A recent BBC Panorama investigation which uncovered alleged abuse of disabled patients in a residential home rightly angered the nation and led to the inevitable angry questions in Parliament.
All of us routinely expect vulnerable people to be looked after, particularly those in the twilight of their years. The concept of state aid from cradle to grave is embedded in the National Health Service and, as David Cameron is discovering, woe betide any government that appears to be threatening the Welfare State.
Unfortunately, most MPs are in a state of denial about what is possible and affordable in terms of caring for growing numbers of elderly and very elderly adults, particularly those with severe disabilities.
The pressure on hospital and council social services budgets would have been unbearable in any event. The financial strain has been made even worse by the calamitous plight of the national economy and the need to deliver the highest public spending cuts in decades.
Birmingham City Council has decided to cut £118 million from its Adults and Communities budget over the next four years. Most of this was to have been found by ceasing to provide care packages for about 5,000 severely disabled adults and by reducing the amount of money the council is prepared to pay private nursing homes to look after elderly people.
The care package cuts, foisting responsibility on to the voluntary sector instead, has been all but abandoned after the initiative was ruled unlawful in the high court. It is increasingly likely that the council’s position with regards to nursing home fees, which have been frozen for up to three years, will also be challenged in court.
Most people, we suspect, will be shocked by the fact that the council pays just £52 a day to have dementia patients looked after in private nursing homes. Even this paltry amount may be reduced in the near future, since officials are considering cutting fees by seven per cent.
The implication here is quite clear. The council enjoys a monopoly over the private nursing sector, as it provides the vast majority of residents, and therefore it believes it can get away with keeping fees at very low levels.
There are signs in Birmingham and across the country that this policy is coming unstuck. Homes are going out of business, particularly the smaller operators, and the country’s largest provider, Southern Cross, is teetering on the edge of insolvency largely as a result of councils reducing fees.
There are important questions to be asked about the standard of care that can be provided for £52 a day. Very large homes might be able to take advantage of economies of scale, but do we really want to revert back to rambling, soulless, institutions?
Birmingham City Council’s stand-off with the private care sector has been in place for a number of years now, during which time fees have either been frozen or not increased in line with inflation. The council has begun an ‘open book’ process, challenging the care homes to open their books and justify demands for more money.
The publication of an advertisement by the care consortium, threatening legal action, is being seen by the council as an act of war at a time while difficult negotiations are taking place.
It is imperative that both sides take a deep breath, step back and begin to talk meaningfully. Social care is too important to be decided off the back of damaging claim and counter-claim.
