Jeremy Walford, Managing Director
Middleton Hall Retirement Village.
“My personal views, comments and thoughts on subjects and topics related to retirement living”.
So we have a “snap election”. Some election bribes have been offered out (students clearly being part of Labour’s target market) and of course politicians on all sides are offering to throw money at the NHS.
Briefly there appeared to be some space opening up in policy terms around social care, before the Conservative party rushed into a U turn after some newspapers used the dreaded “dementia tax” label.
Amidst all this debate (some even focussing on policy rather than personality), it would be great to see courage and leadership shown about the problems in the NHS and Social Care. I fear this will not happen.
Before the election announcement, the government announced a green paper on the future of social care. Yet another no doubt lengthy report that will follow the usual routine. Concerns will be raised about funding, government will feel discomfort about how to deal with the issues so end up playing for time – preferably so the next government will have to deal with it.
The spectre of funding for social care has been stalking the corridors of different governments for over 10 years now and despite various Royal Commissions, Green Papers, White Papers and some actual laws nothing has really changed. The last attempt emanating from the Dilnot Commission produced the Care Act which included the infamous care cap. When the Department of Health finally realised the impact that it would have on the social care market as well as public funding, it was booted into the long grass until 2020 (conveniently after the next election was then due).
And that has been the way of the last 10 or more years. Put it off. Preferably until someone else will have to deal with it.
But neither the NHS nor social care industry can wait. More importantly, nor can older people trapped in hospital beds, in underfunded care homes or receiving inadequate care at home. Crisis is perhaps a rather overused term, but the social care crisis is now real.
Middleton Hall is fortunate in having customers who recognise that they want quality and are prepared to pay for it. But that is only part of the market. Those who do not have that choice are being ill served by our political masters.
History suggests that no government is really prepared to deal with the problem. And with a five year (or less when that is more convenient) election cycle, it is always too easy to find a way of putting it off. So let’s not have more reports or commissions. Let’s have some courage.
Courage for a cross party agreement, not an election gimmick. Courage to face up to the uncomfortable truth.
The truth that we can no longer afford to maintain either the NHS or social care without either accepting that many of us will have to pay more tax or many of us will have to pay for our care.
So party leaders – how about some real leadership? Never mind the election gimmicks and whether someone has the right charisma or dress sense to be Prime Minister but how about someone prepared to speak the truth. We cannot have a low tax economy and high quality public services – especially with something as important as social and health care.
No more vague promises or putting it off. Just be honest with we electors.
Although not any sort of rugby expert, I do enjoy watching Rugby Union. The Six Nations has been interesting this season – England’s winning run equalling the world record and Scotland appearing to provide serious opposition. Until they met England on Saturday at Twickenham that is.
England have extended their winning run to 18 consecutive wins and if they beat Ireland next Saturday will have achieved back to back grand slams in the Six Nations. Interestingly though, for most of the Six Nations they have not actually played terribly well. In some matches they barely turned up for the first half. Despite that they keep winning, which is perhaps a sign of a good team.
On Saturday, they managed to turn up for both halves and Scotland’s new found pride did not last long (nor that of their female counterparts after an equally uncomfortable encounter against the potential grand slam winning England Women). England suddenly looked like real champions. Comparisons with the New Zealand All Blacks may seem premature (beating the All Blacks is not, yet, part of their winning run). However, there are some parallels with the 2003 World Cup winning side.
England won the 2003 World Cup for many reasons. One of those reasons was the drive, leadership and determination of captain (Martin Johnson) and the vision and planning of coach (Sir Clive Woodward). One of Clive’s catch phrases was “Getting Better Never Stops”.
Having previously written about the All Blacks’ values in my blog, another Rugby/Middleton Hall comparison springs to mind.
Last week, Middleton Hall Retirement Village was awarded the coveted “Outstanding” by CQC (Care Quality Commission) following a three day, unannounced inspection in January. Only 0.5% of care homes have achieved “Outstanding”. But Middleton Hall achieved something more impressive – our outstanding team achieved the very rare feat of being rated as outstanding in all five key areas of that CQC inspection. The Grand Slam of Outstanding.
As a result, we received a visit from Debbie Westhead (Deputy Chief Inspector, CQC) last Thursday and also met Andrea Sutcliffe (Chief Inspector, CQC) at an awards dinner that evening. Both asked me how I felt about our outstanding achievement. I said that, in honesty, I had mixed feelings about it. Because I am worried that people might confuse this achievement with being the destination rather than a step on the journey.
You see, I truly feel that Middleton Hall can improve much further and that we still have far more work to do.
Sir Clive Woodward’s mantra is the point. Getting Better Never Stops.
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.