Social Care Brushed Aside Again

Dickens I believe it was Mrs Thatcher who insisted on the outsourcing, which she thought would lead to competition and therefore be cheaper, and prevent social services chiefs from giving contracts and jobs to their friends and relations

Remember the mantra of the purchaser-provider split. The local council purchaser of services couldn’t also provide them.

Oh dear. Reeves has scrapped the Dilnot-proposed cap on social care. Wes Streeting said on 16 June during the election that he wanted to give 'the care sector “certainty” that the cap would be rolled out as planned from October 2025'. Obviously his statement was unreliable to say the least. He clearly does not carry enough weight in Cabinet.

He may not have said 'oven ready plan' in respect of social care but on 24 July 2019, Johnson on the steps of 10 Downing Street promised he had a plan for social care: “I am announcing […] that we will fix the crisis in social care once and for all, with a clear plan we have prepared''. He claimed to have a prepared plan to fix social care. Just another Johnson Tory porky.

Actually I agree with you Casdon that this is a complex area, and it’s unrealistic to expect changes.

Thanks for the links Casdon.
Personally I don’t think that saying they hoped to fix the crisis in social care translates as an oven ready plan. Nonetheless it should be obvious to anyone that with the Covid pandemic arriving within a couple of months of that government taking office, that any embryonic plans to reform social care would be unable to be developed at that time. Basically then, Blair shelved it because it was too expensive, Johnson shelved it because of Covid, I have a feeling that Cameron made promises that were watered down and shelved, and I think Theresa May talked about it, but did nothing. No one wants to touch social care because of the expense, which is why I have little faith that this government, or the one after, will do anything about social care.

Boris Johnson did claim that he had an oven ready plan for social care when he came into office in 2019, but there was no developed plan.
Here is the history from the House of Commons Library to 2021.
commonslibrary.parliament.uk/research-briefings/cbp-8001/
There is a good summary here of the manifesto plans the Tories had for the recent election, which explains more, up to their planned start date for implementation in 2025.
www.communitycare.co.uk/2024/06/11/conservative-manifesto-pledge-to-implement-cap-on-care-costs-unfunded-warns-think-tank/#:~:text=In%20their%20election%20manifesto%2C%20published,implementation%20date%20by%20two%20years.
In fairness to the new government, this is such a complex area, it had taken the Tories (including the Covid period) 5 years to come up with their plan, so it’s unrealistic to expect major changes until this government has conducted their own analysis. I’d be surprised if we see implementation of new proposals within the first three years.

I don’t think Johnson had an oven ready plan for social care, he said he had an oven ready plan for Brexit. In any case, Covid, which arrived a mere 3/4 months after Johnson won the election, put paid to any chance of introducing an oven ready plan for social care, or any other plan come to that. Therefore there’s no point in harping on about it.
Blair commissioned an expensive review into social care but decided to shelve it’s recommendations as they were too expensive. I’m not expecting our new government to turn their attention any time soon to social care either. It seems things will continue as they are for some time. It’s simply not a priority for any government because it’s complex and expensive.

Let's not forget Johnson's 'oven-ready plan' to fix social care.

FPC is also paid to Care Home Residents which reduces the amount they have to pay to the care Home.

Meanwhile in Scotland.........................................................................

Free Personal Care (FPC) is a program that provides free care of a personal nature1. Personal care has been provided for free for people aged 65 and over since 2002, and this was extended in April 2019 for people aged 18-641. Examples of personal care services that are free include2:
Help with personal hygiene
Assistance with eating
Continence management
Assistance with medication
Assistance getting in/out of bed
Help with dressing

growstuff

JaneJudge

there were district nursing teams too, something i think has more or less diminished to very small numbers now

That's yet another point. One of my sisters was the district nursing manager for a large area. She had hundreds of small teams responsible to her. Her speciality was the elderly and learning disabilities.

I can't remember exactly when the system changed, but she was made redundant (at great cost to the NHS) and care was transferred to social services, who didn't have the expertise and started to outsource.

