The lHeaolth newsw and analysids to inforom and emwpower NHSn staff and campaigners Dementia Action Week: End the injustice of dementia patients paying for their care Let down again, charities and campaigners representing should be met by the state. These proposals were rejected, 850,000 dementia patients were united in their criticism and shamefully this issue still sits stranded in the of the government this week for failing to produce a so - current government’s intray, despite Johnson’s promise on lution to the social care crisis, and bring an end to a the steps of Downing Street to “fix it”. Meanwhile the colos - great injustice at the heart of the health system. continued on page 2... Over 40% of dementia patients end up paying for the aspects of their own care, unlike patients with cancer, heart problems or diabetes, or other chronic conditions treated on Also in this issue... the NHS. Independents: seeking more NHS work despite record p3-4 It is over twenty years since the Royal Commission on Legislation: what will be in the Health and Care Bill? p5-6 Long term care, set up by the Blair government, highlighted E-consulting: potential online overload for GPs p7-8 this injustice and suggested that aspects of these care costs History of NHS privatisation pt 5: Blair arrives p9-12 https://lowdownnhs.info [email protected] number 45 – 18/05/2021 2/ ...continued from page 1 of Health Research says this is worth an estimated £14 bil - sal social and economic costs of inaction mount. lion each year. Caring for patients with dementia and helping them to Some commentators see this as a sensible way to offset manage their symptoms involves daily support, and for the burden from the taxpayer, but research has identified many patients this help is defined as social care which, un - that it comes at a higher cost by taking people out of the like NHS care, is means-tested. workforce, reducing tax receipts and incurring extra health Families are often shocked to find how little financial sup - costs. port exists for care costs. If you have assets of over £23,000 The cost to businesses alone from employees taking time (including your house) then you have to pick up the costs of off to care for people living with dementia, was estimated to your care yourself. be £3.2 billion in 2019 according to the Alzheimer's Society According to the Alzheimer's Society the typical cost for - 21 per cent of carers give up work or reduce their hours. the care of a patient is around £100,000 and sometimes up Problems with supply The care sector was financially strained before the pan - demic, 400 care homes have already closed over the past 5 “Vague promises are no longer years, but the extra costs of covid is threatening the future enough... It is time for the government of many care businesses. Most are now run on a commer - to take the next vital steps and honour cial basis - 84% of care homes are run by the for-profit sec - their promises with a concrete plan” tor, 13% by the voluntary organisation and only 3% are run – Alzheimer’s Society by local councils. The UK ranks lower than Belgium, the Netherlands, France and Germany, with only 43 beds per 1000 people aged over 65. Lack of social care has led to 2.5 million lost bed days in to £500,000 which explains why upto 30,000 people a year the NHS in the five years up to the end of 2019 according to end up selling their homes to pay it. Age UK. While successive governments in Westminster have Over the same period delayed discharges’ have cost the dodged the difficult decisions on social care, nearly two NHS a total of £587 million. One of the major reasons for decades ago Scottish political leaders took the bold step to these delayed days is a lack of social care support in the provide free personal care, a step rejected south of the bor - community, either at home or in a care home. The number der. Help with eating, bathing and dressing - daily tasks that of emergency admissions to hospitals of people with demen - dementia patients need help with, are all funded by the Scot - tia has risen by 70% in five years at a cost of £400 million, tish government. potentially avoidable if more care were in place. People in Scottish care homes, aged over 65, who require The government needs to lift overall spending on social personal care receive £174 a week to cover their costs. An care by 12.2bn to 2022/23 – based on estimates by the extra payment of £79 is made for those who need nursing Health Foundation and this funding should be aimed at the care. These payments are made by local authorities with 1.5 million people who Age UK say aren’t receiving care at Scottish Government funding. the moment. NHS support is only available for patients who qualify for Unison is pushing for a scaling up of public sector provi - a funding pot known as Continuing Care, but only the sickest sion, through a national care services. Unsurprisingly low patients can access it. Many dementia patients don’t meet pay and poor working conditions are prevalent. A quarter of the criteria. care staff are employed on zero-hours contracts. There is a NHS care is available from GPs and through specialist big turnover, a third of care staff leave their roles each year services such as memory clinics, which are free to access, and there is a major shortfall of 120,000 staff, which could but day to day support often has to be paid for, or is shoul - double by 2030. dered by an army of unpaid carers. Paul Evans Back in 2014 the Alzheimer's Society estimated that “over 670,000 people in the UK were acting as primary, unpaid For more information on Dementia Action Week, visit www. carers for people with dementia” and the National Institute alzheimers.org.uk/get-involved/dementia-action-week https://lowdownnhs.info [email protected] /3 Independent sector looks to boost NHS work, despite transparency failures Figures released last week showing almost 5 million people being paid to help the health service reduce its waiting lists, while are waiting for hospital treatment in England, with more than also potentially earning more per head from a growing number of 430,000 waiting more than a year, are – even allowing for the patients desperate to jump the NHS queue by ‘going private’. impact of the pandemic – a national disgrace. But they also Working on those waiting lists has considerable PR benefits signal a useful income stream for the private health sector for private contractors too – just look at the websites of Circle, over the next few years while the backlog is cleared. Spire and Transform and you’ll see how they all proudly The pandemic is certainly turning into a ‘win win’ situation for talk up their input during the pandemic – and the sector is under - private operators. Employing staff trained at public expense within standably keen to forge new kinds of public/private healthcare the NHS, some of these companies are in the fortunate position of continued on page 4... Please donate to help support our campaigning research and journalism 4/ ...continued from page 3 tioned the value of the public/private deal, and said, “The national partnerships, given the vast sums up for grabs from the taxpayer. contract for private sector capacity was for the company share - Last month, commenting on the latest waiting list figures, Inde - holders, not for NHS patients.” pendent Healthcare Providers Network chief executive David However useful the block-purchase deal was to the NHS, it Hare told market intelligence agency Laing Buisson that, “The ended last August, triggering a resumption of routine elective care NHS and the independent sector will build on this extraordinary in private hospitals employing NHS staff while the health service [backlog] partnership to give NHS patients access to the best pos - was still dealing with the pandemic. sible NHS care, free at the point of use.” This led several senior NHS clinicians in January to lobby med - Commercial operators already have a very strong presence ical directors at London’s acute hospital trusts, urging them “not within the health service: they’re responsible for a third of all hip to support” staff working in the private sector, according to HSJ. operations and a quarter of knee replacements, as well as more One clinician allegedly accused doctors working in the independ - than 20 per cent of gastroenterology, trauma and orthopedic NHS ent sector as “taking the piss and walking off with the money”. treatments. That’s over 500,000 non-urgent NHS operations and procedures in total. Tax dodges and hidden profits? And they’re hoping for more. As the Guardian discovered last Sadly, the cynicism of that clinician appears justified when con - year, the head of one of the key, long-standing beneficiaries of the sidering the sometimes dodgy ethics and lack of transparency re - government’s taxpayer-funded healthcare largesse – Serco’s Ru - vealed almost daily in media coverage of the NHS’ relationship pert Soames – has privately suggested that the pandemic could with the private sector. go “a long way to cementing the position of private sector compa - Only last week, for example, the Guardian uncovered potential nies in the public sector supply chain”. tax scams by recruitment agencies supplying staff to NHS Test & Labour Party research, released earlier this month, shows that Trace call centres and testing sites, and also to the Lighthouse during the past decade non-NHS healthcare providers banked lab in Milton Keynes.