End the scandal: nationalise care homes
16 July, 2020 — By John Gulliver
Baroness Altmann and William Beveridge. Photo: Chris McAndrew
WHO will campaign for a National Care Service? Who will be its counsel in the corridors of power?
There are voices of protest against the shameful way the elderly are treated in this rich economy.
This newspaper has exposed the failures in care homes in Camden which several years ago were sold off to private companies.
There are murmurings of anger against the cruel way the government arranged for elderly patients to be discharged from hospitals and sent untested for Covid-19 back into care homes – where thousands are reported to have died in the lockdown.
A vocal critic is a Conservative peer Baroness Ros Altmann, former pensions minister, who has taken to the pages of the Guardian and this week the Daily Mail, berating the treatment of our elderly, describing it as a disgrace to a “civilised nation”.
Attacking the way care homes are run by private companies, many of which are based offshore, extracting profits of 12 per cent a year and often paying no UK taxes, Baroness Altmann suggested they could be “nationalised” albeit “temporarily”.
Baroness Altmann is clearly angry with the poor standards at care homes and the failures of the “care at home” service and the fact that care assistants are so badly paid – at the minimum hourly rate but sometimes perhaps not.
But instead of reforming care homes the Prime Minister recently blamed the scandalous death of thousands of elderly people on failure of the homes to follow procedures – something which particularly annoyed Baroness Altmann.
But from the other voices where we would expect a clamour of protest there is silence.
PM Boris Johnson blamed the homes
Some Labour MPs have certainly exposed the poor pay of care workers and the general conditions of some homes. But there has been no concerted plea for the only solution – the creation of a National Care Service.
Years ago the government effectively washed its hands of care homes by taking them out of the control of local authorities and privatising them.
This was bound to fail because to achieve a sound profitable return, overheads and general expenditure would have to be constrained, often to the point of putting the elderly at risk.
It may not be generally understood that care homes are not necessarily the same as nursing homes – a care home, at best, may have one person classed as a nurse but all the other care assistants are usually untrained and unqualified.
All of which means that in effect we, as an nation, allow the elderly, many in the last few years of their lives, with various serious medical conditions, to be “warehoused” and left to be looked after by private companies.
Obviously GPs are on call but few, if any care homes, have a resident doctor on the site.
This creates the strangest of anomalies. The government accepts its “social” responsibility to keep people fit and healthy through the services of the National Health Service while they are of working age but once they retire and grow older all they can be offered is a patchwork of support – short visits at home from a care worker, often lasting no more than 15 minutes, or they are sent to a residential care home for which they have to pay one way or the other – even if it means selling off their homes.
The May 14 CNJ care home deaths story
We never completed the aims of the Beveridge Report in the early 1940s – we set up the NHS, under the Attlee government, but neglected the plight of the very elderly.
Since the 1980s the situation has worsened as we have suffered minimal government and deregulation of state companies.
We have fallen behind other countries such as Germany, Japan and other Asian authoritarian nations where the “social base” is better financed accompanied by much better government planning.
The weakness of our system has been exposed by the pandemic.
To complete the Beveridge dream of providing help from “cradle to grave” the lives of the elderly need the protection of a National Care Service which would operate alongside the NHS. It would mean care homes would effectively be “mini-hospitals”, staffed by specialist nurses backed up by qualified assistants with basic medical training.
The nurses would act as an hourly and daily “hot line” to local GPs if further medical attention were needed.
This would involve a great deal of public investment and therefore government intervention in the economy but the current administration does not seem averse at times to do this.
Piecemeal reforms of the existing broken care system won’t solve the problem.
To simply return responsibility of care homes to local authorities cannot ultimately work because councils are funded by central government who therefore control the purse strings.
A National Care Service – under, perhaps, a separate government department – may be regarded as a revolutionary step but there is no alternative.