My sister always said it would end up in tears. In the end, she shrugged her shoulders and accepted the redundancy pay off, but she still regrets that so much expertise was effectively thrown away and we've ended up with a more expensive, less efficient system.

My sister always said it would end up in tears.

And I think she was right.

My mother was a district nurse, effectively made redundant.

Ended her career as the Sister in the 'Ambulance Room' of a huge industrial complex in Lincoln, prior to de-industrialisation.

When she returned 'down south' she began to while away her retirement looking-in on people locally as an unpaid Samaritan and began to see the downside of 'care-in-the-community'. She was from an era where nursing was regarded as a vocation.

JaneJudge

there were district nursing teams too, something i think has more or less diminished to very small numbers now

That's yet another point. One of my sisters was the district nursing manager for a large area. She had hundreds of small teams responsible to her. Her speciality was the elderly and learning disabilities.

I can't remember exactly when the system changed, but she was made redundant (at great cost to the NHS) and care was transferred to social services, who didn't have the expertise and started to outsource.

My sister always said it would end up in tears. In the end, she shrugged her shoulders and accepted the redundancy pay off, but she still regrets that so much expertise was effectively thrown away and we've ended up with a more expensive, less efficient system.

maddyone

That’s interesting growstuff.
When did the state start to take over elderly care? I can’t remember much about elderly care homes at all when I was younger, but I was aware of geriatric wards. Nowadays of course, we’re not supposed to call them geriatric wards, my daughter told me that they should be called elderly care wards. Whatever, we all know what is meant by those words. So when did the state take over and provide care homes? Although of course, most care homes are privately run and funded.

Where I lived for the majority of my childhood late 60s) there was a massive asylum, with acres of grounds, and also what was known as an 'old folks home' which was run by the council

there were district nursing teams too, something i think has more or less diminished to very small numbers now

PS. I'm going back to pre-NHS times.

maddyone I don't think people stayed in hospitals for very long before they died. They were there, so that increasing doses of morphine could be given, until they died. The provision of state-funded long-term residential care was extremely basic and seemed to be little more than a bed in a ward, adequate nutrition and being washed. People (and their families) avoided it, if they could.

My father came from a large, quite wealthy family and he remembered being dragged round numerous uncles, gt uncles, cousins etc to pay last respects - but always at home. Presumably the families paid for the doctor and nurses to do home visits and they did the rest themselves. Family doctors used to administer morphine.

Witzend

growstuff

Witzend

Re what they do elsewhere, a French friend of a dd, working in the U.K., is apparently legally required to pay €250 a month towards her dad’s care in France.

She bitterly resents it, because she says he was a useless father, feckless and workshy, which is largely why he has no assets to speak of. I gather that he’s not even all that old, only in his 60s.

That's correct. I believe it's called the "alimentation obligatoire". Children are responsible for their parents' upkeep, no matter where in the world the children live.

How would that go down in the U.K., I wonder??

Though having said that, of course a huge amount of unpaid help for elderly parents is provided by adult children - in the majority of cases the daughters.

That's another point. Historically, people had quite large families and one of the daughters became the carer (not the sons).

Yes. I’m wondering if care homes started to be more frequent after the number of beds in hospitals were cut. We apparently now have fewer beds in hospitals than many other western democracies. If fewer beds were available, then every bed needed to be used for the sick, and nowadays the horrible term bed blockers is used to describe people who no longer need medical care, but have nowhere else to go because they’re not able to look after themselves at home. I’m thinking, but don’t know, that maybe that’s when care homes became more normalised.
My own grandmother went to live in a care home in the early eighties after she had a fall, broke her pelvis and suffered a small stroke. She would have been about 88 then I think. It was a council run home because she didn’t have any money. It was lovely and the staff were very caring.
My mother spent her last year in a lovely care home, but she was self funding, although the NHS paid for her first three months after she was hospitalised with a broken shoulder after a fall. My father in law also spent a little over a year in a care home, self funding, before he died. That was also a lovely home with caring staff.
I think many people who are in care homes would probably have died earlier without the care and treatment they received from the NHS.

growstuff

Witzend

Re what they do elsewhere, a French friend of a dd, working in the U.K., is apparently legally required to pay €250 a month towards her dad’s care in France.

