Over the last few years governments of different parties have said that a key part of making the NHS sustainable is to integrate health and social care. This is a fine idea but it has been unclear what this would look like in practice. For a few months I have been thinking through an idea that would improve the quality of health and social care for elderly people, and yesterday Jeremy Corbyn proposed the same idea: take failing care homes into the public sector. This policy is part of the Labour leader’s rebranding exercise, and to be honest if these sorts of policies are proposed then I look forward to see what the next policy will be.
There have been concerns about failing care homes for a number of years, and this concern was heightened after a 2014 BBC Panorama documentary revealed that staff in two care homes were recorded mistreating residents. Since this investigation aired, three of the care home workers n the documentary were sent to prison. Further, the press has been consciously aware of cases of care home abuse and there have been many newspaper undercover investigations revealing staff abuse across different companies.
The idea of nationalising care homes makes sense as the abuse of residents illustrates that the profit motive results in standards falling and hiring people who lack the appropriate training. The fact that not all private-run care homes abuse residents show that there is not something that is inherent about mixing care homes and the profit motive, but philosophically I believe that care homes should not be run for profit. In the United States there are cases where private health insurance does provide people with adequate medical care, but that doesn’t mean that we should have a for-profit healthcare system.
In terms of the politics of the situation, I think this would be an excellent move, however only if Labour promote this policy effectively. The cost of putting an elderly relative into a care home is tremendously expensive, and as such the idea of having care homes paid for through general taxation is a good idea.Elderly voters vote and if Labour was successfully able to market this policy, a lot of people who may not necessarily have a favourable opinion of Jeremy Corbyn may prick their ears up.
In order to remain credible Labour would have to propose how such a policy would be funded but given the amount of tax that is not collected every year, and the changes that the Tories have made to tax brackets, I think that taking failing care homes out of the private sectors seems plausible. When these accusations are made by the Right, Labour should respond with a fully costed plan but they should also put the principled case forward as well. People don’t advocate dismantling the NHS because it’s expensive, and if you argue that social care should be part of the NHS then I think you’ll be able to get popular support.
Elderly people don’t chose to live in care homes if they don’t have to, and because this is part of social care I think that the state should run these establishments. If abuse takes place in a privately run care home, all that we see is the individuals potentially getting prosecuted. If such a situation occurred in a state-run facility there could be a full public inquiry and the managers could be replaced. State-run entities, for all their flaws, are more transparent and do not put profit at the top of the agenda.