Since 1975, Britain has changed a lot. Today the country is leaving the European Union, whereas 42 years ago it was reaffirming its membership of the European Economic Community. It is also considerably older as a nation.
This will have huge implications in terms of health and social care, and soon. A study in The Lancet this week predicts that the number of over 65s requiring some form of care due to age-related disability could reach 2.8 million by 2025 in England and Wales – 25 per cent more than in 2015.
Tracking trends in life expectancy, the study found that the care increase is the result of growth in the population of over 65s that more than wipes out any reductions from expected drops in the incidence of dementia and cardiovascular disease. The authors warn that if the “shortage of caregivers and the poor state of care” are not addressed urgently, many more people on low incomes will be unable to live independently.
If the shoe fits
At long last, the parlous state of social care in Britain, the Cinderella of health provision, is making headlines and attracting political attention. It’s about time. Last year I witnessed the struggles of this corner of our health system when working undercover caring for people in their own homes for a month while researching a book.
There I encountered staff treated by care companies as “glorified cleaners”. The women I worked with (most care workers are women) were underpaid, undervalued and had minimal training before being sent out to vulnerable people.
Much of this boiled down to money. Since the 2008 financial crisis and government spending cuts, there has been a squeeze on council budgets, with less to pay for care providers. As a consequence, it is often companies that change the most catheters and wipe the most bums for the lowest price that win contracts.
It all adds up to a bargain-basement service and an unattractive job. Some 300,000 care workers quit every year.
The most obvious solution is an injection of cash. Going into the general election, the major parties have acknowledged this to some extent, and are for the most part arguing over where that money should come from.
But the care sector – and by extension the government – must also start valuing those who do the work. Paying them peanuts and parking them on zero-hours contracts is a recipe for substandard care and staff shortages. Many earn less than the minimum wage once their (unpaid) travel time is factored in.
All this risks the health of vulnerable people. “Clockwatch care” is rife, as staff rush through appointments stuffed into rotas like sardines in a tin. More than half a million care visits between 2010 and 2013 lasted five minutes or less.
Changing this will improve the treatment received by an ageing population. But it will also make it easier to recruit the carers the country is going to need.
With Brexit’s immigration clampdown likely to deplete the labour force further, turning care into a properly funded part of our health system that people want to work in is going to become a matter of urgency, whichever party is in power.