By their works shall ye know them

Posted on July 7th, by geoff in CT blog. 8 comments

By Caring Times editor Geoff Hodgson

While David Cameron has got his knickers in a knot over the appointment of Jean-Claude Juncker as President of the European Commission, the UK’s care sector is doing its own contorting over comments by the newly appointed chief executive of the NHS Simon Stevens who has said he would be disappointed if in 30, 40 or 50 years’ time nursing homes still exist.

“He’s out of touch!” howl the associations. “He should come and look at a modern care home to see for himself how care homes are centres of local communities providing preventative, intermediate and long-stay care in a compassionate and caring environment.”

Quite so, but I wonder how serious he is. Simon Stevens is a career civil servant who oozes the ethos of the NHS with which he is imbued. In his speech to the NHS Confederation annual conference in early June he was at pains to placate and reassure his audience. For example, he dismissed the almost universal concern about the bloated NHS management structure with the comment: “Rather than constantly debating the reorganisation of our management tiers, let’s now ask the more profound questions about how care is actually being delivered.”

No change, then, on that score. Politician that he is, he used many words to say not much but he did suggest that there might be a new approach to commissioning services so private providers might have cause to be cautiously optimistic. Why then, this off-the-wall comment about there being a decreasing need for care homes? I think it’s because he knows that the care sector has insufficient weight in public sector circles for there to be any significant threat to his position and that, being the customer, he can afford to be offensive.

Simon Stevens is a crowd pleaser. We’ll have to wait to see what he does, but we can discount much of what he says. The problem of course is the weary merry-go-round of NHS chief executives we have to put up with as senior civil servants seek to maximise their retirement benefits. The average tenure of an NHS boss is about three years. Sir David Nicholson jumped ship after two-and-a-half years. So we get these regular infusions of tired old blood carrying the same old maladies. By the time the NHS lurches towards a £30bn deficit by the end of the present decade, Simon Stevens will be long gone, and a growing number of care homes will be doing their best to bail out the future incumbent.

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

8 responses to “By their works shall ye know them”

  1. Bob Ferguson says:

    Oh dear, oh dear, oh dear. Yet another dose of that tiresome (Farage-like) cynicism about politicians and senior civil servants. Give this guy a break – please. At the very least, put his words in the context in which he delivered them: he said he believes better community care and advances in dementia research can be used to help people stay in their homes.

    Then give him credit for saying out loud what many people are thinking – and hoping.

  2. geoff says:

    As my 99-year-old mum often says: ‘fine words butter no parsnips’. Noble goals to be sure, but his roadmap to Shangri-la is a little sketchy. I think again of my headline.

    • Bob Ferguson says:

      Instead of relying on home-spun wisdom, and\or speculation, wouldn’t it be better to offer Simon Stevens a right of reply.

      • geoff says:

        I believe the right of reply is tacit as a blogging convention.

        • Bob Ferguson says:

          That will only apply where the person concerned is aware of the blog(s) – there is at least one other. What harm can there possibly be in giving the guy the option?

  3. Gillian Dalley says:

    Sadly, for the past thirty and more years, newly appointed ministers and officials in health/social care have always made the same pronouncement, predicting the ‘end of residential care’. Just like the ‘end of history’, they’re always proven wrong. In their blind naivety they think they can wish away the need for full-time care and support, the need for human relationships, and the importance of combating loneliness and isolation for people as the enter very old age and infirmity. They are persuaded by a rhetoric which says that living in your own home is always, under every circumstance, best – even though it often brings on the loneliness and dependency they think they are setting out to conquer. Once in office, they gradually realise that ‘doing away with care homes’ will never happen – but in the process undermine the valiant efforts of dedicated people working in the care sector to bring real quality of life to the residential environment. How can people working in the residential sector do their best when they are constantly denigrated by those at the top? We need to re-evaluate care homes and the staff who work in them and recognise their intrinsic value – and stop seeing them as the regrettable last resort. Unless that happens, people in powerful places will always make the same mistake that Simon Stephens has just made. It’s time we treated residential care as a valuable and necessary resource in society’s efforts to bring care, comfort and treatment to those in need – all the time ensuring that residential care itself steps up to the challenge of being the best it possibly can be.

  4. I can understand that Simon Stevens might have been wanting to make a point about the need for more flexible models of care in future, so that there is not an ‘either/or’ choice of staying at home or going into residential care. But many residential and nursing home providers already provide that option. Moreover, his statement could be read as likening residential care to something as bleak and fear-inducing as the old TB isolation wards. Not only is this inaccurate as a picture of residential care; it will also instil needless anxieties amongst current and potential residents and their families. The effect on providers themselves must be frustrating and depressing.

    But Simon Stevens will only get away with this kind of insinuation if the social care sector itself does not speak up.So this is a leadership issue for the sector – as the saying goes, whatever you tolerate, you get more of. And whilst I was pleased to see Martin Green’s press release on behalf of Care England, I would also like to have seen the major providers and other associations coming together with a single voice to rebut the assertions, or at the very least challenge them. The current integration agenda – an approach endorsed by the House of Commons Health Select Committee today – needs health and care to work together. And there needs to be mutual respect for this to happen. If we don’t have that, the ultimate losers will be the people needing care and support in the first place.

    • Bob Ferguson says:

      Debbie may be right that Simon Stevens’ reported comment about nursing homes was a rhetorical flourish to make a point. Then again, she – and many others – may be completely wrong. Only Mr Stevens knows the truth of the matter.

      Currently, everyone is speculating on the basis of one report that has subsequently been widely repeated. That can’t be evidence enough to send him to the scaffold. Let him explain what he meant. And if he really has been a very naughty boy then castigate him. Surely, that isn’t too much to ask for.

Latest blog posts

The NHS and all that jazz

By Caring Times editor GEOFF HODGSON

Last week the National Health Service marked its 70th anniversary. The irony is that, when this all too human institution...

The bland leaving the bland?

By guest blogger JEF SMITH

The headline for an interview which Sir David Behan, the Care Quality Commission’s departing chief executive, gave to The Guardian...

IT comes to CQC

By guest blogger JOHN BURTON

This month, IT is coming to CQC in person. David Behan is leaving, and DB’s replacement is IT, Ian Trenholm...