Link to this page: https://www.socialistparty.org.uk/issue/802/18272
Stop the destruction of care in Britain
The underfunding of social care and the cuts in pay and conditions of care workers as a consequence of the government's austerity measures is a national scandal.
In the following articles, campaigners and workers in the profession speak out on how these attacks are wrecking the provision of social care and also how to fight back.
A North West social worker
Social work, in essence, is about protecting and helping the most vulnerable and needy to make the most of their lives.
Yet social work has been at the sharp end of austerity programmes, even before the current crisis. People who use the services, the army of unpaid carers and those employed in social work, have felt the impact of these cuts.
Cash-strapped councils have demonstrated they prefer to make cuts to services for vulnerable people rather than organise campaigns to stand up for their communities and refuse to implement cuts.
Across the whole of the social care sector, the emphasis is on saving money rather than people's needs and enhancing lives.
Figures produced by Directors of Adult Social Services shows that over the last three years, budgets across the country for Adult Social Care have fallen from around £18 billion to £15 billion.
This is against a background where demand for services is growing as people live longer. The number of people aged 90-plus is expected to treble over the next 20 years.
Meanwhile the government's proposed Care Bill will cap residential care costs for the better off at £72,000, while the availability and quality of care for the many is squeezed further.
For those using services, positive developments quickly turn into negatives as councils seek to save money.
Personal Budgets were introduced for adults from 2007; the stated motivation was to give, to those who are willing and able, more control and choice in the organisation of their care packages.
Whereas someone may have previously been given five days at a day centre, now they are given a Personal Budget from which they may choose three days at a day centre, and two days on a different activity.
However, rather than receive a Personal Budget equivalent to the cost of five days at a day centre, they may, for example, get the money equivalent of four days.
This may lead to people accessing cheaper care, from unqualified sources. That is not choice or control, it is cost cutting.
This can increase stress upon carers. Carers, family or friends who provide unpaid care, are increasingly taken advantage of, with more and more expected of them.
There has been a much greater acknowledgement and awareness of the carer's role, and many people want to help in supporting a relative or friend.
But increasingly this is exploited and carers are pushed into a more demanding role, to the detriment of their health, welfare and lives.
People, often older, who are in receipt of home care or residential care services, are at the sharp end of Tory cuts. The bulk of home care and residential care across the country has been privatised.
For residential homes many families are left with little alternative but to pay 'top up' fees, as the homes cannot provide even basic care from the ever-decreasing money they receive from councils.
For home care, many calls are now squeezed to 15 minutes, when care workers have to get in and out quickly.
There is no time for 'soft' care - having a cup of tea and a chat, treating people as humans, with a dignity and respect that can enhance life.
For those care workers in the private sector, the reality is low pay and poor working conditions. With zero-hour contracts, pay below the minimum wage (60% of home care staff are not paid travel time) no sick pay, little training or career opportunities, these workers are among the most exploited in the country.
With an unsurprisingly high turnover of staff, people using the service suffer as well through a lack of continuity of staff, and missed and late calls.
Social workers are in an increasingly fragile position with many councils looking at privatising social work.
At the best of times social work is a demanding and complex role, though it can also be rewarding, but now the role is becoming intolerable for many.
In a pressurised atmosphere, cuts place unprecedented demand on services. Workloads are growing in all sectors and the opportunities for genuine social work are shrinking.
Increasingly they are pressed by a finance-driven culture, to focus on how care packages and costs can be reduced.
Integration of health and social care, while in theory offering some benefits, is being guided by the need to reduce costs, and is accompanied by privatisation and increasing workloads. Mental Health Services are particularly bearing the brunt of this.
Meanwhile, children have their futures blighted by these cuts.
As poverty increases, and the birth rate increases, so will the demand for services to protect young people.
The scandal of failed services in Doncaster and Birmingham, as a result of cuts will, sadly but surely, be repeated elsewhere.
A fightback to defend these essential services is desperately needed, and there are the first signs of this.
There have been notable successes in defending services - such as mental health services in Salford, which we can build upon.
