Curiously, Alan Milburn chose the last possible parliamentary day –
digging deeply into the holiday season – to reveal his programme
for the care of older people. Similar considerations appear to have
governed the publication of new draft environmental standards for
care homes in the middle of August.
The secretary of state spoke of his plans for expanding services
and increasing choices for older people. By 2006, an extra
£1bn will be available, but these new monies will only begin
to flow from April next year. As a package, it identifies the right
targets, but it seems a rather thin and lethargic approach to what
is a serious, perhaps critical, problem area.
Milburn’s £1bn will have to work hard if it is to meet one let
alone all six of his key targets. Stabilising the care home sector
alone suggests a shortfall of this magnitude now – not in 2006 – in
just this single area. Relaxing details around room sizes and other
aspects of the Care Standards Act 2000 may ameliorate this
situation, but not solve it. The principles of the Care Standards
Act should not be diluted.
Faster care assessments, with specific deadlines, is a worthy
target, even if it causes apoplexy in social services departments.
And these departments have the right to feel apoplectic if the
Swedish fining system is imposed on them unilaterally.
Extra-care housing schemes and better community equipment services
were also part of Milburn’s statement. Both are good, and it is
probable that both will form a major part in the provision of
support to our older population in the future to live independently
and remain socially included. But again, the statement is short and
coy on how and when progress will be made.
Nevertheless, this package does not deserve to be left in a holiday
lacuna. It should have been announced in 1997 rather than five
years into government, and it would be better for a sharper
timetable for outcomes. Many of the people needing care today will
have only a posthumous interest in 2006.
As an agenda, the minister has touched on a raft of key points. The
crunch is whether the financial package is likely to be adequate.
This seems improbable. The care sector is people-intensive,
characterised by low wages and high staff turnover. Given the need
to introduce a new professional ethos, the allocation of £70m
by 2006 to support training seems decidedly modest.
Above all, despite the more sympathetic language about caring needs
and tasks, the prevalent flavour, common to so many DoH documents,
is still that caring is about looking after people without
hospitalising them – of preserving independence and promoting
self-esteem and a positive lifestyle. But this is still some way
from being the policy driver.
Mervyn Kohler is head of public affairs, Help the