Last week, the Telegraph asked me to write a piece about care homes. In the end, the article was spiked… never used.
However, I don’t see why you shouldn’t read it, if you want to, so, here it is…
There was an unusual event at Prime Minister’s questions yesterday. Not just that you could hear the questions and people seemed really interested in the answers.
No, it was Boris Johnson’ s stark confession that there was a Covid-crisis in our care homes.
Blunt admissions of failure are rare pieces of parliamentary theatre.
He is right. Based on figures from the Office of National Statistics, from 10-24 April, there were 4,343 deaths involving CV-19 in care homes. There looks (then) to be no sign of these numbers abating.
Are care homes the last place for Granny to be cared for?
Part of the answer is that many care homes can’t care. It’s not that they don’t care. They just don’t know how to care in a crisis such as this. They are not nursing homes.
Staffed by hard working, well intended people, often, working on minimum wages, with English not their first language. With only basic care and health and safety training and from the outset, scant protective equipment, they stood no chance.
Without nursing input or medical advice, infection control techniques are not routinely taught. Taking basic observations, like oxygen-saturation tests, a sure sign of infection, are rarely carried out and care home operators are left, as spectators, watching CV-19 rip through their vulnerable residents.
Is it too much to describe them as death traps?
The situation was exacerbated when it was decided, to make room for Covid-cases, elderly patients should be discharged from hospital, into care homes, without a routine CV-19 test. The consequences were like throwing petrol on a fire.
Did government abandon care homes to their fate, or was there a reasonable expectation that home operators, paid to care, would have some element of preparedness and be able to do their job.
Epidemic plans, resilience, basic reserves of protective equipment, infection control, barrier-care and arrangements for staff testing. Food delivery company Ocado and Amazon test their staff, why should care homes not be responsible under health and safety regulations and also test?
The government discovered, too late, the care home sector is as fragile as their residents and powerless to stop the contagion.
The care home market has around 473,000 beds, mainly small operators, working on slim margins. About 14%, run by five bigger companies.
One of the biggest, HC1, operates 22,000 beds. The executive chairman is Sir David Behan, formerly the boss of the Care Quality Commission and now chair of Health Education England and associate board member of NHSEngland.
It is reported, two-thirds of his care homes are owned by sister companies in Jersey and the Isle of Man and the provider’s operating company, HC-One Ltd, made a £6.5m loss in 2018 but paid out an estimated £40m in rent to offshore firms.
This points to a fragmented market in need of consolidation and better regulation for the bigger operators. The other solution is to do what Bevan did, in 1948, to pull together the broken health sector. He nationalised it and called it the NHS.
Nationalise the care home market, create the National Care Service and pay for adult social care like we pay for the NHS, through our taxes. Simples.
Successive governments have neglected care homes. In 1997, new Labour’s Health Secretary, Frank Dobson promised a Green Paper on the future of adult social care. Since then, time and again, governments have failed the challenge.
Two years ago I asked Health Secretary Matt Hancock when we could expect a green paper on adult social care. April, was his answer. Alas, I neglected to ask which year.
It will be Boris Johnson’s government that will pay a heavy price for the historic neglect of the care home sector. The assumption that care homes could cope, will cost him dear.
Johnson was honest about the problem. Can he be truthful about the solution?
The Telegraph were very courteous about not using my efforts and thanked me. They gave me no reason for rejection… maybe it was something I said!
Have the best weekend you can.
News and Comment from Roy Lilley