There has also been a welcome growth in user groups, to advocate for and defend services.
Trade unions in the sector need to work with these groups; it is not a choice between services or jobs, it is a common struggle, as well-paid and motivated staff lead to better services.
In social care, as with other areas of the public sector, it is time to put people's needs first. We need a broad based campaign to defend jobs and services, and to stop cuts and privatisation.
- No cuts! For a fully funded care system
- A living wage, and trade union conditions, for all working in social care
- No further privatisation (including transfers to social enterprise etc) of any social care services
- Return of care services (home, day and residential care) to local authority control
- Free quality social care
- A positive framework to end poverty and provide full support to carers
- Personal budgets based on need not cost
- Reinvestment in local authority care services
- Reinvestment in social work - to allow genuine social work with manageable caseloads, to protect and assist those who require support
The amount spent on social care services for the elderly has been cut by £1.2 billion (15.4%)since 2010 despite the population aged over 65 growing by one million between 2005 and 2013.
The government has redirected £400 million from the NHS but this still leaves an £800 million shortfall.
The care needs of some 800,000 older people are not being met
(source: Age UK)
M&S style austerity
Former Marks and Spencer chief executive Sir Stuart Rose has been appointed an adviser to the NHS. The Tory press sang hymns of praise to Rose's 'big business expertise'.
The press were quieter about Rose's current job as chair of private equity firm Bridgepoint Capital. This company owns at least three private health businesses in Britain including one of the private care giants Care UK.
Care UK was paid £190 million a year from public money to treat NHS patients in 2012. Its profits soared up to £38 million in 2010 while its staff pay dropped by an average 1%.
Over 100 Unison members at Care UK in Doncaster have recently taken seven days strike action against attacks on pay and conditions and subsequently voted to undertake a further seven days strike unless the company rescinds its vicious pay cuts (see page 12).
In 2010, Rose was one of a gaggle of big business types to write a public letter congratulating Cameron's Tories on their plans "to institute widespread cuts in public services and state benefits."
It's not just austerity and privatisation, of course, it's M&S-style austerity and privatisation. But it's bad news for the NHS and we must fight his plans.
Low-paid homecare staff working for Apex Care have been subjected to gagging orders and other draconian measures after their union, Unison, launched a campaign alleging the company has flouted minimum wage laws and imposed punitive changes and sanctions on its workforce.
Staff on zero-hours contracts must get management permission to do other work, even if it is voluntary.
Apex has also refused to provide staff with a copy of their employee handbook, insisting that staff may book an appointment to view the handbook in an office
'Person centred' or 'profit centred'?
I have worked in residential care homes run by the public, voluntary and private sectors. I want to describe a few of the outcomes I see in private care for two groups of people who really are 'all in this together'; the residents and the staff.
Nowadays in social care the central core standard is that services should be provided on a 'person centred' basis.
Simply put, it means that all aspects of a service should be designed and run with the needs of the service user as the driving principle.
This alone should rule out private care, recognising the simple fact that when you introduce the extraction of a profit from the public kitty you also extract a range of things from the service.
Services move from 'person centred' to 'efficiency centred' (cuts - make no mistake) and 'profit centred'. You can't easily separate the impact on staff and residents.
Savings on salary means less pay and less staff - this means less positive interaction, less or no outings for residents who need two-to-one care in the community, less attention to safeguarding.
For the staff it means low morale and a clear message that you're not valued. It means staff competing for sparse overtime opportunities to make up a living wage.
Low motivation in staff means damaged relationships throughout an organisation; it means a much diminished environment for vulnerable residents.
Where will there be any scope to prioritise resident needs? Instead our care homes are fast becoming little more than holding and containment tanks.
Beyond this, another saving for the emerging care entrepreneurs impacting on services has been in the removal of sick pay.
Not rocket science this one either: workers who are unwell and low paid will be forced to attend work. If their illnesses are infectious, the risk to residents in their care is obvious.
Recently I lost £170 in wages when I got a tummy bug. That was a new one for me joining the private sector - it's the first time ever I've paid someone for diarrhoea!
