The crisis in elderly care is not brought about by the effects of Brexit but has been with us for some 20 years.
This is not as the Guardian asserts in this excellent piece brought to us by Dr Alf but because of a number of other factors.
Adult Social Care and the benefits system, and the point at which these meet, has been in a muddle for years because the public and successive Governments have refused to fund it properly and because rather too many people have found it convenient not to stay on the dole but to go onto the old incapacity benefit and now onto the harder to qualify for “Personal Independence Payments”.
Whilst some are genuinely disabled, such as World War 2 and later wars veterans many are dole bludgers, perfectly capable of work riding about on mobility scooters pretending that they cannot work or walk and cluttering up doctor’s surgeries and shopping centres and sitting in coffee shops nursing the same cup for hours on end.
A look at cruise line passengers reveals many of these frauds for what they are when the ships reach international waters and walking sticks, Zimmer frames and mobility scooters are left piled up in a corner and these Adult Social Care recipients are able like Lazarus rising from the dead to transmute from someone unable to barely move unaided into a disco dancing, libidinous “pensioner /individual behaving disgracefully”.
I rarely cruise but my friends that do tell me that this spectacle is commonplace.
Then there are councils themselves, whose procedures for looking out for fraudsters are not nearly rigorous enough as I saw for myself when I was involved for a year in the biggest piece of local authority transformation ever undertaken in the UK. Too often woolly minded and well-meaning social workers in that 3 star(top 25%) authority were being conned by sob stories delivered with the panache of a Sir Laurence Olivier in full flow during his heyday. Thus in the 75% of authorities which are worse run than the one I worked in as an interim the incidence of people “gaming” the assessment and pre-assessment processes was and is much worse.
There are too many local authorities which means that money that should be devoted to Adult Social Care is spent on excessive numbers of service directorates and middle managers and because Adult Social Care sits in local authorities rather than being integrated into the NHS as happens in Germany, you get bed blocking in the NHS, plus duplicated layers of management in both the NHS and local authorities.
Then there is the question of demand, in that too many people through overeating, eating the wrong foods, laziness, smoking, drinking and recreational drug use turn themselves into Adult Social Care recipients in the first place.
The prescription is a tougher approach to early intervention in healthcare, a stronger attack on fraud and a preventative approach that reduces sugar content in food and drink,increases pedestrianisation, zones out fast food outlets, promotes healthy eating, eliminates harmful chemicals in the environment and promotes exercise and work as a treatment rather than idleness.
Measures like this reduce the number of people becoming Adult Social Care recipients in the first place and reduces the number of carers needed.
Those people that do need such care can be dealt with by an integrated care system run on German and Singaporean lines paid for by clearing out unnecessary NHS managers and Adult Social Care Directorates in local authorities.
EU migrants are used as carers and in other forms of work that the indigenous population are not prepared to do so with greater economies of scale and better procurement plus the elimination of fragmented outsourced provision from people like Serco and Capita money can be freed up to pay people better and eligibility rules on dole need to be tightened up so people are compelled to do more of this work and not languish on the dole,consuming recreational drugs,watching Jeremy Kyle in their “onesies”during the day and operating in the Black economy by selling goods of dubious origin on E-Bay and at car boot sales at the weekends.