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| Funding obstacles to seamless social care | |
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| The pressures affecting social care described by John Harris (If austerity is over, why can’t we afford proper social care? 2 December) and manifested in the lack of operational complementarity between the NHS and local authority social care are caused not only by the needs of an increasing elderly population, but also by a fundamental funding cleavage between the two structures. Thus budgets can never be properly integrated but only pooled under restrictive controls. A smooth continuum of care based on clinical, therapeutic and social care need remains a pipe dream, despite the rhetoric and exhortation demanding it. | The pressures affecting social care described by John Harris (If austerity is over, why can’t we afford proper social care? 2 December) and manifested in the lack of operational complementarity between the NHS and local authority social care are caused not only by the needs of an increasing elderly population, but also by a fundamental funding cleavage between the two structures. Thus budgets can never be properly integrated but only pooled under restrictive controls. A smooth continuum of care based on clinical, therapeutic and social care need remains a pipe dream, despite the rhetoric and exhortation demanding it. |
| There is also another factor impeding integration and the full meeting of “eligible needs” (a creative way of reducing the scale of services to individuals by redefining upwards what is meant by “eligible”, and eliminating those previously eligible, even though their needs remain unchanged). Social care has been an experiment in progress for 30 years – a prototype for the wider privatisation of care – which is mostly provided by the private sector and paid for by private (means-tested) payers. It is largely unplanned, subject to abrupt market exit (if profits aren’t sufficient) and often hampered by poor pay and conditions for staff. True integration is impossible. | There is also another factor impeding integration and the full meeting of “eligible needs” (a creative way of reducing the scale of services to individuals by redefining upwards what is meant by “eligible”, and eliminating those previously eligible, even though their needs remain unchanged). Social care has been an experiment in progress for 30 years – a prototype for the wider privatisation of care – which is mostly provided by the private sector and paid for by private (means-tested) payers. It is largely unplanned, subject to abrupt market exit (if profits aren’t sufficient) and often hampered by poor pay and conditions for staff. True integration is impossible. |
| Further, little is known of the private payers (apart from the fact that their payments often subsidise local authority-funded social care by paying higher fees than local authority-funded clients) such as the appropriateness of their care, and their individual circumstances. CQC inspections of care services are not interested in them as individuals, only the general quality of the service provided. As long as they pay up, everyone is happy (apart from the individual and perhaps those families concerned that their inheritance is being eaten up in paying for social care – but that’s another story).Gillian DalleyLondon | Further, little is known of the private payers (apart from the fact that their payments often subsidise local authority-funded social care by paying higher fees than local authority-funded clients) such as the appropriateness of their care, and their individual circumstances. CQC inspections of care services are not interested in them as individuals, only the general quality of the service provided. As long as they pay up, everyone is happy (apart from the individual and perhaps those families concerned that their inheritance is being eaten up in paying for social care – but that’s another story).Gillian DalleyLondon |
| • Whatever happened to convalescent homes which were used for the transition from hospital to home? It seems some hospitals are to close for lack of staff but surely the space freed up could be used for convalescence, which I would have thought requires less intensive nursing care than that required for seriously ill patients.Mary ConnNewcastle upon Tyne | • Whatever happened to convalescent homes which were used for the transition from hospital to home? It seems some hospitals are to close for lack of staff but surely the space freed up could be used for convalescence, which I would have thought requires less intensive nursing care than that required for seriously ill patients.Mary ConnNewcastle upon Tyne |
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