reforming-social-care-options-funding), Carers UK (http://www.carersuk.org/forprofessionals/policy/policy-library/carers-manifesto), Alzheimer’s Society (e.g.http://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=833&pageNumber=2), AdAss (Association of directors of adult social services) http://www.adass.org.uk/ADASS-calls-for-fundamental-reappraisal-of-the-role-of-the-NHS/; Dilnot Commission (http://webarchive.nationalarchives.gov.uk/20130221130239/http://www.dilnotcommission.dh.gov.uk/our-report/), The Barker Commission http://www.kingsfund.org.uk/sites/files/kf/field/field_publication_file/Commission%20Final%20%20interactive.pdf), the Public Accounts Committee (http://www.parliament.uk/business/committees/committees-a-z/commons-select/public-accounts-committee/news/adult-social-caresubstantive/);Age UK, http://www.ageuk.org.uk/professional-resources-home/public-affairs/reportage/past-issues-of-reportage/reportage-june-2011/june-2011-radical-reform-of-social-care-funding-is-needed-now/; the Care and Support Alliance(http://careandsupportalliance.com/2014/07/14/csa-press-release-response-to-public-accounts-committee-report-10-july-2014/)37 Carers UK. Barker Commission interim report – response to call for evidence: A new settlement for health and social care. June 2014. www.carersuk.org/for-professionals/policy/policy-library?task=download&file=policy_file&id=477138 Age UK, Policy Position Paper: Health and care integration (England),http://www.ageuk.org.uk/PageFiles/21016/Health_and_care_integration_%28england%29_March_2014.pdf?dtrk=true39 The Kings Fund. Barker Commission. http://www.kingsfund.org.uk/publications/new-settlement-health-and-social-care40 The Kings Fund. Barker Commission. http://www.kingsfund.org.uk/publications/new-settlement-health-and-social-care41 Carers UK. Carers Manifesto. 10 September 2014. www.carersuk.org/for-professionals/policy/policylibrary? task=download&file=policy_file&id=490742 Carers UK. Carers Manifesto. 10 September 2014. www.carersuk.org/for-professionals/policy/policylibrary?task=download&file=policy_file&id=490743 Age UK. Agenda for Later Life 2014. No date. http://www.ageuk.org.uk/Documents/EN-GB/Forprofessionals/Policy/ID202014_agenda_for_later_life_report_2014.pdf?dtrk=true44 The Kings Fund. Barker Commission. http://www.kingsfund.org.uk/publications/new-settlement-health-and-social-care

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