A report published today suggests that the vast majority of local authorities are paying less than the recommended minimum to provide domiciliary, personal care for the elderly. The UK Homecare Association says that just over £15 an hour is the minimum needed to provide essential care – including paying staff national minimum wage of £6.31 an hour, national insurance, pensions, training costs, travelling expenses, etc. The average Council is paying about £12 an hour, some much less. The reason? Cuts in funding overall means some services get cut back more than others.
Three things strike me about this. Firstly if you are paying staff just £6.31 an hour to care for vulnerable adults, what quality of care can you expect, especially when those staff are actually only supposed to give about 15-20 minutes to each visit (often less, with no travelling time allowed between visits!)? Poorly paid staff without chances for further training (paying below the minimum per hour means training budgets are often non-existent) means elderly people getting not even the minimum necessary care. Who can get up, washed, dressed and breakfasted in twenty minutes? Maybe you are quicker off the mark in the morning than me, but how is a disabled or frail elderly person supposed to get up and going in that kind of time frame?
Secondly, this a group that is largely silent, largely invisible, and has little or no political clout, so it is easy to ignore them and cut services without howls of protest. Sadly, cutting these care services has been the order of the day no matter whichever Central or local government is in power. Axe services used by those with a voice and a tendency to vote, and any administration will know about it and be forced to back track.
Thirdly, and maybe most disturbingly, this reflects a deeper malaise: a breakdown in the social contract between the generations. Much has been written on this subject, often blaming wealthier Baby Boomers for inflating property prices and bankrupting pension plans, leaving their children and grandchildren destitute. I would argue it is more complex than that. Last week the Commons Public Accounts Committee raised again concerns about shortages of midwives and obstetricians in maternity units. Successive governments, despite pledges to the contrary have failed to increase the resources allocated to caring for the start of life. We are not allocating resources well if our newborns and frail elderly, the disabled and marginalised, are being left behind in our care and medical services. We are not caring for the generation coming up behind us, and neglecting the generation preceding us. Treating the newborn and the frail elderly as non-productive, ‘social ballast’ not worthy of our full attention is a dangerous road to drift down.
The Bible has a lot to say on all of these issues. It reminds us to honour our parents and not despise the generation that precedes us, to care for and stand up for those without a voice, to pay labourers properly for their work. Society, in New and Old Testament understanding, is held together by the strong laying aside their priorities for the sake of the weak and the vulnerable. Once we start to wander away from that obligation we start down a dangerous path.
We do need radical thinking on this, and debates must go forward on how we can fund the growing need for care (a debate which keeps stalling in Parliament!) and for good maternity services. But we cannot forget our obligations.