The care sector was already mired in crisis. Then came the pandemic, which wreaked havoc on care homes. Consequently, conditions in the industry have never been worse.
The number of empty care jobs is now reported to have risen by around 52% in the last year. These staff shortages are a result of a number of factors. Low pay, long hours, and terrible working conditions made staff retention difficult even in ordinary times. Brexit then exacerbated these labour shortfalls, as the industry relies hugely on foreign labour.
COVID added fuel to the fire, killing around 800 care workers in just the first ten months. The virus has since taken hundreds more lives, and forced thousands more off sick. At the same time, deteriorating conditions and declining wages have driven yet more to quit and look for work in other sectors.
Rising prices are hitting care workers hard. Wages in the industry haven’t risen with inflation. Care workers, like workers in most other sectors, are therefore taking pay cuts in real terms. One employer told the BBC he was struggling with staff because “they can probably go and work in Tesco or Amazon and get more than what we can offer.”
On top of that, more than a quarter of the existing care workforce are expected to retire within 10 years. And as demand grows, nearly half a million required posts are likely to be vacant by 2035. Already, on an average day in 2020-21, 105,000 vacancies were advertised – and many of these remain unfilled. Staff turnover for that same year stood at a rate of around 34%.
Care needs have risen across society: not only on the basis of a steadily ageing population, but with more elderly people suffering long-term health complications from COVID too. Meanwhile, local councils also report that ever-increasing inflation is set to add around £3.7 billion to their costs in 2023.
Early in October, the County Councils Network (CCN) reported that councils were facing a “perfect storm” of pressures. The phrase perfectly summarises the dire situation in the care sector.
Reforms without reform
After flip-flopping on a planned National Insurance (NI) hike, which was intended to pay for limited reforms to the care sector, the Tory government has now stated that any changes will be funded through “general government money”. Councils, in other words, will have to shoulder the costs with their already limited budgets.
These reforms aim to provide a £86,000 cap for those with the highest needs in terms of personal care. This means that local authorities will have to pay for any additional costs over and above this amount.
This was an attempt to tackle the skyrocketing costs of care. But in attempting to solve one problem, the Tory government has simply created another.
Increasing taxes on ordinary working people was never going to be a real solution for a health and social care system devastated by privatisation and profit.
The policy proposal caused a backlash at the time – from within the Tory Party, as well as from the public. And the problems have only mounted since.
Who pays?
In her brief stint in office, Liz Truss reversed Boris Johnson’s NI tax hike plans. But she retained the suggested care reforms, including the price cap, leaving local councils rightly asking who will foot the bill.
Promises of reform without any additional funding is just as much of a disaster, when local council budgets are already stretched to breaking point.
The recent CCN report explained that if the government doesn’t provide any extra funding to offset the costs of the reforms, councils will simply have to reduce available care services, or charge more for them.
Local authorities are already providing skeleton services in many areas, however. And on the current trajectory, things are only set to get worse.
Catastrophe brewing
This crisis in the care sector has a knock-on effect elsewhere too. No sector of society is isolated.
A recent report by the Welsh government, for example, found that “lack of social care capacity is the biggest contributor to delayed discharges and restricted patient flow through hospitals”.
The NHS and the social care sector, in other words, are entirely connected services. And if one goes down, they will both sink together.
As things stand, hospitals and care homes have not yet received a single penny of the £500 million emergency fund promised by the government to prevent the NHS from becoming overwhelmed this winter. And with Rishi Sunak promising yet more austerity, it is clear that there will be no lifeline forthcoming.
A catastrophe is therefore brewing – with fatal consequences.
Broken machine
The entire system is a machine of broken cogs, running on fumes. Government budgets are black holes of debt. And vast amounts of public services have been sold off to private companies through decades of backdoor privatisation.
All the while, the largest chain providers who dominate the UK care home market rake in millions in profits every year – profits paid out of the public purse, and from the life-savings of vulnerable people in need of care.
Whichever way you look at it, it is ultimately the working class who pays.
While so much of the sector remains under private ownership, any promises of reform and increased funding simply means syphoning yet more public money into the pockets of the profiteering parasites.
The health and social care sector can only be managed in the interests of the working class if it is taken under public ownership and control; paid for by the expropriation of the bankers and billionaires.
There is no time left to tinker. We must throw out the whole broken machine and fight for a clear socialist alternative.
