Polly Toynbee’s prophetic article (The ghosts of the care-home dead will come back to haunt this government, 1 June) highlights the neglect of the independent healthcare sector by Boris Johnson and his colleagues, and the endemic malice inflicted on it by successive Tory governments since Margaret Thatcher.
During the Thatcher government, when Kenneth Clarke was health secretary, the Tories stealthily abolished much of the National Assistance Act 1948, which regulated local authority provision of residential care homes for the elderly. Not only did they reduce the availability of residential care, they also withheld grants for building homes for older people. From that point it was not long before people were obliged to sell their homes to pay for the care they could previously obtain for free.
The Thatcher government also encouraged practising healthcare workers to seize the opportunity to establish their own private nursing and residential homes. As a consequence, many healthcare professionals left their jobs and sank their savings into residential care businesses. Events have proved that many of these people have been badly let down by Tory governments, whose management of the private sector has been disastrous.
Toynbee is of the opinion that “care needs to be renationalised, locally run with a single seamless NHS/profession” – a viewpoint with which many would agree. I would suggest we go even further and that the whole gamut of healthcare should come under the aegis of the NHS, even the independent sector, which should be regulated by healthcare professionals. All staff should be treated as professionals in their own right and their remuneration should be appraised accordingly.
• Polly Toynbee is wrong to suggest that “the failure to reform social care’s ramshackle finance” is at the heart of the problem. Although I would agree that we should call out one of the prime minister’s earliest lies that “he had a plan to fix social care once and for all”, this is not the full picture. The problem is more fundamental than historical underfunding.
Throughout the past 40 years there has been an uneasiness about working alongside and funding private, for-profit enterprises whose business was caring for elderly and often voiceless consumers – the residents of homes and their partners. But local authorities, confronted with that new reality, put such prejudices to one side and worked at building partnerships with small businesses on their patch. The problems took off as the character of the private provision shifted from being predominantly smaller and locally owned and managed, to large and impersonal companies with a focus on extracting value by streamlining operations and, where necessary, absorbing others – predatory capitalism in action.
If former Tory ministers are indeed calling for takeovers not bailouts, then it’s time for Labour to remind us of its proposal to establish a national care service.
• Polly Toynbee is certainly right about the impact of privatisation on the care home business and, interestingly, the UK is not alone in experiencing the results of this. There have also been excessive deaths in Swedish care homes, which have also been largely privatised. There is always a drive in business for efficiency, ie doing the same thing on less money so that shareholders or owners can take more in profit. And, inevitably, efficiency drives out effectiveness.
Professor Emeritus, University of Sheffield
• Oh, I get it now. The “protective ring” the government threw around care homes was to STOP them from getting help.