Reports and Campaigns
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Beyond the crisis point: saving social care
Social care is "beyond the crisis point" according to providers. This issue, alongside the NHS, could play a crucial role in the snap general election campaign. Trade union organiser 'Glynn Doherty' takes a look at the sector, and proposes a programme for the immediate future.
Over a sixth of the UK's population has a long-term health condition or is disabled. Life expectancy is now 79 years for a man and 83 for a woman. Almost 70,000 children and young people are in council care.
As the crisis in NHS funding has developed over the past decades, the need for a robust social care system has become ever more pressing, especially as the number of older people with care needs will rise by more than 60% over the next 20 years.
One in ten councils have slashed spending by more than a quarter. These are mostly concentrated in urban working class areas; the largest cut in social care spending is in London. The number of people in England receiving council-funded care services has fallen by 26% in that period.
Spending on day care services has reduced by 30%, leading to a 38% decrease in the number of people using these services. It is not difficult to see why the chair of the National Care Association says "we are now beyond the crisis point."
Care homes don't receive the funding from local councils they need to provide an adequate service. They receive between £550 and £750 a week for each person put in there by local councils, but the National Care Association estimates £750 is the bare minimum necessary.
With the cutbacks in staff this inevitably brings, there are more horror stories emerging about life in residential homes for older people.
A respondent to a recent survey by public sector union Unison commented: "No tea trolley is taken round, there's no regular toileting, residents are left in wheelchairs rather than in a comfy chair, weekly showers are not happening."
It is a sad indictment of capitalism that, in one of the richest countries in the world, older people unable to fend for themselves can't even be granted the dignity of a weekly shower.
That survey also records rationing or shortages of basic supplies like bedsheets, wipes and incontinence pads. We "have been told not to change [incontinence pads] as often," says one respondent, "as the van that calls to collect the yellow bags the pads go in is charging by the bag."
The UK Home Care Association estimates the minimum cost of allowing someone to live independently in their own home with home care provided is £16.70 an hour. The average paid by councils is £14.58.
This in turn means providers pay only the minimum wage and end up losing workers unable to exist on poverty pay.
This will impact on the 'Better Care Fund' - a joint venture bringing together health and social care provision. A major stated aim is to free up hospital beds by having people discharged to be cared for in the community, but those opportunities for community care are dwindling by the day.
These figures - and more - highlight the plight of social care today.
A cornerstone of the welfare state is taxation on working income being used to provide services such as care, both during and after working lives. That this is under threat of being completely dismantled is becoming more apparent.
Recently, Tory health minister David Mowat stated people have just as much of a duty to look after their elderly parents as they do to care for their own children.
In other words, the government expects (mostly) women to leave paid employment to become unpaid carers for parents and grandparents.
The slight increase in carers' allowance promised by Jeremy Corbyn is welcome.
But ultimately, the whole care 'industry' must be brought into public ownership, fully funded, and run under the democratic control and management of workers and service users.
Councils can fight the care cuts
"You have broken me." The words were being spoken by a man of nearly 70, the father of a young man with learning difficulties, to Liverpool City Council's director of adult services on the announcement of the privatisation of the city's day care centres.
The official, in an honest, bleak interview with Community Care magazine about the effect of the austerity measures taken by the council adds: "I stood there wishing I could do something different, but I couldn't."
As an appointed employee of the local authority, his own alternatives may have, indeed, been limited.
But for the elected Labour councillors who - in Liverpool and local authorities throughout the country - have pushed through cuts that threaten the very existence of many essential services, there has always been the option of doing "something different."
They could have voted against the cuts, and launched campaigns to secure the return of funding from central government.
The Socialist Party, and its members who stood as Trade Unionist and Socialist Coalition candidates in the local elections, call for legal no-cuts budgets to be set.
This means temporarily using council reserves (which totalled £22 billion in 2015) to fund the services, while building united campaigns of councillors, trade unions and community groups.
It is a strategy that has received increasing support among council trade unionists. But, sadly, the Labour right has consistently dismissed it, and the left leadership has not fought this.
This meant some Labour lefts calling for the re-election of right-wing, pro-cuts, anti-Corbyn councillors, as a better alternative to Tories winning seats and making 'worse' cuts.
