Social care has broken down, says Dr Kailash Chand
SOCIAL care has broken. To believe you will be looked after from cradle to grave, as promised when the NHS was set up in 1948, is no longer a reality.
The recent case of 89-year-old Iris Sibley, trapped in hospital for six months, highlights our social care crisis. Ms Sibley was unable to leave Bristol Royal Infirmary because the community health care provider was unable to find her a suitable nursing home place.
A multiple sclerosis patient at a hospital in Manchester was also recently left waiting for 295 days – nearly nine months – for a nursing home. And these cases are the tip of the iceberg… By 2040 nearly one in four people in the UK will be aged 65 or over.
It is predicted that the number of older people with care needs will rise by more than 60 per cent over the next 20 years. It is likely that you or your loved ones will need access to good quality social care in your lifetimes, so it is vital that these services are available.
Record numbers are waiting longer than the 12-hour target for a bed once they have been seen in A&E and increasing numbers are lying on trolleys in corridors because of a lack of beds. Patients are also being kept in hospitals unnecessarily because the care they need in the community can’t be provided.
It simply is not safe to send them home without the adequate provision. The National Audit Office estimates that 2.7million of hospitalbed days are occupied by older patients no longer in need of hospital treatment, at a gross cost of £820million to the NHS purse.
So why are we not able to provide good quality care? Funding for the provision of social care in England has fallen. The system is a mess and the collapse can be traced back to David Cameron’s coalition government’s and then-Chancellor George Osborne’s economics.
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Net expenditure on social care has dropped in real terms from £8.1billion in 2005-06 to £6.3billion in 2014-15. The simple fact is the crisis is a direct result of lack of money. If the Government wants to help councils protect the services caring for the elderly and vulnerable it needs to inject money.
At the end of last year doctors welcomed Business Secretary Sajid Javid’s measure allowing councils to increase spending on social care but this alone will not help address the long-term national crisis. Failures within the system impact on an already stretched, overworked and underfunded NHS.
The extra funding is likely to raise £200million in the next two years but it is not enough to plug the estimated social care funding gap by the end of 2020. More must also be done to improve the recruitment and retention of staff. Giving care workers better terms and conditions of service would encourage more people into those careers.
The voluntary sector also makes a significant contribution to adult social care. Charities and volunteers help put in place a wide range of support activities, including care and benefits advice and day centres.
Cuts in local authority funding put more pressure on these services and impact on patient care. And we absolutely cannot forget unpaid carers, the unsung heroes who also play an incredibly important role in delivering care services.
The economic value of their contribution is now £132billion per year. More needs to be done to make sure that carers are given all the support they need. It is vital there is sufficient capacity across the entire health and social care system.
Shortterm fixes will only get us so far. We have to look at the funding and recruitment issues facing the NHS as a whole if we are to get to grips with the pressures hospitals face year in year out, which are compounded during winter.
Prime Minister Theresa May must stop pretending that all is well. Just that recognition will give confidence to the public and staff that she is in touch. And then she must listen to the professionals who have the solutions.
We need politicians of all sides to come together to agree a plan to sort out this growing problem. Put simply, the NHS urgently needs a long-term financial solution to help keep up with demand in every part of the system. The Government should be working on a long-term solution to the black hole in the finances of our health and social care system.