Social care news stories - my thoughts

 Social care has been in the news recently. As someone who at least likes to think he has some experience of the sector, I've taken an interest. Much of what has been rumoured has not impressed me; it seems as if those in charge have little understanding of the way the front-line social care system works, or of how 'service users' feel. 

I've sent a couple of emails to my MP outlining my concerns.

3 September 2021 at 08:43

To: "FULLER, Richard" <richard.fuller.mp@parliament.uk>

Good morning Richard

Did you see last night's ITN News at Ten? They led with a story about the problems facing care agencies, and thepeople who use their services. Staff are deserting the sector in droves, meaning that some people who need help areunable to get it.

Viv, my partner, would not be alive today if it had not been for the help she and I received from Sagecare Biggleswadewhen the NHS failed to correctly diagnose her hydrocephalus in 2017.

It's possible that her condition may return, in which case we would once more need help from Sagecare or anotheragency. From what I saw on the ITN story it makes me concerned that we might not get help when we need it.

The causes of the staff shortage are many and various - the vaccination programme attracting staff, poor pay, lack ofcoordination with local authorities (this I can recall in our case). What is the government doing?

It's making matters worse, by compelling vaccination for all care staff.

Give me strength. Don't Johnson and co understand the basic management principle of when in rough waters, don'trock the boat? (It would be perfectly possible for care agencies to ask 'service users' whether they are happy to bevisited by unvaccinated staff.)

People will die, often in great distress, because of the shortage of carers. Will you please hold the government toaccount?

Thank you

Phil

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6 September 2021 at 13:35

To: "FULLER, Richard" <richard.fuller.mp@parliament.uk>

Hi Richard

Further to my recent email regarding the government's poor understanding of social care, I heard on the news today that increased taxes (National Insurance) are being proposed to fund social care. It's being touted in the media thatthe government is wanting to tax the young so that the wealthy elderly can leave more to their children.

As you know, I have first hand experience of the care system. Vivienne is now reasonably well thanks to (privately funded) support from Sagecare Biggleswade, CBC Social Services and the various health practitioners who helped her recover from total disability. You may not know that for 20 years I was married to a nurse who worked in a number of care homes - so I've seen quite a few of them, and met many residents. I believe a much more fundamental assessment of the social care problem is required before throwing much more money into what is currently a bottomless pit.

Here are some of my observations.

1. Is it right that people shouldn't have to fund their care as they get older? It seems to be assumed that it is right, but shouldn't there be a discussion about it, perhaps involving some pretty fundamental questions? Why do we work? Why do we save for our old age? Is it right that relatives should inherit the value of a deceased person's estate even if the state had to fund their long term care? This sort of question needs to be addressed before we jump to the conclusion that a socialist, one-size-fits-all solution funded by workers is appropriate and what people actually want.

2. Most people don't understand the cost of care or prepare (financially) for the impact of it. Why not? What are private pensions for, if not to facilitate a comfortable old age? My late father and stepmother are a good example; together they had pensions bringing in around £40K a year, no mortgage, and had savings of around £30K. They thought they were well-off, had enjoyed many expensive holidays, and were planning a cruise to the antarctic when my father died in 2006. I've recently done the sums (in case something happens to me leaving Viv) and I know those sort of amounts go nowhere in terms of care. With hindsight, shouldn't my father have been saving some of his income so that my stepmother would have been able to get carers in as she grew older and frailer? (Indeed, couldn't their occupational pensions have allowed for - or encouraged - that sort of payment of benefits, deferred until true old age?)

3. I suspect there may be a tendency for councils to place people into residential care when there may be an option for them to be cared for at home (one acquaintance of ours most probably fell into this category). If someone only needs a low level of care this would be possible, and cheaper - but under current rules councils can only recover the cost of care from a house sale for those in residential care - so, do they place people into residential care because they are more confident of recovering the costs? Is there an argument that costs of in-home care should also be recoverable from house sales?

4. Currently residential care costs are reported to be distorted because councils are not paying the full costs of care for those that they fund. This gives rise to a view that those that have been careful and responsible all their lives and are now paying for their own care are now having to subsidise the care of those who have been fickle and spent all their money. This situation needs to be addressed as a matter of urgency, but is taxing the young the right way to do it?

5. One - obvious but very controversial - option would involve putting oneself in the position of an elderly care home resident. Many are ladies, who have followed NHS advice about not smoking and drinking, and reached a ripe old age only for their faculties to decline. Gradually they become deaf, blind and incontinent. (The NHS pays for 3 pads a day for the incontinent, by the way; anyone who feels this is adequate should try sitting in faeces for four hours, for the pads will only be changed at fixed times. Why can't - or don't - many of those in care have the option to buy their own pads?) An elderly person in this condition knows they are on their way out. What may make it worse is that they could feel they are, in effect, being kept alive by the state, and theirestate is being robbed to pay for the supposed privilege they are enjoying in their squalid existence. Shouldn't they have the option of saying they want to end their lives, thus ending the trauma of their existence, and keeping a little of their estate that can be passed to their family? Or is it too difficult to talk about giving people the right to decide when and how they want to die?

6. Much of the costs of social care are, I believe, not related to the costs of supporting the elderly but to that of supporting working-age adults with care needs. If that is the case the message is not getting out in the media, for it raises very different questions. I don't have experience with this type of care so I'm not able to provide many ideas relating to it: questions I would be inclined to ask is whether such costs have risen in recent years, and if so why - if due to legislation, what, were the cost implications understood when it was drafted, and can it be revised to reduce costs without impacting the lives of those affected?

I hope you find the above useful.

Regards

Phil

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 I'll update this blog entry with his replies.