Labour’s promises on health are setting the party up to fail | The BMJ

Keir Starmer is making big, conflicting, and unrealistic promises on health, without a clear plan for delivering them, which is setting Labour up to fail.

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I so agree, for he is doing what all governments are doing and have done for years and that is completely ignore an essential part of health and that is social care.

While not administered by health (NHS), but should have been, for it is administered through Local Authorities, for social care and the NHS are so part of each other and one can’t exist without the other. If one goes the other will certainly follow.

So, funding for social care, staffing issues and so much more is just as important, if not more so, than for the NHS, but no government is, has been and in the future apparently wishing to admit to.

Social care workers are so poorly paid that people are not wishing to enter the care profession or if they do, there are too much insufficiency of them to make any differences. Their pay rates need to be starting around £14/15 per hour and not the current rates of around £11 per hour.

This leads to great insufficiencies in social care and in many instances no social care completely. Thus leading to cause much health inequalities creating many areas of health deteriorations, which creates more need for social care and much more needs for the NHS to deal with.

This is not just in social care relating to care homes for the elderly, but also much increasing needs for both children and all adults in home care, supported living, respite, hospices and much more.

Families have been doing all they can and much more amounting to a saving in 2021 of £193 billion within the UK, an increase in the £132 billion in 2015, so if it was not for families, social care would be in a much worse state than it is. While this is very bad and getting worse day by day, all due to governments taking no notice. Is this by ignorance or by deliberate design, I feel the latter as UK governments don’t care.

By ignoring the state of social care not only are the persons in need of social care deteriorating in health, but their families also, thereby, eventually causing more demands on social care and then so much more on the NHS. This is nowhere near sustainable, so extremely urgent actions are required by government, but our currently government even only offering a miniscule amount, then halving it and then eventually delaying until 2025, with no guarantee on resolving then.

So the outlook for social care is so very bleak and if Starmer, should he become Prime Minister in 2024, his so unrealistic NHS outcomes will never be delivered, unless he first delivers on social care, which on today’s understanding could need anywhere between £8-12 billion initially with much more on a regular yearly basis for social care only and then will he be able to also concentrate on the NHS.

Very dire indeed and so, so urgent.

Source: Labour’s promises on health are setting the party up to fail | The BMJ

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Vulnerable kids put in foster care up to 500 miles from home due to carer shortage – Mirror Online

This is another shocking example of the state of Social Care in the UK and 2010 Austerity Cuts are much to blame. Social care needs so much immediate funding, but it never does, even when promised it is then halved and eventually then delayed, currently to 2025. But with no guarrantee it will be then.

Social care early interventions could well reduce the need for any foster care, but firstly social care needs to be sufficiently funded, for I see it never has been and I so doubt it will ever be, no matter what the colour of government comes next.

 

Source: Vulnerable kids put in foster care up to 500 miles from home due to carer shortage – Mirror Online

Keir Starmer unveils Labour NHS plan – from AI to diagnose ‘silent killer’ to vaping ad ban – Mirror Online

Well, it is true much needs to be done, but before a problem or problems can be solved you have to understand what the problems are. Money is one thing, but training is another and so are working conditions, not only in the NHS, but even more so in social care. Both have massive staff shortages and many people unwilling to enter both areas.

Rates of pay for care workers are so abysmal and yes, they do need around £5 more per hour. Without a substantive social care workforce neither social care or the NHS will survive. Social care needs £billion more like £12 billion and then continued for years to come, if not say goodbye to social care and the NHS, no matter what Starmer says, he is just spouting hot air for votes.

He says he wants more NHS staff, but does he know that to train a GP takes 10 years, perhaps not.

 

Source: Keir Starmer unveils Labour NHS plan – from AI to diagnose ‘silent killer’ to vaping ad ban – Mirror Online

Why council was found to have breached Care Act needs duty after panel cut indicative budget – Community Care

Thankful for the court’s decision, but is Croydon alone in these areas, I so doubt it.

Also, was it that Croydon didn’t understand the requirements of the Care Act 2014, knew them but decided to not abide by them, or was so short of finance that they took a chance they could get aways with it.

Perhaps a mixture of all and may be some more.

Many, if not all Local Authorities, (LAs) are so short of finance, due to Tory austerity cuts in 2010, that they are having to cut many essential services and LAs are shouldering the blame for these cuts, when the real problem is the Tory governments since 2010. While initially social care was not affected to as much degree as some other service with some LAs, due to the ongoing and more substantial cuts imposed over the years, social care had to shoulder their degree of cuts. This then making social care being provided to many being far short of what is required and to some no social care at all.

