Care – the age old issue

5th September 2021

Care for the elderly – underpaid and undervalued

One of the few things British governments have been adept at over the past two decades is finding ways to dodge addressing the crisis in social care.  The issues in the social care system are hardly sudden or unpredictable.  Modelling for an ageing population and the consequences that follow has been going on for some time. 

The median age of a population is an index that divides the population into two equal groups: half of the population is older than the median age and the other half younger.   In 1950 the median age in the United Kingdom stood at 34.9 years.  In 2015, the median age of the United Kingdom’s population was 40 years.  The median age of the population is expected to reach 44.5 years by 2050.

By this projection, over 50% of the UK population will be middle aged or elderly be the middle of the century.  While advances in medical science have contributed significantly to the increase in average life expectancy across the population, the numbers who are able to live well into advanced old age, without any care intervention, remains limited.  

While the case for investment has been staring politicians in the face for some time, the realities for the care sector have been ones of outsourced services, underpaid staff and squeezed local authority budgets. 

In their report, Health and Care of Older People in England (2019), Age UK indicated that,

“Most people experience the majority of years spent living with poor health after the age of 65, and can, on average, expect to spend around half of their later years living with a life-limiting health condition or disability. There is significant regional disparity between areas with the highest and lowest levels of disability-free life expectancy at 65, with over 2 year’s difference for men and 2 and a half years for women.”

Figures from the Office for National Statistics (ONS) show a huge drop in expenditure on adult social care between 2010 and 2015, with spend virtually flatlining since then. Local authority spending on care per person for people aged 65 and over in England is estimated to have fallen by 24 per cent between 2010/11 and 2017/18.

It is no coincidence that the politics of austerity has coincided so neatly with the rapid decline in social care spending.  The Tories consciously shifted the burden of paying off the bankers gambling debts, following the 2008 financial crash, onto local authorities resulting in massive service cuts.  For most Councils social care constitutes around two thirds of the annual budget, so inevitably this sector was hit hard.

In many areas care homes have fallen victim to the Tory penchant for privatising key areas of the public sector, making care provision subject to the vagaries of the market and the need for providers to make a profit.  The pandemic has exposed the dangers of caring as a choice of work, given the proximity of contact with many who are the most clinically vulnerable, and the paucity of pay in the sector, as private companies seek to maximise their profits.

The fact is that care homes are facing a recruitment crisis which could result in 170,000 vacancies by the end of the year.  Part of the reason for this is that work is better paid elsewhere.  Amazon’s new warehouse in Nottinghamshire for example is paying £13.50 an hour, 30% higher than the going rate locally for care home staff, as well as a £1,000 joining bonus.  That is quite a leap from £9.30 an hour when calculating the cost of food, rent and school uniforms. 

There is a sad irony in the fact that a transnational corporation, which has benefitted by billions from the pandemic while paying little in taxes back into the public purse, can effectively be undermining those who have had to risk so much to provide essential care to the most vulnerable.

The long awaited Tory social care plan may be revealed this week.  It is unlikely that the government will turn its sights upon the rich, the tax dodgers and the profiteers from the pandemic, to dig deep in order to fund the ongoing need for better quality social care.  Rumours of a 2% increase in national insurance contributions have been leaked, hitting those on low incomes with an effective tax increase.

This is likely to be followed by Chancellor, Rishi Sunak, announcing a break in the pledge to maintain the so called ‘triple lock’ for the rise in the state pension; an annual uprate of 2.5%, annual inflation or earnings, whichever is the highest.  The first policy is likely to hit the youngest wage earners, the second will hit the most vulnerable pensioners.  A classic divide and rule tactic by the Tories, aimed at diverting both young and old members of the community away from the fact that they are both victims of a system which looks after the rich, at the expense of the poor.

Social care, like access to NHS treatment, should be free at the point of use.  It should not be a lottery according to the level of local funding, it should not be a source of profit for the private sector.  The only way to really address the crisis in social care is to address the underlying ethos of society; is it driven by the need to make profit, or is it driven by the needs of its people?

The answer under capitalism is quite clear, competition and the profit motive rule above all else, with the needs of people coming a poor second.   Under socialism the need to make profit is not eradicated, incentives remain necessary, but any surplus does not go into the pockets of billionaires to fund vanity projects of space exploration, it goes to meet people’s needs.  

The difference in emphasis is quite fundamental and is the difference between a future which values people and one which continues to put profit above all else.

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