23.11.16
Privatised adult social care is leading to plummeting standards, CHPI warns
Increased privatisation has caused the quality and staff conditions of adult social care to decline significantly over the last twenty years, a new report has found.
The report by the Centre for Health and the Public Interest (CHPI), ‘The failure of privatised adult social care in England: what is to be done?’, found that staff in the private social care sector receive a “considerably lower” rate of pay compared to their public sector counterparts, with staff turnover higher as a result.
The report also highlighted that 41% of community-based and residential social care services have been found to be inadequate or requiring improvement by the Care Quality Commission (CQC) since 2014, and proposed new measures for more effective market provision and regulation.
The report said: “Whilst recognising the difficulties involved in replacing private provision by state provision, the report concludes that it would be possible to introduce a ‘preferred provider’ policy, whereby local authorities would give preference to either their own provision or provision by the voluntary sector or user-led organisations.
“Similarly local authorities could require the return on capital achieved by private providers to be capped to a maximum of 5%. This would reduce private equity investors’ interest in adult social care provision and help re-balance the market between state, voluntary and private provision.”
Expenditure on adult social care support is estimated to be around £22bn, with £13bn attributed to residential care. Although this figure is set to rise due to the UK’s ageing population, the CHPI found that state-funded community services have been slashed by almost 40% over the last decade, with state-funded residential services and nursing homes remaining static.
It noted that although the Care Act has imposed a ‘market-shaping’ role to local authorities, councils have been reduced to the role of ‘commissioning authorities’ due to budget cuts, leaving them unable to direct the outsourcing of care services strategically and making the market unstable.
Despite these concerns, the report also acknowledged that returning responsibility to the public sector would still not be a cure-all to the problems afflicting adult social care.
“A shift in sectoral provision will not in itself solve the many other problems besetting adult social care – the care cap cost dilemma, underfunding and reduced accessibility, the need for more personalised care, the potential of harnessing the digital revolution and more,” the report said.
“However it does offer the prospect of returning to the public realm a policy domain that has been shown to be ill-suited to marketization,” it concluded.
The new measures recommended by the CHPI’s report in order to regulate the care market include a transparency test, where contractual arrangements with a provider are fully open, and allowing the local electorate to demand that a contract be terminated if there are concerns about performance.
The CHPI also proposed forcing private providers to guarantee certain terms and conditions and bargaining rights to their workforce, and a requirement for companies to prove that they are subject to UK tax.
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