As we can see, this has and is severely causing many problems within social care and much suffering and lack of care for persons in need of care and creating much stress and concerns with their families as well.

Families do as much as they can and then even more, thus causing their own health’s to suffer.

In the last few years this has been causing much more demand on the NHS and further increase the crisis in the NHS, so not only major crisis in social care, but also in the NHS.

This government and all future governments have to ensure that funding for social care and the NHS is at least sufficient and then sustainable. To not do so will lead to the eventual complete disintegration of social care and so to much of the NHS.

Perhaps this is what all Tories are wishing for and then they can bring in full privatisation and the complete demise of the NHS and social care.

Will Labour be any better, well I so doubt so.

Source: Why council was found to have breached Care Act needs duty after panel cut indicative budget – Community Care

Why we should celebrate the birth of social care (but not too much) | The King’s Fund

I endorse many of the coments in the article and much insight and hindsight.

Yes, 1948 was and still is a defining moment in many ways and showed that Government thinking was ahead of its time in many ways and not in many other ways.

No one would have foreseen all the major advances in medicines and health provision, or the expanse of the UK population and its much diversity. Due to medical advances more health conditions were found and many persons with disabilities and poor health would not have been thought to survive have and are surviving. All of this is creating major supply and demand issues in both health and social care.

As it stated health is free at the point of delivery, while social care is not, but is not fully charged to persons in need of social care, but the costs incurred are still probmatic and still be demanding. By having some health conditions deemed to be under health and others under social care it is creating forms of discrimination, when there should not be. In hindsight it could have been better for both health and social care be free at the point of delivery and not each be administered and managed differently, being health under the NHS and social care under Local Authorities, (LAs). Yes, much more costly on the State, but less discriminatory.

In the article it states ‘There is even a hint of the personalisation agenda in the Act’s recognition that accommodation should not be standardised but rather should cater for the differing needs and tastes of different types of people.’, that there may have been, but due to each social care being under each individual LA, standardisation as mentioned was never done, well not to cater for ‘differing needs and tastes of different types of people’, as the standardisation was much of the same for everyone and differing needs and taste not being really catered for.

The Care Act 2014 is mentioned and while this did go some way to create more equality, it fell well short of what was really required. Also, instead of creating must’s it mainly states guidance and to create more equality individuals need to challenge by making Formal Complaints and then, if need be take to the Ombudsman or raise a Judicial Review.

While making a Formal Complaint can be made, few do so, well not as many that should do, for many in need of social care are scared to do so, not aware that they can or have a poor history of doing so, therefore there is much distrust between people needing social care and LAs, for one person taking on a large public body can be seen as very challenging  and people tend to put up with the little they have, rather than challenging and perhaps lose the little they have already, which has been known to occur many times. So, many people don’t have the courage or perhaps the ability to do so.

Then, if you are not happy with the outcome of the Formal Complaint you can forward to the Ombudsman or make a Judicial Review. While the Ombudsman process is not that really complicated, but many would feel it is, it is a very lengthy and cumbersome process and then the outcome is down to administration by LAs, rather than right or wrong. But it is free to do, except for time.

Judicial Reviews on another matter for they are costly and very complicated, so many don’t progress to starting, especially as Governments have curtailed many aspects of funding for Judicial Reviews and in doing so making it much harder to do a Judicial Review, unless a Solicitor can be found to do a ‘No Win, No Fee’ application, but Solicitors are very choosey whether they will or not. Then the Courts don’t appear to fully use the full extent of the Law available, especially in using the Care Act 2014.

So, social care is so much less than it should be in many ways and many who need social care don’t receive any or way insufficient. This was made much worse when the Tories introduced Austerity Cuts in 2010 and still are today in many ways, this caused LAs to have much less finance available, even when there was insufficient to begin with. So the amount of social care available is forever diminishing, when demand is so greatly increasing.

Currently there are major funding and staffing crises in both the NHS and social care as the government is unwilling or as they say, unable to fund sufficiently as government funding is insufficient and there is a cost of living crisis. When was there not a cost of living crisis, well forever, for carers in social care for many are only paid or just above the National Living Wage, so around £11.00 per hour which is nowhere near a Living Wage. To make it a better paid profession and a more realistic Living Wage, these carers should be receiving £14/15 per hour, this would then encourage more persons to enter the care profession, rather than go into other employments to earn £14/15 with much less responsibilities.

