The NHS was established in 1948 to cover the health and care of all citizens – including the elderly. Social care as it became known, was delivered by local authorities either to assist in the home or residential locations. My mum worked for many years as what was then called a ‘home help’, cycling around our village to the various properties where she assisted with things like washing, dressing and food preparation. My grandmother lived in sheltered housing with a warden on site to help where needed. For those in need of the most assistance, there were homes where residents lived and staff provided the basics they needed for a reasonable quality of life. All this was managed and delivered by the state and was funded from general taxation. We paid in on the basis that they would look after us when needed and from what I saw, they did a pretty good job.
Then in 1989 the Thatcher government privatised social care and the profit motive entered the sector. Scores of companies entered the care ‘business’ and it wasn’t long before standards slipped. Workers found wage levels falling as workloads increased. Training was minimal and things like an allowance for travelling between calls were often not included in shift patterns. The result was a pressurised and often tired group of workers unable to provide decent care to vulnerable clients. In my time looking after my sick partner, I spent many hours waiting for care workers who often arrived late and when they did they had to rush around due to the fact that they knew somebody else was waiting for them. They often apologised but we appreciated that it was not their fault. A move into a residential home brought more of the same, five workers expected to attend to the needs of thirty residents, without the tools to do their job properly. They spent their breaks writing in the folders that were kept on every resident because they didn’t have time to do it any other time.
Then came Covid-19 and an already overstretched system was expected to cope with a deadly virus that moves through the population at a rate of knots. The result was thousands of deaths and a workforce traumatised by the experience. We clapped for carers but still the politicians failed to come up with a plan to fix social care.
Successive governments have kicked the issue into the long grass, afraid to tackle a sensitive issue that affects millions of our citizens. That cannot be allowed to continue and the progressive parties need to present their vision for the future. Labour and the Greens went into the last General Election committed to the creation of a National Care Service, my party, the Liberal Democrats, must have the debate about what a Liberal plan looks like.
The proposal to put a penny on income tax to fund the NHS and Social Care whilst welcome doesn’t go far enough. We need to decide whether we are on the same page as Labour or whether a different approach is favoured. Whatever happens, it needs to be a not-for-profit model. The way we used to care was better because it put people at the centre, not the need to pay shareholders a dividend.
We must go back to that.
David is a member of Horsham Liberal Democrats.