A CRISIS OF CARE

By Tim Cocking
Director of Bright Care

Jeremy Hunt is right to highlight the loneliness of the elderly in the UK as “Britain’s National Shame” and to raise the plight of the “forgotten million” older people who have little social contact with family or neighbours.

Tim Cocking of Brightcare

The Health Secretary is also justified, in his recent speech to care groups, to call for a change in social attitudes towards the old and urge people to change the way they treat their parents and grandparents.

He would have done well, however, also to emphasise to the current generation of baby boomers that high among their list of priorities should be their responsibility to make financial provision for care – not only for their elderly parents but also, very soon, for themselves – because health care is not free! This is a deep-seated misconception among a generation which has grown up being told that, in the country which invented the National Health Service, care is free at the point of delivery. Everything has a cost, and even if people are not handing over a cheque to their doctors, it is still being paid for indirectly through the common pool of tax receipts – and that pool is drying up. We are running out of money.

Already, we are seeing what we previously considered to be minimum standards of care pared back even further. The controversy over local authorities outsourcing home care visits to the private sector – and limiting them to 15 minutes at a time – is a case in point. It is a consequence of central government’s policy objective – implemented by councils – of attempting to look after the largest possible number of older people while employing the smallest possible amount of money and resources.

The State will not provide care in the future

Curiously, to deliver this “free service”, local authorities increasingly outsource the deliver of these services to the private sector. The private sector are being asked to supply full provision at a rate of between £12 and £14 an hour. However, if local authorities provide the same services in-house – as 25-30% are in Edinburgh and up to 50% in places such as South Lanarkshire – the cost to the tax payer can as much as £25 to £35 an hour.

This is, at the root of it, because public sector is not as efficient, care workers’ wages are higher and they have much more generous benefit and pensions packages, which the private sector can simply not compete with. But the fact remains that the private sector is being asked to provide a service at half price.

However, regardless of a local authorities commissioning policy, free care services simply cannot continue. The public purse is emptying fast and the politically desirable concept of universal free personal care is simply unsustainable. It will disappear in Scotland within five years, whether we opt for independence or not. When that happens, as it inevitably will, anyone who wants care will have to pay for it. But the ageing baby boomers are completely unprepared and have not thought through the implications of having to pay privately.

The private sector will have to take up the slack

Social care is expensive. Even the part which is considered at the moment to be “free” would only comprise about 25% of what would reasonably be considered a holistic care package. So who pays for the other 75%? The reality is that it will have to be funded privately or provided by friends, family, neighbours or local community groups.

Jeremy Hunt, whose wife is Chinese, said that Britons should take a leaf out of China and Japan’s book where residential care is a last, rather than a first option, and most older people are looked after in the family. Again, he has a point, but the reality is that most affluent individuals or people who are in good careers or have their own children or grandchildren to look after, are just going to pay for care rather than taking in an elderly relative.

Care in the home is the preferred option
(Pic from a Scottish Parliament report)

Fifty years ago we were more like Asia, and care was kept in the family, but families are moving further apart, they have less time on their hands and priorities are changing. There may be an assumption that the government will continue to provide for older people; but it is unwarranted because there is no money left.

The burden passed by baby boomers to the next generation is staggering. It has been calculated at £7.8 trillion. This means that more than £80 billion a year is needed in extra tax in the UK (roughly a 15% increase on current levels).

With the rise of property prices and increasing costs of everyday living can the next generation really cope with this? The simple answer is no, and self-funding of care is now well on the way from possibility to cast-iron certainty.

For further information, contact Tim Cocking,
Director, Bright Care,
Summerside, Old Dalkeith Road, by Sheriffhall, Edinburgh EH22 1RT.
T: 0131 524 8181
Registered with the Care Commission: CS2009232912.