Justitia, Old Bridge of Heidelberg

Justitia, Old Bridge of Heidelberg
Justitia, Old Bridge of Heidelberg © Gernot Keller, 2007
Blinkered Justice articles also appear on CrimeTalk and Government In The Lab

Monday, 27 June 2011

Pensions and pensioners: when I'm 67...70...73

The following article has been republished in full from The Pryer as the original has been archived on an old server and is no longer available. This article was originally published in June 2011. 

(c) Roger Griffith
In the second of my series of articles looking at pensions, retirement and beyond, this post will look at issues relating to the care of pensioners.  Care can take place at home or in a care home, and affects pensioners who are fit and well and those suffering from age associated conditions. Caring for the elderly affects the person being cared for, carers, family, businesses, regulators and the state. With reports of the recent scandal at Winterbourne, the financial crisis at Southern Cross and stories of abuse elsewhere, “care” is big news.

The NHS reform bill deals with reforming social care services in the UK, as well as restructuring the NHS more generally. As well as setting out organisational changes to the health care system, the bulk of the bill deals with the “economic regulation of health and adult social care services”. Issues such as competition, licensing and pricing are at the heart of these reforms. 

I am aware that the bill has been sent back to MPs to scrutinise, but I find it faintly disturbing that ideas of public well-being and care appear virtually redundant. Given that many of us need and use the NHS, at least those without access to private healthcare, why does a focus on public well-being and care appear less relevant than competition, licensing and pricing?

Ministers claim that the NHS needs to be more accountable to the public. I do not subscribe to this view. NHS stands for National Health Service; therefore, the NHS needs to be public welfare-centric. It is the government that needs to be more accountable to the public. The government has “responsibilised” all of us over the last couple of decades, so that we now spend our own money helping the state finance practices that it used to manage. 

Perhaps it is now time for the government to “responsibilise” itself, and let us know in detail exactly how much of each of our taxes and national insurance is spent on the public services we finance.

The leading age-related charity, Age UK,  have responded to the proposed health reforms on their website thus:
“We welcome the current pause in the Health Bill’s progress through Parliament as we want to ensure that the needs of older people will be better met under any new framework than they are at the moment. 
Older people are by far the biggest users of the NHS, yet they often experience a second rate service which does not meet their needs. We are working with the Government to try and change that in future.”
This statement re-focuses the debate; pensioners are the biggest users of the NHS and they often receive a second-rate service.  This is further exacerbated by a recent inquiry into home care of older people by the Equality and Human Rights Commission (EHRC).  A full report by the EHRC is due out in November. The main findings of this inquiry reveal that:
·        home care visits are often limited to just 15 minutes;
·        pensioners have little to no time over controlling when homecare visits take place;
·        inadequate homecare is being provided;
·        lack of staff training and awareness;
·        high homecare staff turnover;
·        lack of complaints and low expectations.

Many of these businesses have their own agendas. Based on the EHRC inquiry, it is obviously not the care of their patients, or customers/consumers/clients, that top their agendas. For pensioners, homecare is supposed to promote independence and dignity, yet the service that they are receiving is seriously undermining these notions. They do not know who to complain to if they receive bad service, and/or they fear repercussions if they make a complaint. 

It is widely acknowledged that pensioners are already amongst the more vulnerable groups in society. So whilst the government makes a significant saving outsourcing this service to profiteering providers, they do so, harming those whose interests the NHS is supposed to protect. This is inexcusable behaviour on the part of the government and its partners in crime.

Excellent care home (c) Graham Horn [CC-BY-SA-2.0]
The EHRC report also makes it clear that care staff lack support. A high turnover in staff indicates an unhappy workforce. The evidence suggests that care staff are subject to a form of corporate abuse; they lack sufficient training to carry out their role properly, and are asked to deal with their patients in the shortest time possible. 

So whilst media reports, such as those linked above, rightly make a noise about the abuse that carers dish out, equally we should be informed of the difficulties that care staff endure. I am not condoning what has happened recently, but I am suggesting that this kind of behaviour is embedded in the culture of businesses whose concern is for profit, rather than care.

The Telegraph recently reported that the Care Quality Commission (CQC), who regulate the care services, rate more privately owned care homes as poor/adequate than those run by non-profit organisations or local authorities.

According to The Telegraph and the BBC, the CQC, funded by the Department of Health, are operating within financial constraints imposed by the government last year. Ostensibly, the problems appear to be that there are too few inspectors to ensure that care homes are meeting the required standards. Consequently, fewer inspections are taking place. One inspector who spoke to The Telegraph anonymously said:
“Fundamentally, it’s now got to a point of being dangerous (for residents) – and it’s going to get worse,” (…) “If I had a relative who needed to go to a care service, I’d be concerned.
Inspectors at the CQC and the Department of Health appear to disagree as to who is to blame for the recent care home abuses. Whilst they scrap over responsibility, care homes are being closed down. This further destabilises the lives of the elderly. Not only have they been subject to harm on a personal level, they are now having to endure further injury at an structural level. This is governmental and commercial negligence.

Unfortunately, I have omitted other forms of care in this article, such as that provided by family members looking after loved ones at home (sorry mum). Whilst adult social care services patently need amending, there is little evidence that proposed NHS reforms will address any of the problems inherent in the current system. 

The vast majority of the cabinet (18 millionaires?), as well as those with significant means of their own, will not likely use or need the NHS in their dotage. Luckily for them, they will not have to suffer the injustices meted out by individuals, business or the state.

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