Q&A


TCHE: Do you think the government is keen to be more directly responsible for social care?


MP: I’m not 100 per cent sure the government knows conclusively which way to go with social care – it is a nettle nobody has wanted to grasp for many years. However, they ought to, because it offers an opportunity for a government or an individual to bring about real change, as Bevan did in 1948. If they were bold, they could leave


behind a true legacy. The issue is whether people are prepared to pay a bit more National Insurance now for better care later. Like the NHS, you could pay for it when you don’t need it and it is there for when you do. I think that is a model to tackle. The


Treasury might not be keen on it, but I think it would save money in the long term. One of the big issues the pandemic has thrown up is that the NHS is run nationally, and social care is run locally. That has caused a big divide between the two. Requiring 152 local authorities to do things differently doesn’t work. In my view, either the NHS is run


locally, like social care, or social care goes national under a national care service. You can’t have two interrelated services, one run nationally and one run locally. That is a recipe for disaster. A way must be found either to merge NHS and social care or at least have them so closely linked that it is seamless.


TCHE: So private providers should be contracted nationally by the Department of Health and Social Care? How do you square the circle with self-funders and residents paid for by the state?


MP: I would run it in a similar way to health where you have public sector - the NHS - and private sector provision for people who can afford a bit more. Providers


could decide to be either a public sector provider or operate in the private market.


TCHE: What do you expect the government to bring forward when they publish their proposals later this year?


MP: We have waited many years for reform, social care has been in crisis for years, which explains why the sector was ill-prepared, under-resourced and under-staffed when coronavirus struck. I hope for root and branch reform, but fear proposals might be watered down because of financial restraints. My hope is they merge NHS and social


care. I worry they will come through with a half-baked approach that just tinkers around the edges and isn’t bold enough. I’m worried they may come up with a contribution to people’s care costs, leave it all run locally and not address the real needs.


TCHE: There has been talk about a pooling model to reform care financing, such as payments made by the over-40s. Do you think that is a possibility?


One of the big issues the pandemic has thrown up is that the NHS is run nationally, and social care is run locally…a way must be found either to merge NHS and social care or at least have them so closely linked that it is seamless


March 2021 • www.thecarehomeenvironment.com


MP: I think it should be earlier. It should work like National Insurance, but with some money going to social care as well as the NHS. I think there is a moral obligation for us to help each other out, as with the NHS. I’ve been in this sector for more than


30 years and there must be a better way forward. People have been talking about it since I have been involved, but now is the time to do something. My view is it’s better to do something that may not be perfect but at least can be refined. We seem to be trying to find a perfect solution but there isn’t one. Let us get on and do something.


TCHE: How might the pandemic change oversight of social care by the Care Quality Commission (CQC)?


MP: There is going to be more scrutiny of the care sector. The CQC is only going to get tougher and I don’t object to that. It’s good to have a watchdog making sure we keep high standards and the CQC has said themselves that we should be investing more in social care. I think it is also vital that CQC has an oversight role in commissioning of social care services.


TCHE: What do you think of the CQC’s performance during the pandemic?


MP: I think they have become more realistic now. I think those at the top of the CQC are more sympathetic than some of the front-line inspectors who aren’t always so understanding about what care home managers have to do to keep the service working.


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