So how many Occupational Therapists have we got?

"The Adult and Community Care Committee kept hearing about poor service caused by staffing problems," explains County Councillor Diana Smith. "So it set up a task group to look at recruitment and retention. Proper statistics were hard to come by. We eventually got figures for the reported high vacancy rates in 'front line' teams, from 18% among the essential home based care staff to 31% of highly-skilled occupational therapists. We heard of one team of occupational therapists entirely consisting of stand-ins.

Looked at in purely economic terms, terms the Conservative Executive understands, we found under-staffing led to a big bill for agency staff, over 40% of Surrey's total. The costs in human terms are don't get counted, but they include de facto rationing of care for the people who need it, lack of continuity of care, and stress for staff. Sickness rates are higher among Adult and Community Care staff than in any other Surrey service."

Surrey doesn't seem to know how to look after its staff working in this vital area. A staff survey showed that under half of them felt valued and recognised for the work they do, most of them felt there was not enough opportunity to discuss issues that affected them with senior management.

And the need is growing. Half of us in Surrey are over fifty. According to the Laing and Buisson report commissioned by Surrey County Council, in the next seven years there will be 7% more 'older people' in Surrey, with 16% more over 85.

One danger is that the Conservative Executive will try to cut back on those unfilled jobs as part of their current Policy and Productivity Review. All services, including Adults and Community Care, have been told to look for a 10% gain in staff productivity in the next three years.

"Even the Conservative portfolio holder - our Surrey equivalent of a Minister for Adult and Community care - acknowledges costs are going to rise in real terms. But the efficiency savings he hopes for can't come from an understaffed front-line service constantly 'fire-fighting' the most immediate problems."