The following is an interesting article published in the Tribune Magazine on the dire state of Britain's largest care home provider and the aged care situation in general - much of which has similarities to New Zealand's ageing demographic:
This is the ugly face of ‘caring’ capitalism
Kailash Chand says the recent care homes scandal is a symptom of an entire care system in crisis
Harrowing stories of lives lost in care homes filled the newspapers last week. It was the financial travails of the country’s largest care-home provider, Southern Cross, which propelled the issue of how we treat our elderly onto the front pages. The irony is that while the elderly and their carers were suffering, the directors of Southern Cross cashed in millions of shares. Four, including chief executive Philip Scott, made a total of £35 million by selling their shares. This is a financial exploitation process designed to make mega bucks that does not care if it exploits elderly people in care. If life is miserable in the main tranche of care homes, it is because the private sector – the likes of Southern Cross, the ugly face of capitalism – is unsuited to this work.
It has been revealed that behind the doors of Britain’s residential homes, dominated by private companies for profit, there is a postcode lottery ranging from excellent, unbeatable care to shocking cases of neglect.
But the problems span far wider than that when it comes to social care for the elderly.
Care homes are just a symptom of what is wrong. The entire care system is collapsing. Decades of under-investment need to be addressed, but instead councils are faced with severe spending restraints that are causing them to withdraw services rather than build on them. Means tests are becoming tighter. In the face of burgeoning demand, many are ramping up charges to those they say can afford to pay.
Elderly, frail and disabled people, as well as their carers, are struggling to access even the most basic of services in England. Many are forced to sell their family homes in order to pay for residential care.
It is worth considering the demographic change that is taking place in this country. The fastest growing age group in Britain is the over 80s: three million will become 6.5 million by 2045. In the same period, the numbers aged over 65 will jump by 70 per cent from 10 million to 17 million.
So what does that mean? Half of all those with chronic illnesses are aged over 60. Britain’s retired population take up seven out of 10 beds in hospitals and one out of two consultations in GP surgeries.
The combined cost of National Health Service and social care for older people will swell to £4 billion by 2016. This is about caring for people through as many as four decades from when they retire.
And it is about dealing with millions of individual cases. Some people will remain fit, live independently and perhaps move to retirement villages filled with social interaction. Others may soon become frail, needing round-the-clock care for many years.
Hugely varying needs will require a wide span of provision – from top-level NHS care to purpose-built secure bungalows, with wide doors and disabled toilets, in-the-home help with dressing, eating and showering and – if possible – carers who can offer a little social interaction for those who have become house bound and lonely.
A recent Age UK report highlights that of the two million older people who have care-related needs, 800,000 receive no formal support at all. That figure is likely to pass one million in the next few years.
However, in the past six years, public spending on care for the elderly has increased by just 0.1 per cent a year in real terms. Over that same period, the number of people aged above 85 has jumped by 23 per cent.
We need to solve the funding problems once and for all.
In opposition, the Tories proposed a voluntary insurance scheme, but that would create a two-tier system. And the most vulnerable would feel most unable to sign up.
The progressive argument is the care for elderly has to be met from central taxation – no more than a 1p rise in income tax would suffice.
Without a bold and radical tax solution, the public sector will not be able to look after our senior citizens. This is not about NHS funding. It is about social care in residential homes and in people’s own homes. Sometimes it is things that we may take for granted – being able to dress, have a shower, pick up your post and buy some food. And let’s not forget the value of providing someone with whom people can have a cup of tea and a chat.
The principle of independence also covers access to adequate living conditions, opportunity to work, participation in determining when and at what pace to withdraw from work, access to education and training programmes, a safe environment and the opportunity to reside at home for as long as possible.
Respect and dignity should be restored to the elderly who have made valuable contributions to British society for many decades. For too long, this country has failed in this area.
One area that requires a major review and overhaul is the care of the over 90s – a group that includes many very frail individuals. Most of this cohort will be on between 14 and 20 drugs. And they will need access to a large number of specialists – perhaps cardiologists, gastroenterologists, neurologists, dermatologists and gerontologists.
We need to consider cultural differences in ageing, too, with some groups having varying diets and susceptibility to particular illnesses.
Then there is the issue of education about what might happen in old age – that should start at school and then be restated again and again through life, in colleges, universities, workplaces, doctors’ surgeries and so on. People need to be informed about just how crucial adequate funding is, perhaps by stressing that one day they will want and appreciate quality care that gifts them dignity in old age.
The principle of self-fulfilment embraces dignity and security; non-discrimination; the right to pursue opportunities for the full development of a person’s potential; and access to the educational, cultural, spiritual and recreational resources of society.
Although politicians from all parties acknowledge the huge problem there is as yet insufficient commitment to comprehensive reforms. History has it that society and policy makers alike have shunned the elderly as a wasted resource. That has been a serious error of judgement, belief, misconception and
maltreatment.
Andrew Dilnot, the economist tasked with proposing a funding solution to this crisis, will make his recommendations in July. That is not the starting gun for the solution of social care – but a sign that we are nearing the end of the race. There is no more time for delay: politicians of all colours must then act.
Kailash Chand is chair of Tameside and Glossop NHS Trust
