Public expenditure on services for people with learning disabilities

The allocation of resources to health and social care agencies for services for people with learning disabilities has long been a source of debate and disagreement, centring around the failure of the balance of financing to reflect the increasing consensus that the overwhelming need of people with learning disabilities is for social care, and concerns that the funds released from institutional closure programmes were failing to reach the community. This paper presents the results of a two-year project to explore these and related issues by developing national estimates of expenditure on services for people with learning disabilities through information gathered from a stratified sample of local authority areas. At local levels, information was requested from social services, health authorities, district housing authorities and local education authorities. The information from health and social services authorities was extrapolated to national levels to allow comparison with the most recent national programme budget figures. The information from housing and education authorities was to inform debates over substitution, where health and social services substitute the activities of other local authority departments for their own. The results confirm that at local levels, the majority of expenditure remains under health auspices. The national estimates also represented a significant increase over the programme budget figures, though this was anticipated given the different service coverage. The paper concludes with a discussion of the implications of the results both for local agencies and central government.