Why is elderly care failing? Older people have human rights too

Ariadne you may be right but one thing is for sure we can not afford this enormous public sector final wage pension scheme. To add insult to injury the public sector thanks to all their unions still are allowed to bow out much earlier on a full pension. If they want to bow out early, fine but we should not pay their pension until they are 67 like the rest of us have to wait to get paid. Still leaves the sore point of public sector worker getting a good pension based on their wages. In the case of teachers it is even more rediculous. I know some one who happened to have worked as a teacher for some 8 years but because he puts ex amount in per year is guaranteed a full pension when he is of the right age, this means the tax payer making up the difference to what he has paid in himself. I do not see this happening for Joe the plumber. These kind of practices do put an enormous strain on things. Yes I know the pension was set when life expectancy was not much beyond 70 or so but it was also set as a set amount not based on wages received before.

Ariadne says:

I agree that the public sector is a problem – but, unless everyone takes a “hit”, then this will probably be done over the medium to long term. Those working in the public sector would respond that their wages are generally lower and that they have planned their lifestyles upon the basis of what has been promised to them.

If there is a solution, then it has to be fair to all. It will take time – but, most of all, it needs the political will to do it. This requires the electorate to be realistic – but who is going to vote for a candidate, who is promising to make your life worse?

This is why I believe a start has to be made within families. Once the true extent of the problem is recognised, then and only then might there be the beginning of a political will to actually deal with all the inter-linked issues such as pensions, NHS and caring arrangements.

ekc says:

Yes Ariadne exactly what I have been saying all along. It should be punishable for a politician to base his solutions on short term gain in which case we may see some lasting well thought out solutions.

Ariadne says:

Two other theoretical options would be – give the politicians a longer period in power so that they are not so concerned about the next election or – forget about the politicians and let the civil servants or other professionals run the system!

ekc says:

Ariadne, the public sector are very well paid mostly, teachers, doctors, councillors etc and they do get a pension!!!! The private sector who pays for the public sector has no pension unless they take care of one themselves. Promises have been broken time and time again to those in private employment. It is obvious the private sector can not go on contributing to unfair pension arrangements in the public sector. So start with at least letting the public sector work the same years as the private sector or if they want to leave early no pension until they are 67. Cannot be fairer than that but of course the unions would not agree.

malcolm r says:

We seem to have deviated from the original topic – elderly care. I don’t think pensions will cover the cost of personal care we we become dependent. Should families be required to take more care of their parents? As far as care homes are concerned, one of the major problems seems to be, in some cases, a lack of care and compassion by inappropriate attitudes, just as happened in some hospitals. Money does not remedy this – choosing the right people, and getting rid of the wrong people, would. We fund the CQC, and yet they do not do their job, nor appear to be able to respond to individual complaints. Surely these basics need to be dealt with before we can move on.

Gerald says:

Hi Malcolm,
Funding is the major problem, and there are Acts of parliament which are responsible for determining the State Funding, the main problem lately is that the criterion laid down in these Acts have been manipulated by the Local Government and the NHS, so that previously NHS funded patients are coming under the means tested system applied by the Councils.
I have tried to get information regards this system , with little success but it seems that it is all down to reducing costs in the NHS and making the Public pay privately, if this is the case, it is totally against the original concept of the NHS and there-fore illegal .
To fully understand the above one needs to look back at Residential Home placements (council funded) and Nursing Home Placements over the last 30 years.
Bye the way the CQC gets its funding from fees paid by Care home Operators (£4500 per year for a 40 bed Home based on bed numbers) and other establishments such as Hospitals (Private & NHS)
I agree that the CQC has had a rocky start a lot of this was due to using old Council staff.
If you look at the new people I think you will agree there is hope now for the future.

malcolm r says:

Hello again Gerald,
I generally agree. However times have changed and more people have wealth to help fund their care – although it is unpalatable to have to sell the family home when some others, who have not bothered to save for their care in later life, get the same treatment funded by the state. In times of austerity I think funds have to be targetted at the deserving and needy – money is limited so we need to make best use of it.
I still think there are improvements that money cannot buy – like getting rid of unsuitable staff (at all levels) who mistreat, or condone ill-treatment of, inmates. We should encourage people to complain about mis-treatment, ensure they have adequate support or evidence, and treat them in confidence while the investigation takes place. I hate the term “whistleblower” – reminds me of “snitch” – but unless people are prepared to stand up for what is right, how can we ever expose malpractice? Good luck to the reformed CQC.

