The NHS must not go the way of the Care Home sector.

A CQC report on Liverpool’s Health Care is advising the NHS and the Liverpool Council to work in financial and planning partnership with the private nursing home sector, and other private providers. Haven’t we had enough with Carillon? This is to be discussed at the Health and Wellbeing Board. The Liverpool Integrated Care Partnership Group, would include this sector and other private providers in an integrated planning organisation. Further details of the whole plan canbe found here

old people crossingThe elderly care home sector is very seriously flawed. The system is dominated by big business including hedge funds. A hedge fund is “an offshore investment fund, typically formed as a private limited partnership, that engages in speculation using credit or borrowed capital”. Football fans will have heard of them.

Private sector homes for the elderly now have a combined market value of £11.9 billion; five times that of Local Authority Homes. About half of residents get some Local Authority funding, and some get NHS funding, but most residents have to pay a lot themselves.

The system is run for profit by Big Business and has a poor record.

There are four major companies, owning what often appear to be independent care homes.  Companies that appear independent can be owned by other companies. Three of the big four, HC-ONE, Four Seasons and Care UK, are owned by private equity companies, complete with debts, according to the Financial Times. Private nursing homes are  owned by big business out to make a profit

Four Seasons Health Care has been in deep financial crisis, of its own making, resulting in a crisis in Widnes last year. This is not a crisis from lack of funding from the Government or local authority but from the financial model they use. Many of them are owned by hedge funds, are financially insecure, and can close because of bad debt arising from speculation.

In Widnes, the Millbrow Home had to be rescued from a near financial collapse by the public sector at the end of 2017. This model of care takes a profit, but does not take responsibility. The responsibility seems always to drop back onto the public sector.

Remember Southern Cross?

“Southern Cross Healthcare (Group plc) was a private provider of health and social care services, predominantly through the provision of care centres for elderly and some younger people. The group was the largest provider of care homes and long-term care beds in the United Kingdom, operating over 750 care homes, 37,000+ beds and employing around 41,000 staff. Following rapid expansion financed by the sale of leases of its homes, its shares fell 98% from early 2008 to early 2011, reducing its market value from £1.1bn to around £12m. The company had severe financial problems in 2011 and declared insolvency the following year”. (wikipedia.org).

 

This sector could be voting on plans and allocation of our Local Authority and NHS resources

This is out of order…

Image: Yui Mok/PA WireThe men and women in the homes have the right to respect and the best available care, including medical care. The law and organisation of the Care Home System is not fit for purpose.  It shows all the very worst elements of privatisation.

The staff working in social care can be fantastic, kind and loving but are overworked and underpaid. Many are so overworked they are leaving or having breakdowns. Care on the cheap does not work.

Unison quoted a worker”I have seen many good workers leave frustrated at the poor pay and the way zero hours contracts are used by way of punishment and reward. If you turn down a shift, hours you were depending on can be taken and given to others, sometimes with only hours’ notice. I have seen how many use this as a way to simply force out staff who may have complained about quality of care. Is this acceptable? Duty of care means that we have to raise concerns, yet many are too scared of the implications financially if they do.” https://strongerunions.org/2016/01/14/time-to-care-homecare-workers-speak-out/

unison nurseWe need residential and nursing home care for  some our growing numbers of older and ill people. No one wants people kept in hospital for longer than they need to be there. Although if  so many  hospital beds had not been closed it would be less difficult to keep people in hospital a little longer.

The profit driven private care home sector though, must not have a say in Liverpool’s Health Service or in Council funding decisions. No to an integrated system!

The CQC report lists three sets of local social care providers as part of the local system:

“Adult social care”

49 active residential care homes:

  • One rated outstanding
  • 35 rated good
  • 10 rated requires improvement
  • One rated inadequate
  • Two currently unrated

41 active nursing care homes:

  • 16 rated good
  • 15 rated requires improvement
  • Six rated inadequate
  • Four currently unrated

72 active domiciliary care agencies:

  • Two rated outstanding
  • 34 rated good
  • 11 rated requires improvement
  • 25 currently unrated

This sector, with this local and national record, should have a say in our NHS, our Local Authority Care. Really? What about due diligence?

board2We need good social care

Hospitals negotiate daily with the private sector to accommodate people in need of a care home placement. It is  both routine and difficult because there is not a comprehensive universal service as there should be. What we have is a patchwork of services, some good, and some bad. Significant parts of the service are owned by big companies there to make a profit.

The care home system is inadequate, run for profit, and privately owned and should have no say in how the NHS or Local Authorities are run.

The market does not work in public service. It is inefficient and ineffective. The problems in the sector are not to do with shortage of cash, but to do with maximizing profit through hedge funds.  The needs of our elders come second to profit. The sector needs to be reformed. We have to use the system until the next government acts or Local Government finds a way to take it back in-house.  Do not let them take charge. This system must not be allowed to taint our NHS.

Care homes were one of the first sectors to be privatised

“In the 1980s a significant shift from the public sector provision of elderly care to private sector homes occurred, with the proportion of private facilities increasing from just 18% in 1980 to 85% by the end of the century.[2]

We need to nationalize the care home service, cut out the hedge funds and their speculation, and set some decent standards.

We need publicly owned, publicly provided care homes, with reliable funding and good levels of investment, effective monitoring and good planning, like the NHS used to have.

We need a full regulatory and training system. We need staff with secure jobs, who go home fit to raise a family, to enjoy their leisure, not tired to the bone.

Cruel and disgusting Government cuts

Liverpool City Councils funding has been mercilessly slashed and this has damaged funding for social care. Out sourcing and reducing the working conditions for staff has solved nothing. It has made things worse. The private sector is not efficient at providing public services.

Liverpool Echo reported in 2017 “Since the coalition Government came to power in 2010 and began an era of austerity and swingeing cuts to local councils, Liverpool’s authority has had to make total budget reductions of £330 million.

In 2010, the council received £523.72 m in Government funding, compared with the £243.90m it will receive this (2016) year. That figure will drop even further to less than £215m by 2019/20 meaning the council will have to find more ways to make savings and raise vital cash

We urgently need a better care system. A detailed report in 2015 described some of the difficulties vulnerable patients faced when discharged without good care. Delayed discharge figures were at the forefront of NHS managers’ minds during the winter/spring beds crisis in the NHS. Patients can be discharged only to come back into hospital shortly afterwards. There is a need to improve medical care in the care home sector.The private sector must not be given any kind of decision-making role, whatsoever, let alone sharing risk and gain.

Labour is committed to a national care service. A Labour Council should not be dancing with the devil, but should be preparing to implement its party policy.

 

 

 

 

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