Would you believe it?

Posted on October 19th, by geoff in CT blog. 2 comments

By guest blogger BOB FERGUSON

By and large, care home owners’ representatives give government ministers and officials the respect of assuming that – putting it bluntly – they know what they’re on about. But do they? Take for example, the Director General of Social Care, the top man for the sector at the Department of Health. By all accounts, he is approachable, engaging and welcoming – he probably serves his visitors hobnobs and custard creams with the coffee – but if his recent performance before a committee of MPs is any measure, he lives in a different universe.

When questioned about how he ensures that a developing two-tier market doesn’t degenerate into a contrast between “pile ’em high, put them in tiny rooms, treat them cheap” and “I’d like to send my mother there” – politicians do have a way with words, don’t they? – his response was jaw-dropping: “A private provider should not be agreeing to a price with a local authority,” he said, “unless they can actually meet the service for that price.” “Agreeing” a price? Does anybody recognise that?

There’s more. If CQC waves the big stick, he went on, “the provider has to improve, which may mean renegotiating their contract with the local authority.” “(Re)negotiation”? Is he being serious? How out of touch is that? In fact, it merely confirms a disturbing trend in his department. Officials, who appear to have been educated at the take it or leave it school of economics, have long been in denial about the extent to which councils exploit their powers as single (monopsony) purchasers. They have taken as an article of faith that the uneconomic prices about which providers bellyache could be explained away as prudent management of public money: providers were agreeing discounts in return for guaranteed placements. Really? All of them? It has been only relatively recently that circumstances have forced them to recognise that maybe, just maybe, councils have not been entirely blameless. These days, knee-deep in the bog of austerity, they are wrestling with a problem that is to some degree of their own making.

Ivory tower ignorance is not a factor in the DH: officials have been given chapter and verse on these matters on so many occasions they should be able to recite it from memory by now. That they continue to get this basic stuff so fundamentally wrong must be a worry. It matters.

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

2 responses to “Would you believe it?”

  1. Of course, the other response from the sector – with echoes in responses of doctors and teachers – is to get out altogether, or to focus on sustainable services: hence Bupa’s recent decision to sell off 200 of its care homes and similar activity – at an even greater level – in home care. This is market-shaping only in the sense of carving a joint.

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