21 April 2020
The COVID19 epidemic has exposed the glaring inadequacies of social care in the UK. Reflecting how older people receiving social care are often hidden and forgotten, it took several weeks before the government admitted that the daily numbers of people dying from COVID19 only included people in hospital and not in care homes or the community. Perhaps even more insidious has been an unstated assumption by government that older people will have to be expendable during this crisis because they were expected to be more vulnerable to COVID19. This is at the heart of a much greater prejudice towards older people and people with disabilities that exists in the UK.
The majority of social care services are run by for-profit companies or not-for profit organisations. Very few care services are delivered by the public sector. As a result, government is not directly responsible for how services are delivered, how services fit into wider systems of accountability and how they are measured and assessed. Whilst hospitals have a transparent system for recording deaths quickly, care home deaths are recorded by local GPs, along with other deaths in the community and so take longer to be registered.
The provision of personal, protective equipment (PPE) has been inadequate in the NHS showing how limited government planning and preparation was for this pandemic. However, it again took several weeks to realise that care workers, in care homes and the community, also needed PPE. This provision has been even more inadequate.
The current public health emergency is expected to continue for many months and there may well be future coronavirus pandemics. This means that public health planning must be given greater priority and has to include the social care sector. The problems with recording of deaths and provision of PPE reflect a lack of awareness in government of the social care sector.
The invisibility of care home deaths and the health and safety of care workers show that social care services can no longer be dependent on for-profit companies, which trade profits against service provision. Care services should be part of a National Care Service which is the direct responsibility of government. It would be subject to national regulations, guidance and central government funding just like the NHS. It would be delivered through local government because care services need to be locally planned, managed and delivered to meet local needs, involving local people and local care workers. Care workers would be on the same pay scales as NHS workers with the same benefits and training. Only then will care services be given the recognition that is needed if older people and people with disabilities are to be cared for with dignity and compassion.
By Jane Lethbridge, Centre for Research in Employment and Work (CREW) and Public Services International Research Unit (PSIRU), University of Greenwich email@example.com