By Philip Collins in THE TIMES, 15 May 2020
When the reckoning is done on the extent to which poor government exacerbated Britain’s Covid-19 crisis, it is likely that care homes will be the scandal. Infected patients were moved from NHS beds with no consideration of whether the care homes they were sent to would cope. Staff in the care homes were not given enough protective equipment. As the Nightingale hospitals lie all but empty, thousands of elderly people are now dying in care homes.
There needs to be an immediate and decisive series of reversals. Residents and staff must be tested. Where the quarantine facilities are inadequate, residents need to be taken back to hospital. Truly, this is no country in which to be old.
This scandal has been a long time coming, which makes it all the worse. In a decade of Conservative government nothing has happened. Social care, which is buried away in local government rather than in the sanctuary of the NHS, suffered the brunt of austerity. The Cameron government commissioned Andrew Dilnot to lay out the options, promised to legislate, then disappeared down the Brexit rabbit hole. Theresa May’s 2017 election campaign was derailed by bold promises on social care which survived to the extent that her government promised a green paper. It never arrived. The promised green paper was upgraded to a promised white paper in July 2019 but that never arrived either.
The range of options is limited. There are three ways to fund social care. We can wrap it into the NHS and fund it through general taxation, or perhaps a hypothecated levy. We can ask the individual to pay, drawing on savings which might be mandated through a social care auto-enrolment scheme or equity released from the family home. Or we could do some combination of those two options, which is what Dilnot suggested all the way back in 2011 — the individual pays £30,000, subject to means, and then the state steps in. The May government suggested raising the threshold to £80,000 and then forgot all about it.
So, here we are, with this dreadful, unreformed, unloved system in which we are hot-housing infected patients unto death. There is a lot more to this neglect than a technical argument about the money transfers. Beneath the administrative complexity there lurks a failure to deal with the fact of ageing. While the public conversation never gets beyond the right to hang on to a property asset in perpetuity, the official policy is to keep elderly people in their own homes as long as possible, until it is too late for any option other than institutionalisation in a care home which will be, in effect, segregated from polite society.