While the health and social care are administered differently through different organisations, health through the NHS and social care through independent care providers, who are mainly funded by LAs, both the NHS and social care are so dependent on each other. Lack of social care leads to insufficient capacity and increase levels of health deteriorations, which then causes more demand on NHS resources. Insufficient social care not only causing health deteriorations, but also causing blockages in hospitals who not only have insufficient bed capacity, which leads to restricting more patients to access hospitals, mainly through A&E, but are also short of required funding, so much needed expansions are not occurring or being considerably delayed.

Whatever funding the government gives to the NHS is so insufficient, but the funding to LAs so they can then fund social care is virtually non-existent and what insufficient funding is mentioned is then at least halved and then delayed  for 2 or more years.

Funding and much more is required now, immediately, for to wait any longer will mean no social care and the disintegration of the NHS, so effectively no social care or NHS, even worse than that before 1948, so much for progress.

Source: Why we should celebrate the birth of social care (but not too much) | The King’s Fund

‘Resource pressures’ behind decision to shelve LPS, says care minister – Community Care

The one thing this Tory Government is good at is shelving, for they put off this and put off that and then put off the other, just what do they do, I know, look after themselves and we the others can ‘Rot’ for they don’t care as long as ‘Number One’ is OK.

 

Source: ‘Resource pressures’ behind decision to shelve LPS, says care minister – Community Care

adass-time-to-act-april-2023| The King’s Fund

Thank you to The King’s Fund and more to ADASS, which I don’t say very often, especially to ADASS, but now I welcome saying it.

I have been, in my own way been campaigning for more to be done for social care for going on 10 years and more, because in 1984 I joined a family and became a husband to a single mother of 3 children, one who had multiple physical and learning disabilities, a sensory disability and later we found also autism. I came in not knowing anything about disabilities and especially learning disability and then autism, so I had to learn and learn fast if I was to be of help and not a hindrance.

We didn’t trouble the authorities much, both health and social care, where on reflection we should have done. My wife and myself had some degree of youth and strength and good health, so we decided we could manage, but in time my wife’s health started to deteriorate so we asked for a little help and we were granted 6 hours of care per day during Monday to Friday and received a Direct Payment from our Local Authority, (LA), to manage the costs. But as time went on my wife’s health deteriorated much further and mine also started to deteriorate, so over the years the amount of care provided increased in small amounts until 2016 when we were eventually granted 24/7 care and during this time the Direct Payments were increased to cover the increased costs.

When the original care was granted we did this by employing our own carers, funded through Direct Payments and the rate of pay was recommended by our LA and when the Real Living Wage was introduced by the Living Wage Foundation in 2011/12 it was £7.20, while we were paying that rate as recommended by our LA in 2010/11.

Then came the Tory austerity cuts, so our rate of £7.20 remained unchanged for a number of years, but not only because of the austerity cuts, but in 2010/11 that was the year our LA stopped recommending a rate, but never advised anyone it was going to do so. So there I was waiting for the recommendation not knowing it was not to come and believed it was because of the austerity cuts.

It was not until some 3/4 years later that I heard our LA was going to start paying their staff the Real Living Wage, so I emailed the Leader of the Council, at first no reply, but then I sent a stronger worded email and it was referred to a Council Officer, who eventually, in so many words, ‘what we paid our carers was nothing to do with them’, even though I could only pay what was agreed in the Direct Payment.

I then made a Formal Complaint and eventually after many months in fact over a year was allowed to increase the payment to £8.00 per hour and then in 2019 to £9.00 per hour.

In 2020/2021 not one person employing their own carers and paying through Direct Payments in my LA received an increase for the carers, although carers who were employed by care providers did, even if to pay this the Direct Payment had to be increased. So no equality for paid carers as my LA allowed increases in Direct Payments for paid carers employed through care providers but not paid carers employed directly through families. Surely a case of discrimination, not that I begrudged the care workers with care providers, but so unfair on my own employees and those in other families. It came that when I started employing carers they were being paid more than carers from care providers, but by this time care workers through care providers were being paid more than those I employed and as I had carers who I employed and also had many from a care provider, the later were earning more for doing the same work.

In 2021/2022 I joined a LA Working Group looking at pay for carers paid for by families and after some lengthy discussions and some few months it was agreed that pay rates would be increased by 5.66% for carers paid by families and by 4.99% for carers paid by care providers, so for the first time, or was it coincidence that both the carers paid by me and those paid by the carer provider were being paid at the same rate.

But not all, for it was agreed that each year the pay rates for carers paid by families would be increased each year.

