Is a National Care Service Desirable / Possible?

[Gills 58]

As we age, it's a bit of a lottery on what disease we get.

My Mum got cancer and had the best treatment that you can imagine, free at the point of service.
My Mother in law got dementia and has paid a fortune for her care and treatment and will continue to do so until the money runs out.
Then, the care home owner said she could not guarantee that MiL could stay in the same care home if the CC won't finance that amount.
The cheeky mare even suggested that we may want to top any shortfall.
Fine, I replied, then who will pay for ours, should we need it?

My recommendation is, get a physical illness, not a mental one.

Wierdly, a younger person gets a mental illness and needs residential care, the state pays
An old person gets the same and they are expected to finance it themselves.

Spot on Shotshy re mental/physical illness lottery.

 

[shotshy]

You obviously didn't hear what Hancock said. The patients and care staff are all entitled to free care; are you another who thinks care homes make a fortune?

I haven’t said that and I don’t really care what Hancock said.
If residents of care homes are entitled to’free care’ as you claim, then why is my relative paying nearly a grand a week ?
Nobody gets anything free from a care home.
Either the resident pays or the county council pay.
Please check facts before posting

We may have stumbled across a subject that WK is not an expert on.

 

[Gills 58]

Re the OP, very much yes and yes, like the NHS but people don't want to pay for it.

We need an all party agreement. Brown suggested one circa 2010 but the likes of the DM labelled it a "death tax". In fairness May suggested something but got slaughtered for it, unfairly imo.

Problem is, people want to inherit. It's then a lottery. If your parents drop dead then fine, if they need years of care you get nothing. We need a compromise of the two.

Unlikely to get all party agreement and our "ya boo" politics will prevent rational discussion.

I never cease to be dumbfounded at how people can get so upset about the remote possibility of paying inheritance tax on something they get for doing nothing, yet are less upset about the conventional every day taxes on money they've had to work for.

I'd have been ecstatic if I'd inherited enough to have paid some tax on it.

 

[Gills 58]

I misread the title of this thread at first sight and I think I'll go with that.

Is National Service Desirable/Possible?

I'll go for yes on both counts in relation to social care. We start with every single citizen, who is physically capable, being required to do a month's unpaid work in a care setting. Employers would be legally required to release staff for the duration of their service and to pay them the minimum wage. No exceptions, no excuses.

We would then have a national discussion on what to pay care staff and how to finance the system. I wager that we'd find some answers PDQ.

I think I'd rather do the old fashioned National Service!! I have nothing but admiration for the people that provide this care for the old (or any age for that matter). I recommend people watch "Sorry We Missed You" by Ken Loach for an insight into the job and lifestyles that our carers lead. It puts many of the rest of us to shame. My own experience of attempting to educate stroppy teenagers for 34 years was a doddle by comparison.

 

[jogills]

Is it the government’s responsibility to supply ppe to private limited companies?
That’s what the vast majority are.
The inference has been that these residential care homes are part of the health service.
They either are and free at point of use, or private enterprises and ultimately responsible for their procurement of stock.

In a pandemic yes it probably is. They are chucking money at a lot of other private companies that are not directly involved in the struggle with coronavirus. National planning and all that, government responsibility.

 

[shotshy]

In a pandemic yes it probably is. They are chucking money at a lot of other private companies that are not directly involved in the struggle with coronavirus. National planning and all that, government responsibility.

I actually agree.
It was a talking point
Personally I think the tax payer should cover the whole thing but then I have a vested interest.
Others will think differently and say if you have money, it’s reasonable to pay for it.

 

[Gills 58]

I actually agree.
It was a talking point
Personally I think the tax payer should cover the whole thing but then I have a vested interest.
Others will think differently and say if you have money, it’s reasonable to pay for it.

I think the rich are as entitled to a National service as much as the poor. They pay for it through their taxes.

What I'd like in the perfect world is an end to tax havens and some of the apparently legal avoidance measures that the rich seem to take. How the f### did the Duke of Westminster avoid inheritance tax on an estate of about £9 bn?

 

[Tarian]

I don't like the way that Hospitals discharge vulnerable people who may no longer require that level of care, but there is no joined up system with social services and care homes for them to take over. Nothing has ever taken over from the old Convalescent homes.

There are a lot of valid criticisms of Social Care - but "nationalisation" is the last thing we need to improve things.

For decades, Councils and Hospitals have been pushing patients back towards each other - with too many falling between both.

The NHS used to provide Intermediate Care wards for older patients to recover in before going home. My impression is that the NHS has been getting rid of these.

Which means there is even less of a "bridge" between the NHS and Councils' Social Services.


We could do worse than make the local NHS and Care Homes report to Local Councils and Councillors.

The NHS is appallingly wasteful and inefficient. It's management systems are creaky, at best. (Just talk to staff below management level.)

A few years ago the Govt. recognised the problems from lack of local, democratic oversight of the NHS.
So it encouraged Councils to create "Health & Wellbeing Boards".
Unfortunately Councils have no executive power over the NHS - but they can shine a light on NHS practices.

