Private care + reduced oversight = chaos
I was once in Yendi, Northern Ghana talking to a tribal chief about old people. I was trying to explain to him what a British elderly care home is. He was shocked to the core: “You mean you take them away from the family, from the village?” he asked. “Yes”, I said, “we put them into homes run by the state”.
“But what happens to all their knowledge, all their wisdom?” he asked.
“I’m afraid that goes with them”, I said.
“Well, he said in Yendi, the elderly are the centrepiece of the village, we come to them for everything – advice, wisdom, and good jokes!”.
The exchange has dated. the urbanisation of Africa must now be leading to some sort of embryonic crisis in elderly care. But I doubt they have yet even begun to get themselves into the shambles we are now in. It ain’t the state housing them any more – it’s something called the ‘care industry’. What an ugly ‘Brave New World’ kind of term.
The failure of Southern Cross’s business model and the risk it poses to its 31,000 residents, is only the tip of a much deeper crisis. A crisis with a different dimension is horribly expressed in the Bristol private hospital tending for vulnerable young people (exposed by BBC Panorama, for terrorising its residents earlier this week.
It’s easy to castigate private contractors. What is harder is to understand the appalling mess the people we elect have allowed to unfold. How can anyone have thought that privatising elderly and vulnerable care homes could be accompanied by a concurrent slashing of the regulatory machinery designed to ensure they were functioning properly.
A senior staff nurse at the Bristol hospital blew the whistle not once but three times to the regulator the Care Quality Commission (CQC). They did nothing, and little wonder. The numbers of inspectors have been cut, the number of inspections they can make has consequently been reduced in some areas by a staggering 70 per cent.
In neither the Bristol abuse case nor the Southern Cross failure did the regulator warn early enough of catastrophe. But was the regulator in either case still adequately equipped to do the job? Or had ‘cuts’ neutralised their capacity for oversight?
It is enormous propaganda fun to attack Britain’s Quangogracy, but regulatory quangos are the absolutely only mechanism we have to monitor these industrial care conglomerates. And it isn’t just the CQC. Spare a thought for the Audit Commission, one of the most regarded spending watchdogs in the Western World. It is having to hobble along under sentence of death. So vital are its findings that no one has yet dared to pull the final chord to kill it off. But they will.
What am I to tell my tribal chief in Northern Ghana? ‘Chief, I forgot to say – not only do we park these old and vulnerable folks in separated homes, but we are reducing the system for ensuring that the inmates stay alive and unbeaten inside.