7 Mart 2017 Salı

Government abdicating responsibility for social care, say providers

The head of the organisation that represents adult care providers in England has accused the government of abdicating responsibility for social care and claimed that ageism is affecting treatment of the elderly.


Speaking to the Guardian, Martin Green, the chief executive of Care England, warned the care home sector is at a tipping point and accused the government of lacking leadership on the issue. .


Philip Hammond, the chancellor, has bowed to widespread pressure over funding and will use Wednesday’s budget to invest an extra £1.3bn over two years in social care, including care homes. However, the spending gap in social care is expected to reach at least £2.6bn by 2020, according to the Local Government Association. Record numbers of care homes are already closing and more than 400 care home businesses have been declared insolvent since 2010, official figures show.


Critics of the industry claim it is financial difficultly due to private companies racking up huge debts and failing to invest. However, Green blamed the government for the crisis facing the sector.


“The government is abdicating responsibilities for social care to local authorities,” he said. “I think it owes more to the protection of vulnerable politicians than it does to the protection of vulnerable adults. My view is that if you ask me who is to blame it is the government. The government should be delivering a very clear vision for what social care is, they should be giving clear expectations to citizens about what they should expect from the system and what they should expect to pay for and none of that is happening.”


Green warned that the small businesses in the sector – the so-called “mom and pop” operations which account for the majority of homes in the UK – are under unprecedented pressure due to a rise in costs and a fall in the price that local authorities pay towards caring for residents, which can now be as little as £2.24 per hour. Care England’s members include independent care providers ranging from single care homes, voluntary organisations providing homecare, and multinational companies such as Bupa.


Green claimed that a culture of ageism has become a serious problem for social care. He said that the care for the elderly is treated differently to other health issues.


“The amount of ageism in the system is quite outrageous,” he said. “I was giving a talk to some older people and a lady said a really killer question to me: ‘Can you explain to me why my husband’s disease, Alzheimer’s, has been classed as a social care problem while my brother-in-law who has got cancer gets everything from the NHS?’ My answer to her was ‘I will tell you why, because your husband is old and because they want you to pay for it’.”


He added: “Remember we have an equality and human rights act where age is a protected characteristic. What has the Equality and Human Rights Commission done on this issue? They have done very little on age. They are obsessed with race, gender, sexuality and disability and they completely ignore age. Actually I would say ageism is probably the most prevalent form of discrimination in our society today.”


Green said that the government needed to ensure that any financial support for the sector in the budget made its way to care providers, rather than getting stuck inside local authorities. He claimed that some of the cash raised by local authorities through a council tax precept last year has not made its way to care providers, despite the government insisting that social care should be the recipient of the tax hike. “They need to have an mechanism to absolutely be clear that it goes to the frontline,” he said.


Green, who has run Care England since 2015, said he agreed with the warning last year by the Care Quality Commission, the industry regulator, that the industry is at a tipping point. “What we will start to see is far less services at a time when we have got far more need,” he added.


Despite the pressure on the sector, Green defended the large companies in the industry, such as private equity-owned Four Seasons, which have significant debts and are paying millions of pounds in interest ever year.


“I have politicians that sneer at me about venture capital taking over the sector. My response is ‘Well, it’s a good job someone is because the government is not putting any money in’.”


Hammond is expected to say that the £1.3bn for social care should directly benefit the NHS, by reducing the number of patients who end up stuck in hospital despite being medically fit to leave, because social care in their area is unavailable.


It is likely to be directed at schemes that aim to tackle what the NHS calls delayed transfers of care, or “bedblocking”, and the risk of mainly older patients being admitted or readmitted to hospital.


However, the chancellor is set to face down demands from Labour, the British Medical Association and many NHS bodies by refusing to increase the health service’s budget beyond the sums already agreed.


The BMA has called for an extra £10bn a year for the NHS, while Labour has demanded £12bn for health and social care. Hammond will trigger claims that neither he nor Theresa May appreciate the full extent of the NHS crisis, which saw unprecedented numbers of hospitals declare themselves unable to cope over the recent winter.


But he is expected to make an extra £200m available for NHS capital projects in 2017-18, after warnings from NHS England chief executive Simon Stevens that his planned “transformation” of the health service in England would struggle unless local NHS bodies had more money to spend building and repairing premises.


Jeremy Hunt, the health secretary, controversially moved more than £1bn from the NHS’s capital budget to its revenue budget in an attempt to give hospitals more money to spend amid an unprecedented financial squeeze.



Government abdicating responsibility for social care, say providers

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