Ministers failing in their duty of care

Published by The i paper (24th February, 2020)

As someone whose father has severe dementia and daughter needs full-time care for profound disabilities, I have witnessed this country’s reliance on care workers from Europe. As I write these words, an Italian has just administered emergency medication to my daughter after another distressing epileptic seizure, while a Lithuanian tends to my seriously ill father. So I have deep gratitude towards people from across the continent that have helped to keep my family afloat in tough times.

This was one key reason for my opposition to Brexit, a battle that foundered on the rocks of fear over immigration. But even in 2016, at peak of the panic whipped up over refugees from Syria’s tragic war, polls indicated that voters preferred to see more rather than fewer care workers from abroad. Since then the social care crisis has escalated, which terrifies families such as mine that rely on the state.

This government’s flint-hearted response, however, has been to make matters worse. As ministers pontificate about luring ‘the brightest and best’ and advisers flirt with eugenics, the ‘points-based’ migration strategy released by the Home Secretary, Priti Patel, did not even mention the word ‘care’. They view people aiding others who are sick, old or disabled as ‘low skilled’ on the basis of earnings, denying them even the special status offered to billionaires, footballers and fruit-pickers.

It is thought two-thirds of current European Union carers and health workers would fail to make the cut. This smacks of arrogant contempt towards these sectors, their staff and our citizens in need of help. Cheerleaders argue that it is alarmist to raise fears. But there are already 120,000 vacancies in a sector with high churn and rising demand.

The Nuffield Trust think-tank suggests that we need 90,000 more staff. ‘Migration has been a crucial safety valve for crisis-stricken social care services, filling vital roles helping people with basic tasks like washing, dressing and personal hygiene,’ said its chief economist, John Appleby. ‘Stopping migration for social care risks pushing a sector on which many vulnerable people depend over the edge.’

Boris Johnson lied about possessing a social care plan when he entered Downing Street. His deception followed at least 17 white papers, green papers and reviews of funding over the past two decades. Patel’s fraudulent claim that there are eight million inactive workers needing jobs adds cruel insult to injury for all those worn-out family carers looking after loved ones. A £1.5bn bung for social care is barely a sticking plaster for a sector left so badly wounded by austerity, which hit local authorities hardest – especially when a welcome rise in the minimum wage is about to push up costs.

The care crisis goes far beyond the media focus on middle-class families forced to sell homes. To take one issue close to my heart: how do we get people with autism and learning disabilities out of abusive detention if there are no staff to help them in the community? The health secretary, Matt Hancock, faces legal action on this front from the Equalities and Human Rights Commission unless he can explain how they will solve housing and staff shortfalls. And it is not just about pay, despite often-dreadful wages that deter staff, since even decent payers are facing hiring struggles. This issue symbolises the huge chasm between Westminister rhetoric and realities on the ground.

Take a look at an outfit called CareTech, which posted its annual accounts last week. It is not a well-known company, perhaps because it operates under a variety of names. It is, however, one of the most important care operators in this country. Starting with an investment by two brothers in a single property, it has become our biggest provider of foster care and children’s homes, while also running services for people with autism, learning disabilities and mental health struggles. The firm’s website contains the usual guff about ‘building brighter futures’, although one of its residential units was strongly criticised last month by the Care Quality Commission.

Certainly, its founders, Farouq and Haroon Sheikh, can look forward to a bright future since they pocketed pay packages worth a combined £1,705,000 last year, aided by bonuses that doubled their chunky salaries as chairman and chief executive. Their family collected another £1.48m in dividend payments after revenues more than doubled to £395m and profits before tax surged to £50.2m. Impressive figures. Another £50,000 has been bunged on each brother’s basic pay this year. Meanwhile, CareTech seeks a team leader at one care home on less than £9 an hour and crucial night staff on minimum wage.

Johnson says the NHS is not for sale,  but this firm’s document is filled with glowing words about a growing private sector for services targeted at foster children and adults with learning disabilities. It admits that public bodies face a ‘conundrum’ with demand rising as resources remain ‘largely static’, adding: ‘One response has been to move money away from the NHS.’ CareTech is among a shoal of firms that have moved in like sharks on the care and psychiatric health sectors. Others, often with dire track records, are owned by American health corporations and private-equity players.

This is the flipside of the care crisis that exposes grotesque inequality, callous irresponsibility towards vulnerable citizens and a shocking failure to control capitalism at its most distasteful. Now this private sector, sensing a shift away from lucrative institutionalisation amid anger over abuse, is fighting to relax controls on community provision so that it can run bigger places and keep profits flowing. This should be resisted. Capitulation, however, seems more likely under Johnson’s government.

Ministers bleat about the left behind, about levelling up, about mental health, about protecting the NHS, about helping sick, elderly and disabled people. But last week showed in starkest light possible how little they care about anything beyond themselves.

Categorised in: Health, home page, Public policy