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Will the government pay for overlooking the social care sector?

This week the drumbeats of Westminster are once again signalling that the time has at last come for the government to publish its future strategy on social care. It would be inadvisable to hold your breadth as we have heard it all before, but unless the government acts shortly it will run out of time to persuade voters that it has met the promise of Boris Johnston before the next election.

James Elliott writing in Healthcare Business International Europe, suggests that during the pandemic, governments across Europe prioritised their hospital and national health services at the expense of the elder care sector. He raises the question will elderly care ever get the attention – and funding – it deserves?

Governments have overlooked the care sector in favour of their public hospital systems.

Despite the pandemic putting massive pressure on the elder care sector, not least care homes, across Europe, governments have continued to overlook the sector in favour of their public hospital systems.

In Greece we are told that due to government calls for extra staffing, care home operators lost over 2,000 skilled nursing staff to the public hospital sector during the first wave of the pandemic, when skilled staff were most needed. In Italy we hear a similar story with the national health service gaining an extra 35,000 staff at the start of the pandemic as the government called for extra staff. Most of these staff came from the elder care sector, a major blow for operators who were already struggling to retain skilled staff during the initial wave of the pandemic, and who were performing a vital role looking after some of their countries’ most vulnerable people.

A panicking government

These decisions are understandable. A panicking government struggling with an unprecedented health crisis in Covid can be forgiven for prioritising its NHS. But it is short-sighted after the event not to recognise where elder care has been perennially underfunded, and not to acknowledge that mistakes were made. Care home residents were clearly not many governments’ priority. And the budget for elderly care – and the wider budget for social care – is increasingly seen as insufficient and combined with a lack of joined up thinking among sectors which clearly should be linked.

In the UK, the decision was taken to move (possibly Covid-infected) elderly hospital residents to (often understaffed and under-prepared) nursing homes, despite promises by Matt Hancock, the former Secretary of State for Health, that all hospital discharges to care homes would be tested for Covid 19. But were they? There is an on-going debate about how many were actually tested – though it was his own failing to abide by distancing rules rather than any error in managing Covid dangers which ultimately led to his downfall.

Governments favour the hospital sector

It is understandable that governments favour the hospital sector. In the UK, the NHS is larger far better organised and has the ear of the government, while the care home sector is often made up of many small groups which struggle to make their voices heard.

But it is impossible to ignore the demographics. Europe is aging rapidly and that is a problem which is not going to go away. In early 2018 there were 101.1 million older people aged 65 years or more living in the EU, almost one fifth of the total population. This figure is projected to rise to 149.2 million inhabitants by 2050, 30% of the total population.

Governments slow to act

Governments are often slow to act until it is politically expedient for them to do so. If there is one thing that is true of elderly people across the developed world it is this- they do vote. Should governments continue to treat elder care as an afterthought they could end up getting kicked in the teeth by the grey vote – possibly the only thing that will make them pay attention.

Summary

There has never been any debate that during the pandemic the government would have to prioritise the needs of the NHS before social care. The issue has always been to what degree and to what extent. There is evidence from across Europe and the UK that the prioritisation of the health sector resulted in serious consequences for elder care. Large numbers of staff left caring for the elderly to work in hospital settings.

The short sightedness of the government in the UK continues to have an impact on a social care system that is in crises. The system continues to have serious recruitment issues and is grossly underfunded. The delay in social care reform and the way the care system was overlooked may yet come to haunt the government at the next election.

Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy

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