Even before the pandemic, Britain’s escalating care crisis was rarely far from the headlines.
But it has been all too easy for politicians of all parties to acknowledge the problem, promise the earth — and then move swiftly on.
Well, not any more. In an open letter to Boris Johnson, the head of Care England which represents 4,000 providers, makes an emotional plea for the Prime Minister to fix it once and for all.
‘We are fed up with procrastination: it is a crying shame that this pandemic has shown the nation just what an important sector we are . . .’ writes Professor Martin Green.
Well, not any more. In an open letter to Boris Johnson, the head of Care England which represents 4,000 providers, makes an emotional plea for the Prime Minister to fix it once and for all. pictured: Stock photo of a nurse helping an elderly woman
He demands Mr Johnson makes good his promise — uttered on the steps of Downing Street almost exactly one year ago when he took power — to end the social care crisis, promising ‘a clear plan we have prepared to give every older person the dignity and security they deserve’.
Ravaged
And he lambasts him for trying to deflect blame for the tens of thousands of deaths in care homes as he did last week.
When I first heard the PM attributing the Covid-19 carnage among Britain’s elderly to care home staff, I assumed he must be joking. A bad taste joke, admittedly.
But it seems he was deadly serious. In his view, the shamefully high number was because ‘too many care homes didn’t really follow the procedures’.
I gave him the benefit of the doubt: perhaps he had been wrongly briefed and would soon retract his words? But when pressed, his spokesman refused to offer an apology.
The Health Secretary Matt Hancock’s attempt to clarify the PM’s controversial remark was equally baffling.
‘The PM was explaining that because asymptomatic transmission was not known about, the correct procedures were therefore not known,’ he said.
Had neither seen the harrowing footage of Spanish and Italian care homes being ravaged by the virus which dominated the TV news until the middle of March, when our own impending lockdown began to take over the agenda?
It was slowly becoming clear that a rising proportion of our Covid-19 deaths were happening in the same way.
And yet the Government’s guidance didn’t change: ‘It remains very unlikely that people receiving care in a care home or the community will become infected,’ we were told. That statement turned out to be false. And lethally so.
But this ‘guidance’ was far from the only, tragic error.
On March 19 hospitals were instructed to discharge all patients who were ‘blocking beds’ — which included those awaiting places in residential care or needing care in their homes — in advance of the expected tidal wave of Covid-19 cases.
Many were moved to care homes without being tested for the virus. Inevitably, it soon transpired a significant number had contracted the virus in hospital and spread it to care home staff and other residents.
It was proof, if we needed it, that Government policy was to protect our most cherished institution, the NHS, rather than individuals who ended up paying with their lives.
It was another four weeks before the Government decided that all patients discharged from hospital should be tested for Covid-19 first. But even this was not as it seemed, because the guidance also stated they could be discharged before the test results had come back.
Soon after it was revealed that there had been 100 new outbreaks in care homes across the country — I wrote on these pages that the elderly in care homes were ‘being abandoned like lambs to the slaughter’.
Pictured: A nurse testing an elderly man at a care home for coronavirus in Brussels in April this year
Today, I make no apology for venting my fury about this situation once again. I am deeply concerned at the staggering failure to take responsibility for the abandonment of our most vulnerable citizens.
Unless those at the top of Government understand the extent of the failures in our social care system, there will be no sense of urgency to address them.
Of course, it is possible some care homes may not have followed the proper procedures through incompetence or ignorance or cost-cutting. And perhaps some homes struggling to stay afloat might have welcomed a new influx of residents from hospitals, in order to boost their revenues, despite the risk of Covid-19.
It was concerning to learn last week that 16 struggling care homes in Birmingham accepted a £1,000 extra cash ‘incentive’ from the council to take in hospital patients, even though some had coronavirus. But this is a minority.
Many care home managers started to shield their residents long before being officially required to, while also doing their utmost to source sufficient personal protective equipment and struggling to replace sick staff due to the high costs of locum cover.
Abandoned
But none of this excuses the years and years of political neglect of the failings of the social care system that made this tragedy inevitable.
Legislation passed in 2014 to redress some of the means-test inequity, cap care costs and give more protection to those needing long-term care was subsequently abandoned.
In March 2017, the then Chancellor Philip Hammond promised a Green Paper on the care system by the year’s end. It never materialised.
Hopes were again raised by Boris Johnson’s promise. Almost a year later, that ‘clear plan’ is nowhere in sight. And Britain is left with a social care system unfit for purpose. How else can we explain the unfair rules which mean a millionaire can get expensive cancer treatment free on the NHS, while a widow must run down her savings and even sell her house before the state will intervene to help her in the last years of her life?
By far the most depressing aspect of this is how the care sector and those it is responsible for are viewed as a second-class branch of our health system. ‘Protect the NHS’ was the first official slogan of the pandemic. There was no such exhortation to ‘Protect the Elderly and Vulnerable’, who were the most likely to die from Covid-19.
Failure
It is impossible to imagine any PM publicly criticising the NHS or its staff, yet it was deemed acceptable to try to blame managers and those tireless foot soldiers in the care system.
The NHS has been venerated during this pandemic, and rightly so. But what of those badly paid care home staff without generous public sector pension entitlements?
What about those carers who are not trained to be nurses, yet did their best while working without the proper protective equipment?
The artificial divide between NHS and social care leaves too many of Britain’s most frail citizens exposed. Yesterday’s announcement on new immigration rules that effectively block care providers from recruiting the staff they need is further evidence of the failure to recognise that social care is about healthcare.
Frontline workers often earn well below £20,000 a year. The sector had 120,000 vacancies before the pandemic. If providers cannot bring in staff from overseas, then care provision will deteriorate further.
To right this wrong should be a mission to establish social care and healthcare as issues of national welfare.
The elderly and vulnerable must never again be abandoned on such a scale.
It is a disgrace to any country that aspires to be civilised.
Ros Altmann is a former Pensions Minister.