New social care supremo, Jon Rouse wants more Department of Health cash spent on housing. The former Housing Corporation chief tells Stuart Macdonald of his vision for a joined-up future
When I last met Jon Rouse, it was early 2009 and snow was piled high on the streets of Croydon. Undeterred by the freezing temperatures, Mr Rouse, then two years into his tenure as chief executive of Croydon Council, led me on a walking tour of the town centre. Unashamedly pointing out the challenges the council faced in boosting the economic fortunes of the south London borough, as signified by the growing number of void shops, the no-nonsense Bradfordian brimmed with pride as we passed an unheralded Swedish DIY retailer, Clas Ohlson. The reason? It was the firm’s first overseas store and Mr Rouse and his team convinced it to choose Croydon.
Fast-forward four years and the former Housing Corporation chief executive is now ensconced in slightly grander surroundings: the library of the Georgian headquarters of the Department of Health on Whitehall. To be fair, this is by far the nicest part we see of the 45-year-old’s new stomping ground.
The rest of the sprawling block is a labyrinth of 20th century add-ons, where natural light, to our photographer’s horror, is very much at a premium. Undeterred, we wind round the floors to Mr Rouse’s office. It is large and is even blessed with windows, as befits the director general for social care, local government and care partnerships.
As he slurps from a mug emblazoned with the logo of Queen’s Park Rangers FC (‘When I came to London in 1989 the vicar of my local church was the club chaplain – the rest is history’), Mr Rouse says he took the decision to move back into central government after six years in Croydon, because he felt it would be ‘interesting’ and would not be ‘optimal’ to have moved straight to another top job in local government – although this is the sector to which he sees himself returning after his four-year stint ‘grappling with some of the really big problems and really getting the creative side of my brain going’.
Matt Leach, chief executive of charity Hact and a former colleague at the Housing Corporation, where Mr Rouse was top dog for three years until 2007, says if his old boss is turning his mind to ‘transforming the delivery of social care, health and housing’ people should strap in for the ride. ‘Jon is incredibly bright and incredibly driven. He doesn’t do things by halves and, at the Corporation, wanted to achieve change at a phenomenal rate,’ he adds. ‘He provides you space to deliver, but also has sky-high expectations you will deliver.’
‘Change’ and ‘delivery’ are buzz-words as far as housing professionals working on the care side of their businesses are concerned, as they struggle with housing an ageing population in increasingly expensive extra care homes or further rounds of cuts to projects funded through the five-year £6.5 billion Supporting People programme. This matters because the department has a £3.8 billion annual budget for funding its programmes and capital investment, a chunk of which, Mr Rouse tantalisingly hints, is likely to be channelled towards housing providers in next week’s spending review and is ‘right at the heart’ of discussions with the Treasury (see box: Sector’s prescription for Mr Rouse).
This is music to the ears of Kevin Beirne, director of housing care and support at 15,000-home One Housing Group, who says a ‘game-changing’ investment of, say, £5 billion from Mr Rouse’s boss, health secretary Jeremy Hunt, would allow housing associations to build the 25,000 to 50,000 extra care properties needed to help alleviate the bed-blocking crisis currently paralysing many NHS hospitals. ‘If you have someone in an extra care scheme, this is 10 to 20 per cent of the cost of having someone in hospital,’ he says. It would also help landlords ‘prevent people going to A&E in the first place’.
A common frustration expressed by social landlords over the past few years is that the talk of the clear benefits of closer working between health, social care and housing professionals to help address the soaring cost of caring for the UK’s ageing population has yet to translate into much action.
If Mr Rouse is to be believed, though, he and Mr Beirne are singing from the same hymn sheet: ‘[Tackling the lack of] integration is one of the reasons I wanted to do the job. It frustrates me, and frustrated me when I was a local authority chief executive, that we have not cracked the integration question.’
Mr Rouse’s initial answer – he has only been in post for three months – to help focus attention on the benefits of working in a more integrated way with housing providers has been the ‘pioneer’ bids for the as yet uncosted ‘framework for integration’, which launched a month ago.
Mr Rouse wants to use this to showcase to GP-led clinical commissioning groups and the more strategic health and well-being boards that ‘housing is crucial’ because services it provides, such as care and repair, ‘can be the difference between a person sustaining life in their own home’ or an expensive and potentially traumatic hospital admission.
