Joan Bakewell on how to deal with the ever growing crisis in adult social care
Hospital bed-blocking in Britain is an ongoing scandal that impacts on not just older people kept in hospital long after they need other forms of care but others whose access to NHS treatment is being delayed as a result. The Commons Public Accounts Committee – membership of which includes Conservative MPs – has now however, branded the situation a ‘national disgrace’, highlighting a significant deterioration in the problem over the past two years. At its root is a lack of urgency or scale on the part of the government to resolve the ticking time bomb of funding.
Ministers have neither a defence nor excuse, having been well and truly warned that a crisis in the funding of social care could escalate – and with the obvious knock on effects of the sector’s ability to support those who otherwise end up staying in our hospitals. Plenty of people have seen it coming.
Health Minister Alistair Burt declared earlier this year that of the estimated 1.52 million people in adult social care jobs in England up to 900,000 are expected to benefit from the introduction of the National Living Wage. And so they should. The sector is woefully underpaid. At the same time, the Low Pay Commission tells us it has been regularly informed of long-standing concerns about the affordability of the minimum wage increase for both domiciliary and residential care. Local authorities that purchase 60% of all residential care had not generally increased the amount they pay care providers over the past five years. No wonder turnover is high and recruitment difficult. But there’s worse.
In a Commons debate in March, MPs repeatedly told of care workers not being paid for travel between clients and even being penalised if they overstayed their allotted time. These are long-standing complaints, aired regularly in the press and on television, but it seems to no avail. This is a sector in some cases guilty of the most unfeeling and callous behaviour to its own workers and thus to frail and dependent clients.
Things can only get worse. In April of this year, my Labour Lords colleague Jeremy Beecham set out the situation in his home city of Newcastle. The council there has suffered cuts and cost pressures – including matters of social care – of some £332 million. The social precept introduced, ostensibly to meet the massive shortfall that’s about to arrive, will only raise £1.7 million. The introduction of the National Living Wage will cost £4.5 million a year, which means a shortfall over the next three years of £9.5 million.
The situation is by and large worse in the north of England. Care homes in the south, south east and south west have a higher proportion of private payers, who it is assumed can be squeezed to help meet the funding gap. Although even councils in Conservative heartlands have complained about their ability to deliver vital services in the face of such financial challenges. The UK Home Care Association has written to the government warning that unless additional costs were fully funded it saw a ‘serious risk of catastrophic failure’ to meet people’s needs.
We have been here before. But earlier closures will be nothing compared to what is predicted now. The head of Care England has declared the sector could be heading for a bigger crisis than the steel industry, warning that up to half of care homes could disappear. Is this scare talk designed to winkle more money from the government? Far from it. The Local Government Association warns there could be a shortfall of £2.9bn in social care funding by the end of the decade.
These are grim forecasts, especially brutal when we know those who suffer will be old and bewildered people in their twilight years, asking nothing more than to be left in peace to live out their days in simple and unassuming style. Can we really face the prospect of our grandparents, our parents, ourselves and others being subject to such unending anxiety, including long stays in hospital when their final days should be filled only with peace, contentment and – when necessary – the right sort of care.
Baroness Joan Bakewell is a writer, broadcaster and backbench Labour Peer in the House of Lords. She tweets @JDBakewell
Published 7th June 2016