During this time my wife succumbed to her health problems and died in September 2020 and this was then followed by my daughter in October 2022, but I am still involved with the LA in various discussions and have been advised that they have kept their word and the yearly increases are continuing.

I gave the aforementioned as some history to some of my involvements, but I do have many, even though I have now no family within social care, with the possible exception of myself due to my own declining health, but mine is minimal on my LA resources, currently only a loan of a shower chair.

So my involvements in social care and in many areas of health have been extensive and varied and I have deep worries for the future, not mine, for my future will now be short, but for others around and not just within my own LA, but every LA within the UK.

For once a government has to look and take decisive action about social care for otherwise it will not survive. But it has to survive for the continuation of our much desired and required NHS, for the NHS can’t survive without social care, as social care can’t survive without the NHS.

They are really that inseparable and without either one we are all in great peril. The Government funds the NHS to some degree but not Social Care.

This King’s Fund report is a great start, but should have come many years ago, but now we have to have a listening government and then for it to act accordingly, but unfortunately I have never seen one in my near 74 years. One is desperately required, but I don’t see one coming no matter what the colour of the next government, for no party is mentioning social care.

It is said there is no money, but the government found it for King Charles III Coronation and yes, there will be rewards to the economy, well it certainly needs it. Funding needs to be found for social care and it is required now, for 2025 could be well too late. I also agree that the cost of living needs to be controlled, but at what cost, is it lives for no funding for social care?

Where is the governments ‘Duty of Care’ and all the consequences of safeguarding alerts?

Source: adass-time-to-act-april-2023.pdf

NHS social workers’ pay deal to go through after majority backing from unions – Community Care

Yes, it has but is it enough, well no it is not, not for nurses and other NHS workers who have accepted and will not be for those still to accept and again for teachers and any others.

But, there are workers still much worse off and this does affect the NHS, yes the care workers, those who provide care in care homes, home care, supported living, respite, hospices and others for both children and all adults. Many of these workers are on or just above the National Living Wage , which effectively is not a living wage because it is taxable. A living wage should be so not have tax deducted as the tax threshold should start at the National Living Wage. Even then, it would be so insufficient for the work care workers do.

Like workers in the NHS, teaching and other professions, there are very real shortages of care workers, so many people are reluctant to enter the profession as they can earn much more in other occupations with far less responsibilities.

This is and has led to a serious decline in the availability of social care which is bringing and has for some many years much more usage of NHS services adding to the so severe crisis already in the NHS. Not one real mention has been made about funding social care by this government or any of the opposition parties. Except this government has stated to delay funding, which was so short of what is required until 2025, social care and the NHS may not have that long, but no politician cares.

The government found the money for King Charles III Coronation, even though there is a cost of living crisis, but not what really matters to the most vulnerable people in our Society. Charles has £millions, more likely £billions, but the government, or really we paid. Yes, it was a splendid occasion and may be some of what the country wished for, but there were much more urgent needs.

Neither Rishi or Starmer mention social care and in fact neither do any of the other party leaders, so the writing is there for all to see, the further demise of social care and with it the NHS.

None of us want a privatised health care system, but it is becoming so much closer, when will it become like the American system, for then we may all as well give up and die, which many are doing today, many yesterday and much more tomorrow.

Nobody is bothered about safeguarding and Human Rights, well not in government or in all areas of politics.

 

Source: NHS social workers’ pay deal to go through after majority backing from unions – Community Care

Readers’ Take: how much does negative media coverage affect social workers? – Community Care

Social work has never been easy and it continues to get worse for many reasons, one of course is funding, as it is funded through Local Authorities, (LAs) the employers of social workers, but LAs are to some degree funded by government who are not prepared to fund LAs sufficiently to invest in social care with the necessary amounts it really requires.

This and previous Tory governments have done this by introducing austerity cuts to LAs since 2010 and thereby severely reduce the amounts of finance LAs have, not just for social care, but all other essential services, and yes. social care is indeed an essential service. But, it is not recognised as so by government, who at times go out of their way to deride it by many means. This the media pounce on and do many of the UK population, so social care and within it social workers are not thought highly of, when they all should be.

Pay rates for many in the UK are well below what they should be and this is so much so in social care. Social workers are poorly paid, but that not as much that care workers are. By these poor rates of pay the state of care workers in the caring profession are well short of the required numbers and therefore there is a great reluctance of people entering the profession, so the amounts of social care available are well short of what is really required.

