Kevin McKenna: It’s time for the care sector to be completely nationalised

They were an eternal rebuke to the spirit which has disfigured the politics of modern Britain in which a person’s value is measured only in their potential to be exploited for a profit.

In April the first indications of something obscene lurking in our attitudes to the old and infirm were exposed to the light. This is when it became apparent that old people, having tested positive for Covid-19 in hospital were released back into care homes.

I prefer to give the Scottish Government the benefit of the doubt here; that such a manifest failure of basic care management was the panicked response of a government finding itself in uncharted territory and having to respond quickly.

Back then I caught up with an old school friend now working as a care assistant in a local care home who was eager to speak to me about the horrors being experienced at his place of employment.

He was caught in a terrible moral dilemma: between a duty to go public with his concerns and the knowledge that in doing so he might jeopardise his income and his ability to support his family.

This is what can happen, of course when a workplace is non-unionised and managers can intimidate and exploit, knowing the scope of workers to challenge their behaviour is limited.

My friend then related a story of a care home which had effectively been re-constituted as a mortuary and where staff without basic PPE had been ordered into rooms jumping with the virus.

All potential whistle-blowers had been threatened with termination of employment should they even think of talking in public about this. It was the first evidence of a wider wickedness that can be found within this sector, one which sees human infirmity as something to be exploited rather than nursed.

Somehow in Scotland and across the UK we’ve arrived at a place where the most vulnerable in our society, those who need care at the end of their days, are subject to the whims of predatory capitalism.

In Scotland, more than 50 per cent of Scottish care homes are privately-run. In England that figure rises to around 80%.

Lest anyone think that these privateers are moved merely by a higher purpose an article in Start-up, the specialist business magazine conveys the reality. It explains why investment in this sector can be so lucrative. “In the smaller care homes, if you’re the registered manager you can make 35-40% profit from fees.

“Fees are around £250 per week per bed. Therefore, on a smaller home with say 10 beds, you will make a profit of £50-60,000 before interest payments.

“With larger businesses you can make more money since you get economies of scale.”

He adds helpfully that, as at least 50% of the care staff must be trained to NVQ level two, this can make finding staff “a major problem”.

The care sector in the UK is a place where mercy can seem scarce yet deals with people when they are most in need of it. According to Care Information Scotland the current rates even for “publicly-funded service-users” are £714.90 a week for nursing care and £614.07 a week for residential care.

Local councils are required to set rates for the care homes they own and manage at a rate equal to the actual cost of providing accommodation and care.

This market was always going to be an iniquitous side-effect of Margaret Thatcher’s right-to-buy initiative for council house tenants.

If you have capital assets of £26,500 or more, including the value of your home, you must meet your own care costs in full.

For many this means being forced to sell those homes they were told would unlock the key to prosperity.

The great right-to-buy deception was only ever about feeding the rapacious instincts of the financial services industry.

Last year, the Centre for Health and the Public Interest calculated that care home operators were making £1.5 billion a year with much of it being siphoned off by offshore investors.

In 2018 an investigation by The Guardian found that some of the country’s worst care homes were owned by companies who raked in profits totalling £113m.

These homes housed people with dementia and learning difficulties, but were given the lowest possible rating by the Care Quality Commission.

In her Programme for Government earlier this year Nicola Sturgeon announced plans to investigate the creation of a National Care Service, following an independent review of adult social care which is due to report at the end of next month.

It led to squawks from within the care sector that this could lead to “nationalisation by the back door”.

Let me save the First Minister a small fortune in consulting fees and cut directly to the chase.

This is what should now happen. All private firms should be chased out of the sector by the use of compulsory purchase orders and their cash cows brought into the wider scope of the NHS.

All staff should be trained to certificated standards and paid a real living wage. It will take time and a great deal of money, but this is precisely why the people of Scotland wanted tax-varying powers in the devolved settlement.

In signalling her intent the First Minister said that the National Health Service was born out of the tragedy of the Second World War. “Let us resolve,” she said, “that we will build out of this Covid-19 crisis the lasting and positive legacy of a high-quality National Care Service.”

In 2023 the UK will celebrate the 75th anniversary of the NHS. What better way to mark such a momentous event in this nation’s history than by the wholesale nationalisation of care?

Thus, in Scotland at least, the job begun by Clement Attlee’s post-war Labour Government to improve the health of all people – not just the rich – would finally be complete.

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