Have Your Say

Community Care’s new online discussion forum is now
underway prompting lively debate on a topical issue. If you want to
contribute just click on the e-mail link at the bottom of this
page.

This week’s issue is the ministerial reshuffle, with
the replacement of John Hutton as social care minister at the
department of health with former education minister Jacqui
Smith.

Hutton has moved sideways to replace John Denham and
is now in charge of primary care and NHS pay and conditions. Alan
Milburn has kept his job as secretary of state for
health.

Just click on the e-mail link below to say what you
think of the changes in Whitehall.

Last week’s question was about new occupational
standards for social workers being drawn up by training body TOPSS.
Do you agree with the introduction of standards, and how wide
should their remit be? You may also have a view on what specialisms
the standards should cover.

Just click on the e-mail link
below.

Feedback to last week’s question is below, including a
view on the care homes crisis:

“I read this with interest, having been a
social worker for 25 years, and having heard all of this before,
plus having been through; student supervisor; practise teacher etc.
One question, where are the people, plus where is the money?

Too many delegates, professional bodies, etc, have spent half of
their careers becoming, not doing. I politely suggest that non of
this will make the slightest difference to good practice which is
carried out daily by working social workers, and the forums etc
should stop talking and get back to work and ease the staff
shortage.“

Nick Savage

“As someone who has worked at a senior level in
a large county social services, and then moved to manage a group of
nursing and residential homes I have experience of both ends of the
telescope.

I remember a very wise comment from my senior AD in SSD saying
when the Griffiths report appeared – “Beware of Greeks Bearing
Gifts”. SSDs took the poisoned chalice and are now reaping the
benefits. Caught between care homes and the government with rising
demands of an ageing population, limited settlements from central
government and rising expectations from consumers the cracks are
now so wide that they cannot be smoothed over.

Yes the care sector has been squeezed by commissioners using
their monopoly purchasing powers to keep prices down. However the
market is changing – the closures of independent sector homes and
many local authority ones too, has led to providers now
experiencing better occupancy yet still on the brink of financial
collapse with the plethora of cost increases created by legislation
– care standards, working time directive, minimum wage,
administering family tax credit plus a welter of other red tape and
regulation – and experiencing massive increases in the dependency
of residents. It is no wonder that businesses where the property
market allows have opted out.

SSDs can sit trying to make out the independent sector is the
devil incarnate for refusing to take residents at uneconomic costs,
but the reality is that fees need to rise on average
£70-£100 per week if the new standards are to be achieved
and sufficient homes are going to stay in the market to meet need.
The 85+ highly dependent elderly population is rising steeply –
these people cannot be kept at home with home care, and anyway in
many areas near full employment mean that care agencies can’t
recruit to provide the care.

Two questions needs to be asked:-

1. Why are older people’s care and nursing fees so much lower
than under 65-year-old people. Is this not ageism which the NSF for
Older People is supposed to outlaw?

2. When is health going to come into the market and start
purchasing some of the care? For too long SSDs have picked up the
tab of faster turn round times in acute hospitals and the closure
of geriatric wards in the 1980s and 1990s. These monies stayed in
the NHS.

Unless the government opens its ears, listens and inwardly
digests what is happening we could end up with an Australia
situation where homes closed and then the government had to throw
money at the problem. If billions of pounds can be found for the
NHS when will some real money be found for older people needing
quality care? John Hutton admitted to the Lancashire Care
Association 18 months ago that the sector needed extra fees, but
where is the cash? Government says they have given it, local
authorities say they can’t find it!! Care homes are in the
middle.

Well the result is the sort of desperate action which is
mushrooming across the country.“

Steve Newton from Lancashire