She bitterly resents it, because she says he was a useless father, feckless and workshy, which is largely why he has no assets to speak of. I gather that he’s not even all that old, only in his 60s.

That's correct. I believe it's called the "alimentation obligatoire". Children are responsible for their parents' upkeep, no matter where in the world the children live.

How would that go down in the U.K., I wonder??

Though having said that, of course a huge amount of unpaid help for elderly parents is provided by adult children - in the majority of cases the daughters.

maddyone

That’s interesting growstuff.
When did the state start to take over elderly care? I can’t remember much about elderly care homes at all when I was younger, but I was aware of geriatric wards. Nowadays of course, we’re not supposed to call them geriatric wards, my daughter told me that they should be called elderly care wards. Whatever, we all know what is meant by those words. So when did the state take over and provide care homes? Although of course, most care homes are privately run and funded.

I'm not sure. My gt grandmother lived in a home run by the Salvation Army. My grandmother died in a charity home run by the Church of England.

One of my grandfathers actually owned a care home in the 1960s and 70s (and made quite a bit of money out of it). I don't think the residents received state aid - from what I've heard, most of them were wealthy.

As far as I know, the first "care homes" were run by local councils, but I'm not sure when they started. Local authorities have theoretically been responsible for their residents' wellbeing for hundreds of years. (That's why they were so keen to send people back to their "home" parish.) I guess they thought it was better to have people under one roof than begging and dying on the streets.

There are still inappropriate and expensive services for people with learning disabilities and/or autism in the way of assessment treatment units and similar facilities. Bespoke community based care usually costs a lot less in the case of complex disabilities compared to ATU delivered care. In fact they were only supposed to bring short term care whilst alternatives were found, instead people are incarcerated in them for years

There were also asylums for younger people with disabilities and learning difficulties, where people just had a bed in a ward. The idea of treating the elderly, disabled and those with learning difficulties with some dignity is relatively modern. It's one sign of a civilised society, but we haven't worked out yet how we resource it. (And, no, I don't think we should turn the clocks back, but we do need to face some uncomfortable truths.)

That’s interesting growstuff.
When did the state start to take over elderly care? I can’t remember much about elderly care homes at all when I was younger, but I was aware of geriatric wards. Nowadays of course, we’re not supposed to call them geriatric wards, my daughter told me that they should be called elderly care wards. Whatever, we all know what is meant by those words. So when did the state take over and provide care homes? Although of course, most care homes are privately run and funded.

I remember when my grandad was ill elderly care was carried out in hospitals long term, there were wards and wards full of elderly people. He also used t go there for a couple of weeks so my grandma could receive respite

foxie48 My experience with parents, grandparents and other ancestors is similar. My own father died quite suddenly at home. He never had any official "care", although neighbours and family helped him when we could. My mother didn't have any care either until the last couple of weeks of her life, when it was obvious she was dying and she went into a hospice.

My grandfathers died in their 60s. One grandfather went into hospital for a cancer op and never came out. My grandmothers were older. One grandmother was quite frail and paid for help at home until she was too ill and went into a nursing home to die. The alternative would have been to be admitted to a hospital ward.

Two of my gt grandparents died in a hospital geriatric ward. One gt grandparent lived until she was nearly a 100. She lived in a room in my grandparents' house for nearly 20 years until it all got too much for my (now) elderly grandparents and they paid for her to be admitted to a private (charity) home. The alternative would have been a geriatric ward.

Looking through records of other ancestors, some died in the workhouse - not because they were "down and outs", but because workhouses had wards for the elderly and "insane" (ie suffering from dementia). The only alternative was to keep relatives at home and pay for nursing care - there wasn't any state help.