Q&A


The time is now for a national care service


Mike Padgham, managing director of the North Yorkshire-based Saint Cecilia’s Care Group and chairman of the Independent Care Group, talks to The Care Home Environment editor Tim Probert about the need for a post-pandemic national care service


TCHE:At around a third of total Covid- related deaths, care homes have borne the brunt of the pandemic. What could have been done differently at the start to have prevented so many deaths?


Mike Padgham (MP): The government was slow to recognise that care and nursing homes are on the front line, despite our warnings. They were slow to supply proper PPE and testing, as well as financial support. People in care and nursing homes were extremely vulnerable and susceptible to Covid-19 but the government concentrated too much on NHS care. The advice at the start was that care homes did not need to do anything different! But you can’t talk about it without


mentioning that social care has been forgotten about in the past. I blame governments of all parties - Labour, coalition, Conservative - for the state that social care is in now. They all had their chance, and all were


in power for quite a long time. We were not prepared for the pandemic because of two decades, if not more, of neglect. We were weak at the start and it has to be set in that context.


TCHE: How do you rate the government’s handling of the pandemic?


MP: Mixed. It was slow to react at first and slow to provide PPE and financial support to the sector and testing when hospital patients were discharged. At times it was also guilty of a lack of direction and clear instructions over visiting and lockdowns, for example. Support over indemnification was also lacking for a long time. Things have improved over the year


and I will give them credit for the vaccine. Obviously, there were others involved with the vaccines, but the government


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care, funded by taxation or National Insurance, a guarantee that people receiving publicly funded care can receive it in their own home or close to where they live, and a commissioner for older people and those with Learning Disabilities in England. I would like to see a properly costed


Mike Padgham, managing director, Saint Cecilia’s Care Group


deserves credit for making the programme happen quickly. The way they have worked to get the vaccines out to the public has been fantastic. But I don’t think they did throw a


protective ring around social care and I believe that we were neglected. I have also noticed that Matt Hancock seems to have stopped wearing the ‘CARE’ badge he was so keen to be seen with last spring. That seems to have been forgotten. I don’t think any government would


have got everything right because it was impossible. My angst about the government would have been the same with any government. All the parties share equal blame for social care being in a poor position when the pandemic struck.


TCHE: What do you want to see from the government in relation to social care reform in response to the pandemic?


MP: A root and branch overhaul of the way social care is planned and funded with NHS care and social care merged and managed either locally or nationally. That involves extra funding for social


national rate for care fees linked to a national career pathway and salary framework for care staff, dementia treated like other high priority illnesses like cancer and heart disease, a fixed percentage of GDP to be spent on social care and a cap on social care costs, including ‘hotel’ charges. If there is one thing I would like to see


come out of the pandemic, it is a radical shakeup of social care that creates something like a national care service. I think this is the moment to do it and the government should seize the opportunity and do it this year.


TCHE: How would a national care service work?


MP: I think it could work in a similar way to GPs, who are private individuals but working within the NHS. That’s how it came about in 1948 in the first place - they were paid to come into the NHS but retain their independent contractor status. They are independent businesses, but they work for the state with certain guarantees. That is a model we could look at.


The mistake was that social care never became part of the NHS in 1948. In those days life expectancy was lower and there was less need for social care. People rarely lived long enough to need it. Nowadays, people may live another 40 years beyond retirement age, often with complex care needs.


www.thecarehomeenvironment.com • March 2021


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