Care homes across Britain are facing a financial disaster because of the Conservative government’s drive to end all central government financial support for local councils. Claims by Chancellor Osborne that councils will be able to raise up to £2bn a year for adult social care through a 2% increase in council tax are just lies; the real figure will be about £400m. In the case of Liverpool the amount would be just £3.2m a year, a drop in the ocean of £50m cuts in its social care budget since 2010. The result is a funding gap for the care home sector estimated at £2.9bn a year by 2020, with perhaps half of all care homes facing closure. Southern Cross which collapsed under a burden of debt in 2011 may well be followed by Four Seasons, which operates 470 homes with 22,000 beds (out of 430,000 nationwide). The company, along with Annington Homes of Sweets Way notoriety, is owned by the Terra Firma private equity group. It has £500m debts and is losing millions a year. Robert Clough reports.
With 37% of residents paid for by local authorities, and a further 12% who pay extra on top of local authority funding, the cuts in adult social care will only make the problems worse. Over the last five years, local authority payments have been cut by 5% in real terms. Already most care homes top up local authority payments with private fees, and some care home chains are starting to focus on the private self-pay market and reject state-funded residents. In the case of Four Seasons, 60% of its residents are paid for by local authorities, so it is not surprising that it has been reduced to junk status.
While in the past there was a real distinction between residential and nursing homes because of differing levels of residents’ dependency, in practice this no longer applies. Bupa estimates that ‘three-quarters of care home care is “nursing care”…The substantial decline in the number of hospital beds for older people and associated transfer to nursing home care has led to the increasing medicalisation of care home care and greater levels of dependency among care home residents.’ Care home residents experience 40-50% more emergency hospital admissions and A&E attendances than the general population of over-75s. More than 40% suffer from some form of dementia with the incidence increasing 30% a year; 70% have some form of incontinence.
Yet the care home sector is one of the biggest employers of casualised, poverty-paid staff. Pay levels are so low that the introduction of the government’s bogus National Living Wage will cost £1bn. Poorly paid, poorly trained, working in impossible conditions, 42% of staff leave within a year of joining and 61% after two years.
Osborne’s solution is further deskilling by loosening restrictions on the employment of student nurses in place of agency staff. Re-badging part of the NHS budget as the Better Care Fund and allowing councils to raise extra money through hikes in council tax is no more than a sticking plaster.
The reality is that the combination of NHS and social care cuts means a miserable end for many working class lives – and Labour councils are complicit.
Fight Racism! Fight Imperialism! 249 February/March 2016
