Link to this page: http://www.socialistparty.org.uk/issue/621/9410
National Care Service - fact or fiction?
And how will it be paid for?
MOST RESEARCH suggests that the general population is living longer. Advances in science and healthcare mean that more conditions are treatable and many people with previously life-threatening conditions can now live well into old age. Socialists welcome these advances, but we also have to explain that people living in poverty or on low incomes still live much shorter lives than their rich counterparts.
Paul Couchman, TUSC parliamentary candidate for Spelthorne
One of the results of longer life-expectancy is the need for better and more widely available social care for elderly people and disabled adults. The New Labour government has published a White Paper (discussion paper) called Building the National Care Service. On the face of it, the proposals sound progressive. The new National Care Service will apparently:
- Be universal - supporting all adults with an eligible care need within a framework of national entitlements.
- Be free when people need it - based on need rather than the ability to pay.
- Work in partnership - with all the different organisations and people who support individuals with care and support.
- Ensure choice and control.
- Support family, carers and community life.
- Be accessible - easy to understand and use.
But just weeks before the general election and Labour is already backtracking and now says the new service will not come into being until 2016.
Cuts are already being made in care services in local authorities across the country and Labour, the Tories and the Lib Dems all clearly state that more cuts are on the agenda.
The government says that efficiency savings (read cuts) of around £4 billion will have to be found in social care from 2014. All the three parties agree that the level of cuts after the election will be 'even worse than under Margaret Thatcher'.
Read between the lines and it is clear that this White Paper will do nothing to enhance the lives of vulnerable adults in our communities. It is also likely that the bill will not be passed by an incoming Tory government or hung parliament.
Eligibility criteria are now so high in many councils that only those who are at death's door or who cannot care for themselves at all are receiving services. The level of services when you do meet the criteria is a scandal in many areas - a ten minute visit from a private homecare agency to check you are still breathing, then the company charges the council for a half-hour personal care service!
Increased 'Choice and Control' has become synonymous with closing day centres and residential homes, whilst repeating the mantra that 'people should stay in their own homes'.
Direct Payments (cash for care) and Self-Directed Support (individual budgets) are just other ways of 'saving' money while hiding behind a cloak of progressive, disability-friendly policies.
The truth is that many more vulnerable adults, elderly and disabled people will become isolated and neglected over the coming months as social care budgets are cut and day and residential options closed.
It may well be nicer to remain in your own home rather than go into residential care, but if the services are not in place to support you at home then you are actually in a very dangerous place. Every week the media shows another vulnerable adult who has been abused or killed when living in their own home.
For independent living to be truly safe and to be a real choice then billions of pounds of real investment needs to go into home care, social work and outreach services.
What does the government mean when it talks about 'partnerships'? On past experience this means working with the private sector - selling off our social care services (such as home care which is now 85% privately run) and siphoning public money into the private purse.
Partnership working with families actually means asking family members (usually women) to give up their time to provide extra unpaid care to loved ones. Working in partnership can also mean passing the buck to the poorly-funded and ill-equipped voluntary sector and local charities who have already stated that they are facing a funding crisis.
The 'comprehensive' element of the new National Care Service, if it was treated in the same way as the National Health Service is meant to be, ie fully funded by government and free to all at the point of need, would be welcomed by socialists. But New Labour will not deliver this.
A socialist government would though and could pay for it by re-nationalising the gas, electricity, telecommunications, transport and water companies under workers' and users' control - providing compensation to shareholders only on the basis of proven need. The top 150 companies should also be nationalised.
The massive wealth and productive potential of these national and multinational companies could then be ploughed back into the NHS and also fully fund and provide for a truly universal care service, education and other public services.
In The Socialist 21 April 2010:
Youth fight for jobs
Socialist Party editorial
Socialist Party news and analysis
Socialist Party election campaign
International socialist news and analysis
Socialist Party features
Socialist Party workplace news