I want my money back


News and Comment from Roy Lilley.

It looks like the shemozzle over the next pay-rise is over.  The basic minimum wage, in the NHS, will be at least £8.93 an hour, which is 18p above the voluntary, living wage of £8.75.

The average Cabinet Minister receives a salary of around £140,000 a year.  On the back of a fag-packet, that’s about £2,700 a week.  Most will do, at least, a six-day week, so that’s about £500 a day.  It’s a tough old job, certainly a twelve hour day; about forty quid an hour.  Less tax.

I figure it took The Tinkerman under an hour to deliver his speech at the British Association of Social Workers conference, where he promised to ‘kick-start the vital debate’ into social care funding.

It was such a poor speech, I think we might be entitled to ask for our forty quid back.

The future of social care, its funding, access, staffing and outcomes has to be the most pressing problem facing us today.  Yup, I know, Brexit is a big worry but so is this.

Right now I’m in Australia.  Health system watchers will know that Australia has had a very sensible approach to elder-care, but even Oz is starting to creak under the strain.  I think their problems are our problems.  Not enough resources, too many patients, too few staff.

Health systems, almost without exception, world wide, are largely bewildered.  Just what to do?

In the UK we’ve kicked the can down the road, passed it into the long-grass and lobbed it out and in again.   Think-tanks, reporters, commentators and affinity groups have had their two penny-worth.  Now The Tinkerman has had his forty quid’s worth and we are none the wiser.

Apparently he said ‘[I]… feel the weight of stalled reform programmes on my shoulders’.  Oh, really…

So do the commissioners, the carers, the care workers, the care-home providers, the residents, patients and their families.  They all feel the crushing weight of inactivity, dodging the issue and indecision that goes back to when Frank Dobson was the secretary of state for health. 

The Tinkerman gave us a speech with ‘seven principals of reform’; 

‘…integrated care with the NHS and social care systems operating as one; the highest possible control given to those receiving support; a valued workforce; better practical support for families and carers; a sustainable funding model for social care and greater security for all…’

… along with a nice big slice of Mum’s apple pie.

Like we’ve not been trying to integrate care for the last 20 years; ‘no decision about me, without me’, where did that go;  paying the workforce on the minimum wage and getting away with it; Dilnot told us how to fund social care and what happened…

I want my forty quid back.  Buy the child, with the lap-top, who wrote the speech, a bag of crisps.  It was an insult to intelligent people, an affront to the families and a snub to the staff who try and keep the services going. 

This will not do.  It only will-not-do, it is dissembling and dangerous. 

Dave Eaton, policy and public affairs manager at the International Longevity Centre, UK, reckons if the Government delivers on its commitment to reduce levels of net migration, there will be a social care workforce gap of more than 750,000 by 2037.  

Simon Bottery, senior fellow for Social Care at The King’s Fund, said;  

‘…the government also needs to find more money to address the £2.5 billion funding gap the social care sector faces by 2020…”

Fixing this problem is easy.  The solution is staring us in the face.  If we want to look after people as they get older, we have to pay.  Government has no money. 

In his forty quid’s worth The Tinkerman spoke of;

 ‘…a partnership between the state and individuals…’   

...that’s code for you’ll have to stump-up.

We know, we get that.  We also know you need to get on with it.  

Look at the timing.  Green paper… consultation… white paper… consultation.  Draft Bill… finagling through Parliament… the budget cycle… the upshot, or not, all neatly parked until after the next election.  

I want my forty quid back…

Have a good weekend.


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Reproduced at TrainingPrimaryCare.com by kind permission of Roy Lilley.