Covid-19


requires means testing and administering. That is an issue that may also be impacted by Brexit, with the rules of supply and demand in an industry that values foreign workers meaning that, when these become scarce, there is bound to be an upward pressure on wages. However, with many homes on the verge of collapse, there are bound to be opposing forces also. In a normal market, where only the fit


survive, it could be argued that this was a normal part of the business cycle, save that the residential and domiciliary care markets are impacted by other factors. One is that, for most clients, the decision to buy care is not discretionary - their state of health makes it essential for their comfort and survival. A rising tide of wage costs might


therefore be expected to be met by a rising tide of fees, keeping the whole care industry afloat, save that there is a monopoly purchaser skewing the situation. The government, which has its own budget pressures, would ideally provide sufficient funding to meet the care needs of all those unable to pay for their own, but are instead having to make difficult decisions about who gets funding, and at what level. Typically that means those receiving


support get less than the cost of providing care, with many care homes only managing to hold on by attracting private clients who can subsidise those funded by the government. Apart from the moral questions such an implicit ‘tax’ places on these private clients, the future funding of care is a long-standing question yet to be resolved. Sadly, the role underfunding plays in how the industry performs is seldom focused on in those quiet-day news stories, only its consequences. Perhaps the bright light of Covid-19 will


illuminate a hitherto unseen solution to both funding care and carers fairly, but the intractable nature of these challenges does not fill me with hope. Scotland has grasped the thistle and now funds care but this is not the panacea that people were hoping for. Those needing care are still having to


sell their homes to pay for the accommodation element of residing in a home. Those in the industry are also collectively baffled how the care element has been valued at such a small fraction of the amount paid for social service- funded clients, which is generally accepted to be at a level less than the cost of providing care anyway. While the figure being considered south of the border is higher than the


16


I find it difficult to see the moral argument for the most fortunate generation ever in terms of wealth creation not funding their own care where they are able


£100 weekly contribution paid in Scotland, this option does not really work for anyone. So will Covid-19 now persuade the Government to release sufficient money to fund care properly whereby all homes, and not just those able to attract private clients to subsidise those who are state funded, can afford to provide a great service? That would mean a service where care


managers no longer have to make unenviable choices as to who gets the care they need and who must continue to suffer. It also means those receiving care no longer need make a choice between selling their homes or getting the support they need. Will all this happen? Probably not and,


on the last point, would it be equitable anyway? I find it difficult to see the moral argument for the most fortunate generation ever in terms of wealth creation not funding their own care where they are able, given the alternative is for an increased tax burden to fall on a younger generation who are already facing a far bleaker future. In regard to whether there will be more


government money, State funding of social care has already reduced significantly as a consequence of paying off the debt created by the Great Recession of 2008, which many commentators are expecting to look like a speed bump compared to what will follow the coronavirus pandemic. If anything, government funding of social care, and its secondary impacts on care wages and the viability of care homes, is likely to go down rather than up.


Caring for ourselves My final question is whether the coronavirus will lead us to make better decisions about our own health. There are a number of more common correlations to Covid-19, including age, ethnicity, obesity, and suffering between one and three pre-existing conditions, many of which are also linked to obesity such as type 2 diabetes. The UK is among the worst countries


impacted by Covid-19 and is also the most obese in Europe. The fact that we are also the most densely populated country in Europe may also have


accelerated transmission rates, but of all these factors there is only one that most people can personally address. So, will we all now collectively take


more exercise and improve our diets in the knowledge that it is likely to positively impact our vulnerability to Covid-19 and various other health issues? Given that a collective increase in fitness would also help to lift the pressure on the NHS, it is perhaps an obvious win-win situation and is now on the government’s agenda. The cynical side of me fears that, in


regard to this last point, we are more likely to focus on a habit negatively-correlated to Covid-19, smoking, which makes us far less likely to catch it in the first place, and ignore the long-term consequences for us personally and the NHS in general. However, I am also aware that, given a big enough incentive, any change is possible. Will Covid-19 be that incentive?


TCHE


Nick Bruce


Nick Bruce holds a doctorate in business administration from the University of Liverpool and is the founder and non-executive chair of Nightingale Retirement Care, which has been providing care for over 30 years. Nick believes the very real challenges being faced by the care sector are only likely to be resolved through open and honest consideration of all the issues, looked at from all relevant perspectives. If you would like to contribute to this conversation, please get in touch at n.bruce@nightingales.co.uk.


www.thecarehomeenvironment.com• August 2020


Page 1  |  Page 2  |  Page 3  |  Page 4  |  Page 5  |  Page 6  |  Page 7  |  Page 8  |  Page 9  |  Page 10  |  Page 11  |  Page 12  |  Page 13  |  Page 14  |  Page 15  |  Page 16  |  Page 17  |  Page 18  |  Page 19  |  Page 20  |  Page 21  |  Page 22  |  Page 23  |  Page 24  |  Page 25  |  Page 26  |  Page 27  |  Page 28  |  Page 29  |  Page 30  |  Page 31  |  Page 32  |  Page 33  |  Page 34