Choice, alongside respect, are already the two most prominent
words in the Labour lexicon if the Queen's Speech is any guide.
Tony Blair's notion of respect has already rightly been much
ridiculed by the media.
Choice, whether in hospitals, schools or long-term care homes, will
benefit the middle classes most - because they have the knowledge,
confidence and extra cash to make it work in their favour. Labour
does not yet appear keen to properly address the issue of what
happens to those who have only the leftovers.
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The Office of Fair Trading's study of British care homes, for
instance, has uncovered substantial failings in the sector worth
£8bn. Its report says three-quarters of the residency
contracts contain "unfair or unclear" billing terms. One fifth of
care homes charge residents who pay their own bills more than those
funded by local authorities. The OFT's recommendations are sound,
among them a one-stop shop for information, care home inspection
reports to be made available online and greater transparency on
costs.
Counsel and Care, a small independent charity working for older
people and their carers, has an excellent range of factsheets and
has published, with the Department of Health, The Care Home
Guide.
Still, a basic dilemma remains which may grow more acute. How do we
pay for quality, long-term care that offers genuine choice to
all?
Many care homes are ripping off some of its residents because it is
impossible to operate on the money provided by local
authority.
Nine years ago the Joseph Rowntree Foundation proposed that
long-term care should be free at the point of delivery (as it is
now in Scotland) but funded by a compulsory national care insurance
scheme. It pointed out that wages of staff must rise and conditions
improve.
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It also proposed that improved health education, more investment in
low-intensity support to keep people in their own homes and better
intermediate help on leaving hospital would reduce the number of
people requiring care - all suggestions beyond cash-strapped local
authorities on the scale required at present.
We have 20 years before a huge increase in demand kicks in as baby
boomers reach old age and their children are less able or willing
to act as carers. Without radical action, many poor older people
will face only one choice in care homes - between the bad and the
scandalous.
Yvonne Roberts
