Lewisham’s healthier communities select committee expressed concerns over outsourcing services at a meeting on cuts last night (November 11).
The council needs to make £40 million in cuts over the next three years – “at least” £24 million next year.
In its draft budget cuts the council identified £15 million for next year and is set to publish the next round in January, ahead of full council in February.
Cuts relating to health include scrapping discretionary free travel for vulnerable people, an attempt to save £3 million from making elderly/vulernable people more independent, and outsourcing several adult social care services.
One of Lewisham’s policy objectives is to move services in-house, rather than out.
The enablement service, which helps people develop skills to live more independently, and Linkline, a 24-hour alarm system for vulnerable people in case of an emergency at home, could be outsourced.
The council has not ruled out staff losing their jobs, and significant cuts relate to merging teams.
Speaking to the committee on Wednesday, Tom Brown, executive director community services, explained the context of the cuts, including a “decade of austerity” and the impact of the Covid-19 pandemic.
He said: “Government support is still less than the impact recorded to date [of Covid-19].”
After applying Government funding and in-year savings, the council is still forecasting an overspend of £6.7 million this year.
The comprehensive spending review is due at the end of November, while the final settlement for local government is not expected until mid to late December.
Mr Brown said outsourcing the enablement service “doesn’t sit comfortably”.
“But in terms of bridging the budget gap, we know that we could buy this service cheaper on the external market.
“The reality is that as we are looking for the £40 million, this is the sort of place we are having to look – I won’t say it’s anything other than a cheaper way of delivering the service,” he said.
Members pushed for co-production, using engagement with service users to inform how a service is provided, and making sure the quality of contractors is good.
Vice-chair Cllr Coral Howard said: “We cannot refuse to use a cheaper service but we don’t want to be giving something very much lower in standard to our vulnerable residents.”
Mr Brown said: “There has to be a minimum standard that we would deem acceptable to make sure that people are safe, this is isn’t something that we can just go for the cheapest bog standard one we can find.”
He said the majority of the spend in adult social care is “already spent in the independent sector”.
“The commissioning team that we have are very well used to specifying, clienting, and monitoring the delivery of contracts for our most vulnerable residents,” he added.
Lewisham offers a discretionary freedom pass to people who have medical conditions that are not severe enough to meet the criteria for the mandatory one, which then allows them to travel for free within London.
By getting rid of the scheme, the council hopes to save £300,000 in 2021/22.
The committee chair, Cllr John Muldoon, asked for “appropriate communication” with anyone affected, echoed by other members, who pushed the need for proper consultation and equality impact assessments in general with the cuts.
Cllr Howard warned of the need to be “careful” when making cuts to people with health conditions in the midst of a pandemic.
“We’re being told constantly that the pandemic has had a very negative effect on people with disabilities and medical conditions.
“I imagine that a lot of the people concerned are on a very low income and if you’re not entitled to a pass, travel costs are very high.
“It’s going to make quite a big difference – we need to be careful about people who have had […] something that makes their life tolerable, how they’re going to react to this,” she said.
Following the discussion, the committee wanted to get “assurances” about the quality of the contracts, a “willingness that co-production will be a theme that runs through all our activities” and the need for effective engagement “on multiple channels”.
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