If there’s one good thing about Southern Cross and Winterbourne View, it’s that they bring the scandal over care for the elderly to boiling point. Yes, the depredations of uncontrolled private equity in both cases masking a killing out of the most vulnerable should now lead to regulation reining them in over social care – fat chance under Osborne and Cameron. But at least the silent crisis over social care is given voice which should echo through the dark corridors of cuts-obsessed Whitehall. The killer fact is this: since 2004 net spending on social care for the elderly has risen by just 0.1% a year in real terms, a total of £43m. Over the same period real spending on the NHS has risen by £25,000m.
Spending cuts will of course make this much worse. Even on optimistic assumptions, spending on care for the elderly is due to be cut by £300m over the next 4 years. Spending in real terms on oler people’s care will be £250m lower in 2014 than 10 years previously. Yet over the same period the number of people over 85 has risen by two-thirds or an extra 630,000 people.
Even before the cuts really begin to bite, care of the elderly has been cut back drastically, largely because elderly people have the least capacity to fight back. In 2005 half of all Councils provided support to peopole assessed as having ‘moderate’ needs; this year it was down to less than a fifth. This means that the number of people receiving Council-funded care at home has been slashed over the last 5 years from nearly half a million to less than 300,000.
And the quality of care has sharply declined, as the current scandals expose. The cuts have decimated regulation too. CQC’s budget is now 30% less than the regulators it replaced, so in the past year it has had to cut its inspection by a massive 70%. Its 900 inspectors have to cover more than 8,000 GP practices, 400 NHS Trusts, 9,000 dental practices and 18,000 care homes. Of course it’s easy to point the finger of blame at CQC (and they certainly should have responded right away to the whistleblower), but the real fault lies with the cuts – and with their failure to complain publicly that it made their function impossible.
Similarly local authorities grossly under-pay for elderly people’s care homes – because it’s easy to make a big cut without any public fuss. The average shortfall per resident is estimated by Age UK to be £60 a week, and even double that in the South-East. That then gets reflected in diminished service, poor pay, lack of staff training – and abuse. Indeed many care homes are now demanding that families ‘top up’ the shortfall – a move not just to privatised homes, but to wholly private care, as before 1948.