Betrayers of self-funders’ trust?

Posted on June 26th, by geoff in Caring Times, CT blog. 4 comments

By guest blogger BOB FERGUSON

That loud clucking noise you can hear is the sound of chickens coming home to roost. The Competition and Markets Authority (CMA) has turned over a rock and found a mess of repellant practices that should have the care home sector hanging its collective head in shame. But the day of reckoning could be nigh.

Not least for providers that exploit self-funders – robbing Peter to pay for Paul, while keeping Peter in the dark, is just one example. If, like me, you have come across pathetic attempts to justify “cross-subsidies” by citing differential pricing for airline seats and hotel rooms, you too may have wondered how holiday jaunts can be compared with once in a lifetime decisions, typically taken at a time of crisis.

While the sector frets about the detrimental effects of unfavourable quality ratings, it seems blind to the reputational damage inflicted by the way in which self-funders are routinely taken to the cleaners. When the CMA market study was announced, industry leaders – a word I use in the loosest possible sense – merely speculated about what they could get away with. Rather than lift a finger to put their house in order, they effectively stuck two fingers up to their residents.

Now, confronted by the watchdog’s damning (interim) verdict*, there’s not a tweet of contrition; all they can offer is either ear-splitting silence or a shameless attempt to blame families for (can you believe it?) failing to study the small print. Let’s not mince words: the practices that caused the CMA such concern should have the providers responsible investigated for institutionalised financial abuse.

Perhaps we should expect no better from a representative sector that makes Monty Python’s wacky ringers – the People’s Front of Judea and the Judea People’s Front – look like the model of a close-knit community.

If there is a crumb of comfort for care homes in the CMA report, it lies in the regulator’s decision to pursue the idea of an independent body overseeing the development of “reasonable fee rates”. Self-interest springs eternal …


  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

4 responses to “Betrayers of self-funders’ trust?”

  1. One of us (Geoff Hodgson) writes a weekly online blog in order to stimulate discussion and debate in the social care sector. The primary qualities required of a blog is that it is brief and provocative and/or entertaining. Each blog carries a disclaimer affirming that this CT Blog is written in a personal capacity, and that comments and opinions expressed are not necessarily endorsed or supported by Caring Times.

    That said, we find that this week’s blog, written by Bob Ferguson on the divisive topic of cross-subsidies in the context of the Competition and Market Authority’s ongoing investigation of the care homes market, is too catch-all in its condemnation of care home operators, many of whom charge private fees which cross-subsidise local authority residents as the only means of remaining viable and accepting a proportion of publicly-funded placements.

    While disagreeing in the round with Bob Ferguson’s criticisms, and while it will be interesting to see the CMA’s final conclusions regarding cross-subsidies, Caring Times believes that, despite not agreeing with some opinions, nothing should stand in the way of those opinions being voiced and debated.

    Geoff Hodgson, editor,

    Dr Richard Hawkins, editor-in-chief

    Caring Times

  2. Tara Teubner says:

    This article is extremely disappointing and uninformed. I would suggest that Mr Ferguson take the time to conduct further research and speak to a variety of care providers about why this pricing structure has come into effect. I am confident he will discover that the chronic under funding of the care sector would have caused its collapse long ago were it not for care providers to whom, as always, it has been left to resolve the problem with no support from the Government.

    Local authorities are well aware that they have relied on private payers to make up for shortfalls in the fees they pay and have done nothing about it, so why then is it the providers fault?

    Poorly informed articles like this are shameful and the suggestion that providers should be investigated for financial abuse is in my opinion purely ignorant. Perhaps the better way forward is not to point fingers but rather to educate oneself on the underlying causes, support and find a fair solution to all. After all, it is care providers that fight every day for the welfare of our elderly population…a little more understanding and support and less ill-informed judgement by those who presumably do not want to get their hands dirty and actually get involved with care provision, seems appropriate for the common good of society.

    Villainising care providers will achieve nothing – they are fed up of it and it is and will continue to have a further detrimental impact, pushing care providers out of the market and reducing capacity and the quality of available care beds. Is this what Mr Ferguson wishes to achieve I wonder? Who will care for him when he reaches that time? It is not as easy as he presumably thinks.

    • Bob Ferguson says:

      Tara, as the CMA findings demonstrate, “cross-subsidy” – in which self-funders are seriously disadvantaged by what LaingBuisson has called “information asymmetry” – is one of a number of questionable practices.

      Is it really fair that these folk, not all of whom are rolling in money, should – without so much as a by your leave – be squeezed to offset the underfunding of state-supported residential care? On that basis, poverty could qualify as a justification for armed robbery.

      By the way, it isn’t just me: last year, during a parliamentary debate it was condemned variously as “a secret tax” and “abhorrent”.

      Looking ahead, is it likely that, as the tide of austerity recedes, the business/contractual practices that have given the CMA cause for concern will vanish? It’s fair to say not everyone is convinced.

      For what it’s worth, I had my hands well and truly “dirty”, as you put it, for many years. Consequently, I do recognise that it ain’t easy.

  3. John Burton says:

    What Bob’s admirably trenchant blog demonstrates is the folly of “going along with things” when we know they are wrong. If care providers had stood together and refused inadequate fees from local authorities, we wouldn’t be in this situation and government at local and national level would have had to tackle the issue of underfunding care. We have the same situation with regulation and inspection. Providers have grumbled but they have in effect meekly complied and even supported the CQC in their creeping bureaucratisation of care.

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