No going back: Nationalise social care!
In the second of our 'No going back' series, trade union organiser Glynn Doherty looks at the pandemic scandal which has devastated care homes, who's to blame, and, what needs to change.
The anarchy of free-market capitalism has been brutally exposed to millions through its inability to combat the Covid-19 pandemic in the richest countries on the planet.
This is highlighted clearly - and tragically - in the social care sector in England and Wales. The lives of thousands of the most disadvantaged in society have been sacrificed in the pursuit of maintaining private profits. Always the poor relation to the NHS, this has been devastatingly confirmed by events.
While health settings received a third of the number of eye protectors from central government, care homes received 5%; hospitals received three-quarters of gloves required from central stocks, care homes received 8%; and care homes received no gowns from central stocks.
By May, central government's online PPE system was catering for about 1,400 providers. There are over 50,000 primary, social care and community care providers across Britain!
The shortage of PPE meant some care homes were paying more than £1,000 a day for masks! Others - without such resources - just forced staff to continue unprotected. One care home I came across set its own 'rules' so staff were only provided with PPE if residents displayed two separate Covid-19 symptoms - one symptom was insufficient!
Testing, which should have been mandatory for all care staff from day one of the pandemic, was virtually non-existent. It may never be known how many people have died - and continue to die - through this failure of the Tory government.
The lack of planning in social care is its stand-out characteristic. In 1979 two-thirds of care was NHS or council-run, but now 84% is for-profit.
No one seeking to run a comprehensive, joined-up service would start from suggesting there be tens of thousands of different employers! In 2018 there were around 18,500 organisations across 39,000 care-providing locations in England alone. And yet, big business with all its money-grabbing has a firm foothold.
HC-One, catering for 17,000 residents, has 62 companies, including 19 registered offshore, with the parent company based in the Cayman Islands. It paid a £6 million dividend to shareholders in the year to September 2019 - down from a total of £48.5 million in 2017 and 2018 - though only some accounts are publicly visible, making it impossible to tell whether more money is flowing out of the company.
Four Seasons Health Care, the second-largest provider, has already been taken over by US hedge fund H/2 Capital Partners. This is not care provision; it is syphoning public funds from overstretched local government budgets into the coffers of the already rich.
To highlight the pickings that can be accumulated, recently agencies have raised the price of staff to as high as £90 an hour, per person, while, of course, the carers themselves receive the minimum wage.
The calls for change are many and varied. The Association of Directors of Adult Social Services has called for the sector to be "reformed" and "reset" and demands "sort out social care once and for all".
The Chartered Institute of Public Finance and Accountancy chief executive Rob Whiteman said: "It's time for the government to stop treating social care like the poor relation and provide this critical sector, which cares for the most vulnerable people in society, with the resources and long-overdue reform it requires".
While the Chief Executive at the Health Foundation, Dr Jennifer Dixon, called on the government "to ensure that those who already face most disadvantage do not continue paying the highest price [by seizing] this moment to implement a national health inequalities strategy."
Not all are as demanding. A Guardian editorial on the government edict to move patients from hospitals to care homes without the necessary safeguards, which caused a great number of the 20,000 more deaths than would normally have been expected in care homes, simply said: "Boris Johnson needs to say sorry for this deadly failure to protect the elderly". Millions will say he needs to resign not just apologise!
Integrated health and care
But none of these demands will tackle the root of the problem. While social care, and health services in general, are run for profit, most of the failings exposed during this pandemic will recur.
Journalist Polly Toynbee, hardly a left winger, recently concurred: "After this, care needs to be renationalised, locally run with a single seamless NHS/care profession... the service needs to be free for rich and poor alike by the time they use it... There is no better time for brave reform, with care newly valued by all who have stood and clapped."
The Socialist Party agrees and embraces the demands of a publicly run, fully integrated health and care service, where resources, expertise and experience can be shared to the benefit of all, rather than the privileged few.
It must be funded to the level where it can be run as a professional service, with staff health, safety and wellbeing properly protected through full training, with a career structure that would encourage staff to specialise and, of course, where decent living wages would be paid.
Charles Tallack, an assistant director at the Health Foundation, has said "Social care professionals are clearly undervalued and underpaid". He correctly predicts this "might create pressure to professionalise and improve pay and conditions."
It's often said care workers can take home more pay with a sideways career move into supermarket shelf-stacking. It is not intended as a put-down of shop workers, but to publicise the appalling pay levels social care work attracts. It highlights what capitalist society will get away with if workers' organisations allow it.
The unions - Unison, Unite and the GMB - need now to take stock of their failures over decades to significantly organise social care workers, specifically those working for private employers or in the voluntary sector.
Yes, they need to launch campaigns for more pay, for better conditions, for shorter hours. But they also need to mobilise social care workers into a much larger campaign for political change - for nationalisation, an integrated health and care service, and an end to big business and hedge fund profiteering on the backs of deteriorating health and ageing.
When the neoliberal think tank, the Adam Smith Institute, feels the need to comment in a recent report that "making social care free to everyone as part of the NHS is a non-starter and would be the largest nationalisation ever", you know its time has come!
Millions are learning through bitter experience that capitalism can't protect them. They need socialism. Social care workers will be a key force in transforming society.
If union and Labour Party leaders don't listen, those workers will strive to transform the unions and build a new party of the working class, as a step towards ridding us of capitalism and building a socialist future.
In The Socialist 8 July 2020:
No going back