So how many OTs have we got?

"The Adult and Community Care Committee kept hearing about poor service caused by staffing problems," County Councillor Diana Smith explained. "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 Adults 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 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. The salaries offered are said to be competitive and compare reasonably with other authorities, but it's a low-paid sector of the economy, and despite a lot of talk there is very little help for key workers wanting to live in our expensive county.

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. On present patterns this means an increase of 11% needing care home places by 2010, while Surrey is failing to recruit and retain enough people to cover the staff needed in Adults and Community Care right now.

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.

"We know many of Surrey's services could and should be better organised, but we need to be recruiting staff and supporting those we have better," Diana said. "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."