In the 1980s, Liverpool's Labour council - led by supporters of Militant, the Socialist Party's predecessor - fought Margaret Thatcher's hated Tory government, twice winning extra funds for the city.
Interestingly in the thread that follows the Community Care article online, one commenter has written: "Perhaps [Militant] comrades Derek Hatton, Tony Mulhearn and Terry Fields had it right back in the 1980s.
"Maybe it is again time for civil disobedience. I am tired of hearing 'we have no choice, we are just following orders' ... Better to stand and fight than live on your knees."
One of the most difficult times in your life to accept change is when you become old and frail. And moving into 24-hour care is a colossal, life-changing moment.
Imagine what it must be like, once you've accepted this change, to be told where you live is closing down.
This is what happened to a private nursing home in my village. Because of a string of failures, and a loss of interest from owners when it was not making money, the home was unceremoniously shut and its residents moved.
The bus 'service' to our village is almost non-existent, so to live in the village where your family can visit is vital for quality of life.
The workers who were laid off had to try and find other work outside the village. The low pay they received at the nursing home was marginally compensated by at least not having to travel far to work, plus child care was easier to manage for the staff, who were majority women.
We need fully funded, publicly owned health and social care, not a system where greedy fat cats can make money off the most vulnerable members of our society.
Tom Hunt, Mansfield Socialist Party
Organise care workers
'Glynn Doherty', trade union organiser
Working in the care sector - particularly for private companies - is a precarious existence. The hours are long, pay often at minimum wage levels, and health and safety regimes severely lacking - leaving workers open to assault, false accusations of abuse and even unfair dismissal.
As local authorities privatised care functions, specifically homecare, over the last two decades, the trade unions found themselves on the outside. The main council workers' unions - Unison, Unite and the GMB - were far too slow to react to changing circumstances.
Workers who went from councils to new employers with their job saw little benefit in remaining with unions that had failed to prevent privatisation - or even to fight it - and now had little influence.
More recently, unions have belatedly taken a more active approach to organising in this sector, driven by membership falling through council cuts. But it is still for the most part haphazard, unplanned and done 'from above' without the active involvement of care workers.
Over the last period, unions have concentrated on seeking legal redress over issues such as travelling time, 'sleep-in' payments and holiday pay. Some of these have been victorious, and mean many care workers could now be in a position to recoup back payments owed them by employers.
The tribunals and courts can be an important battleground for workers' rights, but to enforce those rights consistently needs trade union solidarity and action. Simply relying on all kinds of unscrupulous employers to change their ways because of a legal decision is not good enough!
Indeed, almost every care provider has looked at ways of offsetting legal instructions to pay higher wages by cutting other terms and conditions or making redundancies.
The unions should be using legal victories for huge recruitment campaigns. The sleep-in case - where workers were only being paid a supplement for having to stay overnight, rather than their hourly rate - will result in workers being able to claim up to six years' underpayments. This is quite often a significant amount of money to low-paid workers.
But bringing to task such companies and organisations, and making them pay the legal minimum wage, is only half the story.
Many survive on a shoestring budget - although, of course, in most private companies someone is doing very well! But most will not be able to continue providing a service without making staffing cuts, which obviously impinges on the level of service.
There needs to be a political solution alongside unions redoubling their efforts to organise the sector.
Jeremy Corbyn needs to lay out a whole raft of policies on social care for the coming election. They would be hugely popular with service users, care workers. And the huge number of unpaid carers having to cover the gaps and care for their own relatives, often leaving or reducing the hours of their own employment to do so.
What should Corbyn's programme on care include?
- Reverse all council cuts and sell-offs introduced in the last decade
- Commit to new central funding for social care and council services based on the real needs of local communities
- A £10 an hour minimum wage without exemptions for age or training, as a step towards a real living wage
- Proper enhanced pay rates for care workers on nights and during other unsociable hours
- Care companies who fail to pay these rates to have their contracts stopped immediately, with all work, facilities and staff transferring to the local authority
- Provide proper care at home: an end to the 15-minute visits that are becoming the norm
- Nationalise the banks and top corporations under democratic control - with compensation paid to shareholders only on the basis of proven need - to pay for these and other anti-austerity measures