An early lesson, was.....
The Council may have a very good idea of the number of older people needing different types of Social Care.
NHS Data was minimal ... or not properly shared and used to inform decision-making.

[Apparently most, if not all Hospitals in Sweden are the responsibility of Local Government.
In Germany, health is decentralised.
So there are models to look at.]


Back to Care Homes. Valid Questions are:
* How is it fair that a Council sponsored "guest" pays (say) £600, but enter privately and it can cost over £1,000
* How can charges be so high, yet staff get near minimum wage ?
* How is it fair that a physical condition gets taxpayer support but not dementia ?
* What % of one's home (if any) should be used to fund a Care Home ?

Local Councils, with people having local knowledge, could be better placed to get proper answers - without being fobbed off by "high level" woffle !

 

[Vambogills]

It is not about owners it is really about the quality of care even in some of the most expensive places the people in there can be badly cared for.Unless there is a relative or friends keeping a eye on things often poor care can creep in.There should be some sort of regular inspection at very least with the best staff and care homes being rewarded for their efforts. In much the same way as schools the care sector should be more regulated.

Don't disagree with any of that. I was just commenting about the possibility of any future nationalisation. That obviously is, very much, about the current owners of care homes.

 

[Tarian]

How the f### did the Duke of Westminster avoid inheritance tax on an estate of about £9 bn?

Family Trust

Here is a source that might be more accurate than the Guardian:>
https://www.grosvenorestate.com/the-grosvenor-estate.aspx

 

[nitram77]

There are around 5,500 care home providers in the UK. The vast majority are small with around 4,000 owning just one home to the largest half dozen groups having over 100 homes each.
Nationalisation might be nice to have but the cost of buying out this size of private sector care home business could not be contemplated for decades with the level of borrowing we are racking up at the moment.
Shame, as I would suspect currently many owners would be only too keen to offload to the government at a knock down price.

The figures I've found put the number of care homes at 11,300, housing around 410,000 residence.
A large part of the costs are paid for by local authorities already.

 

[Wayne.Kerr]

If residents of care homes are entitled to’free care’ as you claim, then why is my relative paying nearly a grand a week ?

It is estimated that it costs £400 a day to stay in hospital; so, paying a grand a week in a home looks like a good deal by comparison given that 24-hour cover is provided along with food, laundry and establishment costs plus qualified staff for giving medication. Yes, you're one of those who thinks care homes are raking it in. The Care Act 2014 and CQC keep these homes ion a very tight leash. How do I know; I had to look after an aunt in Broadstairs and she was moved to Dover overnight because her Broadstairs home was subject to summary closure by the CQC. You need to get real.

 

[Wayne.Kerr]

There are a lot of valid criticisms of Social Care - but "nationalisation" is the last thing we need to improve things.

For decades, Councils and Hospitals have been pushing patients back towards each other - with too many falling between both.

The NHS used to provide Intermediate Care wards for older patients to recover in before going home. My impression is that the NHS has been getting rid of these.

Which means there is even less of a "bridge" between the NHS and Councils' Social Services.


We could do worse than make the local NHS and Care Homes report to Local Councils and Councillors.

The NHS is appallingly wasteful and inefficient. It's management systems are creaky, at best. (Just talk to staff below management level.)

A few years ago the Govt. recognised the problems from lack of local, democratic oversight of the NHS.
So it encouraged Councils to create "Health & Wellbeing Boards".
Unfortunately Councils have no executive power over the NHS - but they can shine a light on NHS practices.

An early lesson, was.....
The Council may have a very good idea of the number of older people needing different types of Social Care.
NHS Data was minimal ... or not properly shared and used to inform decision-making.

[Apparently most, if not all Hospitals in Sweden are the responsibility of Local Government.
In Germany, health is decentralised.
So there are models to look at.]


Back to Care Homes. Valid Questions are:
* How is it fair that a Council sponsored "guest" pays (say) £600, but enter privately and it can cost over £1,000
* How can charges be so high, yet staff get near minimum wage ?
* How is it fair that a physical condition gets taxpayer support but not dementia ?
* What % of one's home (if any) should be used to fund a Care Home ?

Local Councils, with people having local knowledge, could be better placed to get proper answers - without being fobbed off by "high level" woffle !

Thank you Lord Beverage - one day you will come up with some suggestions rather than reprint Google etc using different type using Italics and Bold and pregnant pauses etc

 

[Wayne.Kerr]

What I'd like in the perfect world is an end to tax havens and some of the apparently legal avoidance measures that the rich seem to take.

Constructive avoidance - yes; tax havens - not sure because many pension funds benefit as do UK internationals who pay tax here.

Stop this sham self-employment and the tax/NI that is lost to the nation.

 

[Tarian]

Thank you Lord Beverage - one day you will come up with some suggestions rather than reprint Google etc using different type using Italics and Bold and pregnant pauses etc

You're just wrong.
Sometimes I do check before posting .....but that post was all my own work.
Believe it or not, I know stuff.

(And I've been at a Health & Wellbeing Board a few times.)