FIXING SCOTLAND’S CARE HOMES WILL NOT BE DONE ON THE CHEAP

Brian Wilson writes for The Democrat

wilson brian 3Something must be done, everyone agrees, about care homes.  Yet until now the subject was filed under “non-urgent”, writes Brian Wilson.

There are two required levels of inquiry. The first is immediate, home-grown and involves failure to test staff or patients over critical months after the implications were all too apparent.

It is now in the script that the imperative for clearing hospitals derived from images of the “tsunami” that hit Lombardy. But why were no alarm bells sounded by even grimmer scenes from care homes in Spain, confirming the sector’s vulnerability? (Staff ran away and left residents of care homes dead in their bed).

Though the outcomes in Scotland are distressing, this is not an issue for us or the UK alone.  In Sweden, the Health Minister has acknowledged a “society-wide failure” and many governments will face hard, ethical questions.

So the second level of inquiry must recognise that one of the great challenges of our century cannot be evaded – or can it?  The population will continue to age with the need for a caring response correspondingly greater.

Throughout the UK, the defining legislation was the Community Care Act of 1990, turning local authorities into brokers of care rather than providers. This was the spiv economy heyday with buses, utilities. care homes, you name it, subject to the same ideology – privatise first and ask questions afterwards.

The new industry boomed  but never fully recovered from its early reputation – profit-driven, low-paid and sometimes cruelly unfit for purpose.  A sector that should have been designed to NHS standards was left to the mercies of the market.

It would be foolish to pretend nothing has changed. Regulation is far tighter and many privately-owned homes are excellent. But fundamental weaknesses in the system have never entirely gone away and have now been cruelly exposed by the pandemic.

In 1998, the Labour government confirmed: “Our third way moves the focus away from who provides the care and places it firmly on the quality of services experienced”.  That remains the prevailing model. So how can it be improved?

First and foremost, status and pay of those who work in the sector must be placed on a par with NHS counterparts. This is on grounds of fairness and also necessity. As the age balance switches, it will simply not be possible to retain staff unless they are properly paid.

Take one piece of anecdotal evidence. On Skye last year, I was told the AirB&B boom – with every room in lucrative demand –  was making recruitment to minimum wage jobs on the island more difficult.

I have no idea whether that had any bearing on what has occurred on Skye. But it does confirm a wider truth –  the fragility of a sector which depends mainly on women undertaking hard, challenging work for very modest remuneration. That is unsustainable.

Secondly, we need far greater variety of provision. The emphasis on keeping elderly people in their own homes has been marginalised as cuts to council budgets took their toll on home help and other services. Sheltered housing also merits a new impetus.

In the Western Isles, there was a great concept of local care units established in the 1970s. It kept folk in their own communities instead of being shipped off to a care home. It created local employment and allowed residents to interact with family and young and old around them.

At the time, it attracted international interest as a model with application in both rural and urban settings.  But relentless pressures of centralisation and funding cuts took their toll. The last of these lovely units closed this year. Progress?

In 2014, the Scottish Government and COSLA commissioned a report called The Future of Residential Care for Elderly People in Scotland.  It made 34 recommendations of which only three have been acted upon. But there is plenty groundwork to build on.

This is a devolved policy area in which Scotland has the opportunity to be innovative and different, just as it was in many areas of social policy in the past. The certainty is it will not be done on the cheap and without political will, it will not be done at all.

LEAVE CUMMINGS AND COMPANY TO STEW IN THEIR OWN IGNOMINY

When it come to Dominic Cummings, I am in the “let’s move on” camp leaving the great Svengali and those who pledge such craven allegiance to him to stew in their own ignominy.

I watched three minutes of Cummings’ press conference before deciding it was the old trick of offering so much detail that the central charges would get lost. It didn’t work because nobody really cared about the detail.

Thousands of families with circumstances at least as upsetting had followed the rules while Cummings had not.  End of …  None of the others had access to the Downing Street Garden, in itself a reduction of politics to farce.

As Cabinet ministers were drilled into robotic support, my favourite was Michael Gove when interviewed by Nick Ferrari on LBC.  If you haven’t seen the video clip, make the effort. It’s worth it – since Gove is supposed to be the clever one.

“Would you go on a 60 mile round trip to test your eyesight?”  Gove: “I have, on occasion in the past, driven with my wife in order to make sure that… what’s the right way of putting it…?”

Ferrari could not believe  his luck. “I’m staggered. I don’t know how you are going to get out of this. But it should be fun”. Thus was Gove reduced to national laughing stock, all in the cause of protecting Cummings. Leave them to it.

One Minister took a different tack and Douglas Ross deserves respect for identifying a straightforward matter of principle and acting accordingly. Calling for other people to resign is easy but doing it oneself involves real sacrifice  – which is why it very rarely happens.

One comment

  1. A very good analysis of the issues affecting the care sector by Mr Wilson if I may say so.

    The move in 1990 from care providers to care brokers is a very good point.

    The care sector very much requires better regulation, and if there is any silver lining then this tragedy may have brought to the forefront of our minds the changes that need to be made.

    Let us hope that we now move to make the changes needed.

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