'Pushed to the limit'
I'm a support worker for adults with learning disabilities in Milton Keynes. The council's horrendous cuts are directly affecting the individuals I support, including a price hike and stricter boundaries for community buses.
Last year's budget also included cuts to homeless services, disabled children's services, dementia care and youth services. All the Labour councillors voted through the proposals.
Within my service the managing director sent a report to say our wages will remain frozen. The staff have not seen any pay increase since April 2009, this is despite working for a private charity, not a public sector service.
According to the charity's report it met its financial target in 2011. I wonder why the target didn't allow for standard pay increases.
The financial report also stipulated that a handful of staff had received bonuses of as much as £120,000 that year.
Service users are also losing funding, services and even having their incredibly modest food shop budgets reduced.
Meanwhile staff are being pushed to the limit, working illegal hours just to make ends meet. This is having a detrimental impact on the quality of care being provided.
Some staff worked Christmas Day, Boxing Day and New Year's Day with no additional pay, just the basic salary.
Night shifts pay the same as day shifts and we are only given one weekend off a month, even the part-time staff.
24-hour and overnight shifts don't allow eight hours of sleep as you are not allowed to get ready for bed until 11pm and you must be ready for your shift at 7am.
There are regular shortages of basic sanitation supplies such as gloves, hand towels and hand wash. The site has so many broken and faulty lights that people are falling down the steps.
Unsuitable staff are regularly hired as the job is so unappealing for a starting rate of £6.77 with six months' probation.
Despite an employment tribunal ruling last year saying care providers must pay staff the national minimum wage, take into account travel time and when someone works overnight on a sleepover shift, compliance is undermined by local council commissioning practices, such as reduced fee rates, not paying for travel time and 15-minute care visits, particularly in home care.
A survey by the United Kingdom Homecare Association found that the overwhelming majority of care providers were only paid by local councils for contact time with clients. Less than 2% of providers were paid anything at all towards travel time
We can defend services
Last year Salford Council set out a plan that would have led to the closing of vital groups and drop-ins for mental health service users and the privatisation of the remaining services offering them one-to-one support.
Staff were told first and immediately informed service users, despite being warned not to. As far as our members were concerned service users had a right to know and their involvement would be vital in ensuring the cuts could not be enforced.
Using a number of tactics, including threats of industrial action and occupations of council meetings, the campaigners forced management back to the table.
This led to a six month process of meetings, which in the end reached an outcome that drop-ins and groups would remain (albeit at different locations and with different staff), no aspect of the service would be privatised and there would be new investment in a mental health centre to assist recovery.
However, less than a week after this was announced in early January this year, we were told that the budget for the staff would be cut from this April.
If enforced this will mean that the developments we worked so hard for last year will be worth nothing. Again, staff and service users have decided to fight together.
The staff (all Unison members) have already gone into dispute with Salford council and have requested a ballot for industrial action from the union.
The service users, through their organisation the United Service Users Committee (USUC), organised a well-attended public meeting, linking this issue with proposals to cut the number of beds at Salford's psychiatric unit.
The meeting led to the formation of "Save Mental Health Services in Salford", which has now achieved even more public awareness because of the involvement and support of Beverley Callard, the actress who Coronation Street fans will know better as Liz McDonald.
The Socialist Party has been pivotal throughout the campaign. Also, one of USUC's lead organisers has already stood as a TUSC candidate and will be doing so again in May.
We have worked with all those sincere about saving these services, but at the same time have shared our ideas and views, which has generated a great deal of respect for us from all involved.
We have learnt two key lessons throughout this ongoing battle. The first is that no matter how difficult the challenge might appear, by working together, utilising the best ideas and employing the best tactics, staff and service users can defend care services.
The second is that under capitalism we will be forced to fight the same battles over and over again. That is why we need a socialist society.
In The Socialist 13 March 2014:
Socialist Party news and analysis
Socialist Party congress
Socialist Party workplace news
Socialist Party reports and campaigns