Why we’ve failed to build a national care service

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Sage seem to consider the major problem in care homes the impact it is having on the R number. At least that is how it is being reported. Sage member Professor John  Edmunds told the FT

Covid-19 infections in hospitals and care homes had pushed up the R number to between 0.75 and 1.

The rate of new infections in the community is “levelling off,” , but the country had been left with “residual epidemics” in hospitals and care homes. The community transmission rate had “come down quite sharply” but the R in hospitals and care homes was not going down at the same rate,

Prof Edmunds added. Dominic Raab, foreign secretary, agreed that the situation had been “a real challenge” owing in large part to the ebb and flow of people through homes, but added this could be controlled.

We will have to wait to know why the R in care homes isn’t going down, but whatever the answer is, it will come too late for those in these homes who have died, whether residents, or carers.

“Residual epidemics” may sound a side-effect of the pandemic, but they are in fact the fastest growing aspect of the pandemic in the UK

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Because many deaths in care homes are reported by GPs without the patient being tested for COVID-19 , many of these “excess deaths” are not being reported on the official figures for COVID deaths,

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Later numbers unavailable,

This is allowing the impact of the “residual epidemic” to be downplayed. Indeed the tone of Government reporting is now shifting to blaming the care homes for the R getting stuck and for non-residents having to stay inside.

A national care service

The crisis UK care homes are now in is not unique. Other European countries have been reporting high excess death rates of as much as 60% of total hospital deaths – again.

The numbers in my blog in April will certainly by now have been exceed. Care Home deaths are thought to account for a high proportion  of the gap between total excess  deaths (between 55 and 60,000) and reported COVID deaths (30,000).

The elephant is out of the care home, and is now trumpeting 20 years of Government failure to create  national care service, to match our NHS.

In Labour’s Towards a National Care Service, published last autumn, we were reminded that 1.4m people in the UK go without the help they need to perform basic activities of daily living. The document was an update of the Command Paper in 2010 when Gordon Brown was prime minister. Since 1999, there have been 11 green and white papers on the need to reform and improve care but there is still no proper in strategy and it shows.

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What Labour called for and we rejected

Labour’s plans were widely dismissed as too radical and formed part of the “policy failure” that was seen to have made Labour unelectable last year. The electorate weren’t in a mood to listen to arguments for spending on the vulnerable.

This is not a party failure, it’s a general failure of Government created by an electorate who have stood in the way of a proper debate on the issue. Indeed the failure of Teresa May to win an overall majority in 2017 is in part attributed to her botched attempt to make reform of elderly care an election issue.

Rather than make the failure to address the inadequacies of our care system with a national care service, a political issue, we should be asking ourselves what have we individually done to engage with the elephant.

I should point out that one area of financial planning provision that has lagged all others is the provision of products and advice on the private funding of long-term care. I hope that this change as we go forward.

The PM’s belated admission of failure

In one of the few signs of compunction for failures so far, Boris Johnson said last week that he bitterly regretted the care home crisis. This is not regret for the R number not dropping to 0.5 (see above) but grief for the casualties of logistical failure

it has been enraging to see the difficulties we’ve had in supplying PPE to those who need it” but the government is now “engaged in a massive plan to ramp up domestic supply”

Care homes are not quarantined from society, people come in and out of them and they bring out infection. Many of the residents in care homes were in hospital and were taken out to care homes to free up beds. The infection was brought into care homes with them.

And while we clap each Thursday for the NHS we do not clap for the carers, despite them taking the same risks and performing the same duty of care to their patients.

There is a double standard at work which results from this 20 year long failure of parties and electorates to treat those in residential care as part of our health service.

That they are dependent on others is a sign of their cogitative and physical decline. Were these people younger, they would be more valued and Ros Altmann is right in campaigning for the rights of older people to be treated with the same dignity as everybody else.

As part of the realignment of priorities following the end of the pandemic, we must make sure that we build a national care service of which we are as proud as the NHS.


About henry tapper

Founder of the Pension PlayPen,, partner of Stella, father of Olly . I am the Pension Plowman
This entry was posted in actuaries, advice gap, coronavirus, pensions and tagged , , , , , . Bookmark the permalink.

2 Responses to Why we’ve failed to build a national care service

  1. John Mather says:

    Do you think the family might have a responsibility roll to play?

  2. P D BEATTIE says:

    John. With respect ‘Family’ are the only ones in our society that we may depend on – if they are willing to cooperate. There is a basic flaw in the running of our society – it only works if ‘government penalise someone’ ie we as a country are ‘under resorced’! Support is left to the ‘private sector’ and uninterested local authorities who decide who they favour with support! Hence Care Homes and to a degree GP’s (self employed under contract from government departments). So our cabinet office is only really responsible for funding NHS service and that is why their present policy only supports that ‘self interest’ to protect the Treasury! Therefore those that are ‘outside the NHS umbrella’ need to ‘fend for themselves’ for support, funding and equipment. The way it presently works is a fudge that government can take advantage of!

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