Britain’s social care crisis means misery for millions of the most in need:
- 1.4 million older people in Britain are not having basic care needs met.
- Between March 2017 and February 2019, 54,000 people died waiting for a care package. 626,701 people had requests for care refused.
- Between 2009/10 and 2016/7 the number of people receiving publicly-funded care fell by 400,000.
- Almost a quarter of local authorities in England still commission fifteen-minute house visits for elderly people – barely enough time to make a cup of tea.
- Funding for care services by local authorities has fallen by nearly £8bn since 2010.
- In the decade from 2008 to 2018, 929 care homes housing 31,201 residents closed.
Meanwhile, private care companies, or their financial backers, are making a killing. The private market in care homes for older people – which supplies 83% of care home beds – has been priced at £16.9bn, and is growing by 3% annually. Finance-capital-owned providers price a 12% profit margin into their calculation of ‘costs’, and are attracted to care because of the funding streams that are received – mostly from local authority fees, but also, increasingly as local authorities’ spending on social care declines, from wealthier clients who can afford to pay. These streams are used to pay debts to the financier owners which allow the companies to post ‘losses’ while paying out millions in shareholder dividends and consultancy fees.
To meet this crisis, the Labour Party Manifesto proposes a National Care Service, which, if implemented, could have a positive impact in both residential (ie care homes) and domiciliary care (delivered at one’s own home) – but only if all aspects of care are taken back into public hands, and this the Manifesto does not promise.
Residential care
Aiming to court the home-owning middle classes threatened with the loss of their homes to pay for a place in a residential care home, Labour promises a £100,000 lifetime cap on care costs. If care home provision remains primarily in private hands, however, any excess over this £100,000 will be paid out of public money to private companies – who, unlike the state, must draw their expected 12% profit.
Domiciliary care
For those who receive care in their own home, Labour promises free personal care (at-home assistance with basic daily tasks) for over-65s. Earlier vague promises to assist local authorities to employ care workers directly do not appear in the Manifesto. Instead, contracts will be awarded to organisations and private companies which pay tax. If care continues to be contracted out in this way, the rising costs – due to an ageing population – of free personal care will be paid out of public money to private companies, with the added ‘costs’ of a tidy profit, and the chaos and instability created by a system where care is only provided where a profit can be turned.
Thus a National Care Service up to the task of solving the care crisis must completely end the outsourcing of care to private companies. If it does not, real power will remain in the hands of the private providers, and they will rather close down their institutions than submit to state demands that may damage their power and profits. Preventing such sabotage means mobilising care workers to take over and run the system with wages paid and resources guaranteed by the state. There is no shortcut through Parliament – a National Care Service will only be won through real struggle.
James Pike
Fight Racism! Fight Imperialism! 273 December 2019/January 2020