It is unfortunate, then, when I check after the interview, that the invitation from the DoH for organisations to bid for ‘pioneer’ status does not contain a single mention of housing.
Perhaps this is a blip, because Mr Rouse continues to talk a great game from the housing sector’s point of view. ‘Another big theme for me is prevention – particularly given the financial context in which we are operating,’ he says. ‘But I also believe that a system in which the starting point is high personal and community resilience is likely to be a more successful health and social care system. So the issue we are all grappling with is: how do you move money within the system to recognise that what it makes most sense to do is disconnected from where the money is spent. If there is a need to invest to save, you’ve got make sure the money can flow to do that.’ He adds: ‘For me, it really breaks into two parts: how we make best use of our existing stock in terms of supporting health and care; and secondly what about new build and new development and what do we need and where do we need it?’
Disappointingly and like the trained lawyer he is Mr Rouse bats away any attempt to elicit further information. What he points to instead is the £300 million ‘housing and care fund’ the DoH launched last month. Croydon-based landlord Amicus Horizon is one organisation to have bid for a slice of this cash. Paul Hackett, chief executive of Amicus Horizon, says he hopes to secure support for a £9.5 million, 59-flat extra care scheme in Bexley-on-Sea and is more generally ‘very encouraged by what we hear from the DoH – it’s great to finally see a bit of joined-up thinking between health and housing’. For Mr Hackett, this cannot come soon enough because ‘our traditional spending department, Communities and Local Government, is taking cuts. Yet the DoH is ring-fenced in the spending review. This is a great opportunity for us to look beyond the CLG’.
There has been some talk in the countdown to the spending review, of the DoH taking funding responsibility for some hitherto CLG projects, such as decent homes work, disabled facilities grant and troubled families. The Financial Times has suggested that as much as £2.5 billion could be at stake to help councils facing the burgeoning cost of social care. Mr Rouse once again declines to comment. However, he might be more interested to learn that, while Amicus Horizon sees the preventive value of services such as care and repair for older people, it has pulled out of this area of business because it ‘couldn’t make it work financially’.
Mr Hackett has some better news for Mr Rouse when asked about his views on the latter’s tenure in south London. This is surprising because, in an interview with the Croydon Advertiser in January, Mr Rouse admitted housing was the council’s ‘number one problem’, owing to looming welfare reforms and a surge of homelessness caused by a lack of affordable properties that, at the time, had resulted in 170 households being put up in emergency bed and breakfast accommodation.
Yet Mr Hackett says: ‘The criticism has been unfair as the situation has been out of Croydon’s hands. It has been a difficult period for the housing market, so it was difficult to do many of the things to capture value you would do in a rising market. Jon got the former Nestlé building redeveloped as residential and retailer Westfield is coming to town. Jon has made the best go out of difficult circumstances.’
When I ask Mr Rouse about what he can do to help alleviate the similarly difficult circumstances for councils across the country, he points to the fact responsibility for public health returned to local authorities in England in April. Crucially, this comes with £5.5 billion of funding across the next two financial years, which is ring-fenced. ‘It would be perfectly legitimate for local authorities to choose to use some of that public health money to address some of the housing issues they are facing,’ he says.
This is typical of our conversation: Mr Rouse is shining a light in the dark recesses of the DoH and, as a result, is finding plenty of reasons for social landlords to be cheerful. He may have been seeking a social policy challenge to put himself to the test and he has certainly found one.
He says he will be ‘very disappointed’ if, in his four-year term, he fails on the integration and prevention agenda. Sceptical landlords should heed Mr Leach’s words on his mentor’s time overhauling the ailing development role of the Housing Corporation. ‘It is impossible to overstate just how much difference he made. He was relentless in turning it around.’ Those dark DoH corridors are about to get a whole lot brighter.
Jon Rouse is speaking at the Chartered Institute of Housing conference on 26 June
‘I see an opportunity under Supporting People for floating support workers to be funded by the Department of Health with a clear eye on the preventative agenda.’
Paul Hackett, chief executive, Amicus Horizon
‘There needs to be much more joined-up thinking between young persons’ and adult social services. More and more people are slipping through the net as planning for young people leaving care is woeful.’
Mark Henderson, chief executive, Home Group
‘The DoH must be clearer about what it means by people receiving care in their homes. We’re talking about age-appropriate housing for last-time movers, not just focusing on first-time buyers.’
Kevin Bierne, director of housing care and support, One Housing Group