Keep Calm but Let’s not just Carry On

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The current affairs discussion group seems to be growing in popularity – we regularly have slightly more residents than can comfortably sit round a table these days. It remains broadly unpredictable however.

I can rarely guess the topics that the group will choose to discuss each week. I normally select four or five potential topics from my favourite newspaper (BBC website) and the group choose one or two that they fancy having some intelligent debate about. Some topics are humorous. Some serious. Some seem both (Step forward Mr Trump. Ah. That’s no longer a joke).

We recently took on the serious and relevant crisis in care to talk about.

Nursing homes are closing every week and providers have started to pull out of home care contracts. These now include not for profit providers. When the not for profit sector cannot make care stack up, the government should pay attention. Middleton Hall and the top quality providers are generally not reliant on publicly funded clients, so are very fortunate.

I am not going to blame local councils. The simple fact is that they do not have enough money and with the advent of the so called National Living Wage increasing costs it is no surprise that 15 minute care visits at homes still exist and care providers are struggling.

Of course, all this has an impact on the other rather large elephant in the room. The NHS. More elderly people ending up in hospital sometimes becoming “bed blockers”. Lack of social care resulting in more hospital admissions.

When the NHS was created in 1948 (along with the origins of modern social care), hospitals put a few limbs in plaster and whipped out the odd appendix. Life expectancy was 66 for men and 71 for women. Medical care has got a great deal more complicated now and consequently a great deal more expensive. In 1948, the budget for drugs was £30M. It is now over £15B.

We live in a different world now. Once we reach 65 we now have almost 20 years to live. Which means potentially 20 years not working or paying tax but increasingly using public services.

Surely it is time to accept that we cannot sustain this. Which means many of us in the future will have to pay – for healthcare as well as social care. And yet, no political party is prepared to break for cover and admit that is what is needed.

One member of the discussion group is a retired doctor. Even when she was still working, it was clear to her that a free for all NHS was no longer possible. The rest of the group all agreed that people would have to pay. But why do our political leaders refuse to raise the possibility?

“It is not really voter friendly” concluded the group. And they were honest enough to admit they would be reluctant to vote for a party that proposed charging for the NHS. A slight element of turkeys voting for Christmas perhaps.

But surely it is time to be realistic. The current system is clearly unsustainable. So how about some political honesty in at least talking about the reality – and the long term solutions?

The Care Act was never going to solve the problem, but of course was a vote winner for retired people believing they would not lose their savings paying for care and for their families thinking their inheritance was safe. The current generation of baby boomers is wealthier than the previous generation, largely due to unprecedented house price inflation and threatens to live even longer. So it is hardly unreasonable that we should have to pay for increasingly expensive healthcare and social care.

So, let’s be calm about the current care crisis but not just carry on.