To a great extent the same is similar with social workers and most if not all social worker areas are also well short of the numbers required and this increases the pressures and workloads on the social workers available. In some instances LAs bring in agency social workers at higher rates of pay and so, not only deplete the funding available overall, these agency social workers are usually unaware of how each area works and maybe don’t fully understand the people in the cases they are given to work with. As they could well be on short-term contracts, they may then leave before the case is sorted and if it reoccurs may not be there to deal with it again. This all increases the pressures all social worker have to work under, in a profession that is already full of pressures.

Yes, mistakes are made and in these instances lives are involved so many of these mistakes causes lives to be lost. Now no one wants to make mistakes and certainly not be some cause of loss of lives, but pressures do cost lives. But, the ‘buck’ stops with social workers and the social work area and in many respects it should do, but blame should also be cast to governments for their inability to fund social care is one of the main reasons for many of these problems, but do Governments and Ministers get the blame, no not even slightly.

I am not discounting the mistakes made and the consequences caused, but blame should be shared with all parties involved and the government is a party to all this.

Unfortunately all of this with LAs and social workers leads to a great distrust with persons in need of care and their families and in some instances families will not disclose all relevant facts, even when there is no criminal activity.

I have been involved with a LA for over 39 years as a family carer and know all was far from right before 2010, but the austerity cuts made all the situations so much greater.

Unfortunately social care has always been the emergency service which is never recognised, when it should always have been.

To right these wrongs, certainly funding, we need a listening government which there has never been, but whatever listening there was, which was never much, has been so more lacking over the Tory years, but Labour were not strong on that either and with any new government, I, unfortunately don’t see any changes for the better occurring and maybe even worse to come.

 

Source: Readers’ Take: how much does negative media coverage affect social workers? – Community Care

NHS pay deal signed off for one million staff – BBC News

Ministers agree to pay a 5% rise in England – but nurses are still threatening strike action.

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Yes, Prime Minister Rishi Sunak MP and Health and Social Care Minister Steve Barclay MP are applauding this and yes, it is more money in NHS staff pay packets, but it should be very much more.

Some nurses could still decide to strike, those in RCN and Unite, but this is the final offer, so they will not gain more this year, but every NHS worker should have receive so much more and by Rishi and Barclay refusing to do so, the staff exodus will continue. Even the staff from out of UK will not for they gain their 3 years’ experience and then leave for better pay and conditions away from the UK, who can blame them.

But, the discontent is not just with NHS workers for we see it with teachers and many other professions, especially care workers whose rate of pay is abysmal. Without care workers not only is social care doomed, but also the NHS, for the NHS will not survive without a robust social care and that has not been so for many years and is a major part of the crisis effecting the NHS.

You may say what has care workers pay to do with the government, well Local Authorities (LAs) fund the care providers so they can then pay their care workers. But since 2010 this and previous Tory governments have serious cut fun ding to LAs through the Tory austerity cuts. This has led to depletions of many essential LA services and no matter what you think Social care is also a very essential service. For without social care people in need of care will continue to further health deteriorations, so more demand on the NHS.

But it is not just the people in need of care, but also their families who do all they can before requesting social care help from LAs. If that help is not forthcoming or is insufficient then the families health will also suffer, so they then need more from the NHS. If every family care decided they would not care for their relatives, which they never will do, this would cost the UK well more than £193 billion for that was the saving family carers saved the UK in 2020, which is much increased from the £132 billion in 2015.

This government and many previous just haven’t a clue, or perhaps they have but just don’t care, or they are aware, but cut funding for the NHS and certainly for social care so both can be fully privatised, in effect having no NHS, well certainly not free at the point of delivery, which is one of the cornerstones of the NHS as formed in 1948.

Even this 5% increase will not be fully funded by the government, as NHS budgets were decided in around January 2023 so they could be ready for April 2023. An allowance will have been made for salary increases, in all NHS budgets, but most likely not for the full 5% or the one-off payment, so the balance will come from existing budgets, which means less for day to day care in the NHS, so the crisis well deepen.

All governments are corrupt to a degree and with some the degree is much bigger than others.

Lets all do what we can for every worker who is paid insufficiently and that in most respects is holding the government to account, every 5 years in a general election is way too long, there needs to be some means to ensure accountability is immediate.

So on top of all the other problems and crisis our form of government needs to be changed so that accountability can be ensured.

Unfortunately, a change of government is way insufficient for any change in government will be in the same system and it is the system that is in dire need of change as well as the government. One change would be to bring in proportional representation, (PR), but neither Tory or Labour are wanting that, because it would diminish their power and power is what they crave for, including Starmer, as well as Rishi and perhaps other Party leaders, no one politician cares about the UK population.

Source: NHS pay deal signed off for one million staff – BBC News