June 8, 2011

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Most elderly and disabled people who live in care homes have their fees paid for by the government and people in care homes are some of the most vulnerable in our society.

The publicity about abuse at one care home and the financial difficulties at another group of care homes highlights the concerns about the speed and scale of the cuts being made by the government. The lack of money means companies which run care homes can go bust with huge risks for the people in the homes. But the cuts also mean less money for wages, less for training and less for regulation of care homes. The Care Quality Commission regulates care homes but has had its budget slashed meaning fewer inspectors with less time to visit homes and check whether staff are looking after the residents or not.

The Prime Minister, David Cameron says he is against "excessive regulation and bureaucracy". He also says that "the grip of state control will be released" from "the enemies of enterprise" as he stops the "dead hand of the state getting in the way". Writing in the Daily Telegraph back in February, he was two weeks away from publishing an open public services white paper which would, he promised, "create a new presumption … that public services should be open to a range of providers competing to offer a better service".

One of the Prime Minister’s own Conservative MPs, Sarah Wollaston is also a GP. She says: "It can't be right to make a fast buck and leave the taxpayer with the bill", and adds: "The idea competition drives up standards in care isn't necessarily the case." I completely agree with Dr Wollaston and there is a very real danger that hospital trusts could fall into the same trap, making more money from their property than from treating patients.

Too few badly paid, under-supervised carers will often mean neglect, but the only way private companies can make significant profits out of most of their vulnerable residents is by hiring cheaper, worse-trained staff. Local authority and charitable homes pay higher wages for better care but the government calls that "feather-bedding". Many regulators are burdened with tasks beyond their resources. Many Sefton residents work for HMRC. Just 100 HMRC inspectors check all employers to make sure they are paying the minimum wage. Inspection of employers is the only effective way of finding illegal immigrants. No wonder illegal immigrants are rarely found. I have argued before that enforcing minimum wage rules would at a stroke stop illegal immigrants being paid less than local staff and stop them being employed in preference to local staff. Ofsted should complain it can't properly inspect the vast private daycare and nursery sector – another scandal waiting to happen where the money the state pays in care credits doesn't cover the standards expected.

I have very real concerns about the dangers of inadequate inspection – and about the possibility of financiers making a killing out of the most vulnerable. The public is rightly very worried about privatisation of services for the weak. The Prime Minister ignored political warnings about his government’s NHS plans, which have already cost £1bn and met with strong public resistance. The care home crisis shows all the inherent risks in a privately-run NHS.

The care homes scandal shows just what happens when financiers are free to make a profit out of the most vulnerable without regulation, proper standards or the public money to pay for those standards. Perhaps the Prime Minister will think again about whether privatisation is the way forward when it comes to care for the elderly and disabled. I also hope he will scrap his expensive and flawed NHS reforms before it is too late and before health care in this country suffers the same fate as the care industry.

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