On the cusp of sixty, having witnessed so many speeches of unconvincing emotion – Thatcher: the tragic King’s Cross fire, Blair: “I love this party, it was losing I hated”, or various Lib Dem leaders over the years lecturing Liberal Assembly or the early Lib Dem conferences that we weren’t “serious about power” – it would be churlish not to recognise the raw power and daring delivery of Burnham’s speech about care.
Having been both a politician and a worker in the care sector, I for one appreciated the PM’s direct apology to camera that the former profession had let down the latter one.
Some of the care sector is inspirational, some is positively Dickensian and Burnham has certainly hit the nail on the head about the status of care professions. Physios, chiropodists and occupational therapists are qualified people on reasonable salaries, treated with respect; if you are an activity coordinator brightening the lives of those living with dementia in a care home, you are likely to be on poverty pay. I know. I have done it.
If you work with people with dementia, you know that primarily you work with the amygdala (the emotional brain) rather than the hippocampus (the fact brain). Burnham’s speech too spoke to our emotions yesterday.
But the morning after the speech before how does the Prime Ministerial emotion stand up to scrutiny?
- “Bringing back control” – knowing the sector, it is hard not to feel a little glee at the prospect of nationalisation putting paid to so many unscrupulous operators. But if you nationalise care you will drive out good operators too. Won’t the government be tied up with years of expensive litigation and compensation disputes?
- It is fine to well up about the old system when many more councils had direct control of care homes but, sadly this can go very wrong too. In Southwark I and my Lib Dem colleagues (and one courageous Tory) took the lead on the council-run Corbet residential home scandal and the aftermath of the Nye Bevan Lodge scandal in the 90s. Cosy relationships between care home managers, Labour councillors and the unions resulted in cover-ups of abuse.
- Separating “care” and residential “hotel” costs isn’t as easy as it looks. Aspects of the proposals could bring about a labyrinthine new bureaucracy.
- Throughout his speech Burnham put the NHS on a pedestal as the perfect model for the new care service, bur recent maternity and other scandals over snooping on patient records show the NHS needs radical change around patient autonomy, dignity and privacy – which are even more pressing questions in the care sector where dementia, loss of mental capacity and deprivation of liberty present huge challenges.
These are issues Burnham will have to answer. But so will we, as a party that “fights” for care.
* Ruth Bright has been a councillor in Southwark and Parliamentary Candidate for Hampshire East
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5 Comments
Ruth, I think also we need to recognise that many people reacting to the NCS proposals (inside social care sector as well as out) have been acting like it offers freedom from rationing and haggling over how much care is proportionate to need. There’s no suggestion of this being true. There’s also an ongoing tussle between NHS and council managers about who calls shots on what is proportionate to risk (with individuals and their families often shut out, or professionals siding with family vs individual or the other way round); and the difference between diagnosis and risk is an ongoing flashpoint. Its not clear how much local autonomy there will be, and how much council provision will be regionalised, or whether – as with so much of Burnham’s Metro-Mayor thinking – there’s a risk of credit and funding control going to Mayors and central government, but blame remaining with councils. So much to be unpicked.
This is where coherent and thoughtful engagement from all parties and bodies in Burnham’s ‘consultation’ approach is desperately needed.
And expectations still need to be managed. It’s not going to be a revolution over night, and people’s aspirations for what could maybe be done hypothetically with social care across the whole field are both high and contradictory.
Thanks for this Matt.
Solidarity with you Ruth on this. We may only have one chance to eliminate private equity profiteering in England’s adult social care sector. Reforms by the government aim to redirect public funds from shareholder dividends into frontline care. Currently, private equity controls 83% of adult social care. Its so wrong.
Thanks Michael. Apropos your point about private equity firms. At the other end of scale, smaller operators in the sector (with a turnover of under 10.2 million) don’t even have to submit proper accounts.
With our Southwark/health/social care hats on we should do a joint article about this sometime 😊.
The first step has to be to take the profit motive out of the system.
As a family carer for several years I witnessed companies trying to squeeze every last penny out in both the home care and residential sector. The workers were treated appallingly, not given enough time to do the job and paid a pittance.
I raised these abuses with my then local Labour controlled council and was ignored. In fact they started attacking me for having the temerity to criticise.
If Burnham is true to his word then he has set himself quite a task!