Gerald says:

Dear Malcolm

Are you referring to the recent cases of cover ups by the exec of CQC , if you are you might remember me referring to completely biased actions of the CQC for many years, this is also happening in other institutions such as the BBC,THE NHS,THE LOCAL COUNCILS,MINISTRY OF HEALTH ETC. if you check out the common denominator all all these is UNISON isn’t it ?? It seems as though the Public Sector is not so unbiased as they would like us to believe.

ekc says:

Hi Gerald, the problem is so enormous that it is difficult to see our way out of it. The Bank of International settlements (BIS) which is at the top of the banking tier is totally above the law and any taxes. They instruct the banks underneath them. The banking system has been sucking the life out of everything by loaning money to governments which was not real money, merely a ledger entry, but wanting real money back in return. Our previous government threw the money away at an alarming rate, including the gold and had to borrow some of this ‘money’ from the imf. The banking industry has the government in a strangle hold as the interest alone is costing beyond belief. Because of this UK PLC is unable to see itself clear to give the cash where needed and we all suffer. There are only 4 countries left in the world that are free of this banking system which is run by just a few families. What to do????????

malcolm r says:

ekc, if the UK had not been so reckless with borrowing money to fritter away our problem would be less. Close to home, look at the ridiculous costs of PFI that government used to avoid debt on the books. Look at NHS and Defence lack of control over procurement. Money wasted on useless computer systems. As examples.

Gerald says:

Dear Malcolm,
It is all very clever to look at the grand view but I think that doing so totally takes peoples minds from the real issue which is that the Government (both parties) with the aid of Public officials are forcing the Public to pay for Care which was previously funded by the NHS ,if you refer to the NHS Act this is illegal , there has already been court cases which have acknowledge this and still this goes on .Most Councils and NHS PCTs have colluded in this .What I cannot understand why the Public has not been made aware.
For current conversations on this refer to other WHICH conversations.
It is not the Public’s fault as you say most of the blaim should go to the NHS Management for being totally inefficient and wasteful .This situation is appalling and like most things in the NHS people are gagged, paid off , and generally ignored.

Gerald says:

Hi EKC
To complicated just deal with the main issue concentrate on getting the NHS to be efficient, at the moment it cna’t even be bothered to collect its debts from Private Payers from abroad (only running at approx £500,000,000 Five Hundred Million) yes £1/2 BIllION Pounds and then impose real purchasing directives between the PCTs and the TRUSTS.
Whilst I totally agree with everything you say regards the Banks I really think such a world wide problem is out of the scope of this conversation and could just rather cloud the issue.

Ariadne says:

There is clearly a problem. I would like to know – what solution do you all propose?

Gerald says:

Dear Ariadne,

With the existing Management structure of the NHS there isn’t a solution, I think that all the latest Governments have sort and obtained advice and non of them had have the guts to take on the problem.
Everyone seems to be blaiming the Banks for all our ills and to some extent I can see their point but Banks have been screwing everyone around the world for Centuries , the NHS only came into existence in the 1940 ‘s.
It is not the concept which is wrong it is the way it is being managed (what ‘s new?)

ekc says:

Hi Gerald,
Yes I know what you mean, the problem is, it filters down into everything as the government is no longer in control of its own spending really.
However getting back to the NHS, it is totally mismanaged with far too many management jobs created to manage the managers. Unfortunately Cameron committed the ultimate crime in selling of the one really good thing Labour created all those years ago i.e the NHS. We will be going the way of America if we don’t watch it.

Ariadne says:

So – if either and/or both of the two of you were in power – what realistic and possible solution would either and/or both of you propose? It is no good just complaining – we have to move forward.

Gerald says:

1 March 2014

Dear Ariadne,
Encourage WHICH? to carry out a campaign against the Local Authorities and the NHS Rip off to stop them making Nursing Care “Means tested” .
Bring back the old system wherbye Doctors are responcible for determining medical needs for Care Home placements instead of Beurocrats .
Deal with the problem at hand , do not try to deal with World Wide problems as other are trying to do,this is totally confusing and unnecessary.Just a reminder for everyone what this conversation is
all about “Why is elderly care failing? Older people have human rights too” I suggest this is Everyones rights under the NHS Act where it states quite clearly treatment is free and now we also have a choice of “where” Why are we being means tested I ask, simple question requires simple answer !

ekc says:

1 March 2014

Yes Gerald you are right we did stray a bit. However the problem is that there is no money to go round which is why people are now being means tested. We can all scream and say but it should not but when there is no money because it was frittered away and the IMF stood there actively encouraging the UK to borrow, what do we do?? GP’s salaries went up far too high under labour which does not help. Once a wage goes up it is difficult to reduce it but it has a knock on effect. Yes we can bury our head in the sand and say but we need to talk about why the elderly care is failing and do not look beyond it. However the picture is much wider which is why we need to look further. It is all very complex. The biggest problem is however there is no money to go round any more and as usual the most vulnerable are hit first, in this case the elderly. So where do we take the money from?? Overpaid GP’s, too much management in the NHS, bureau cratic failure in collecting monies from overseas???

Gerald says:

dear exc
Since nursing care is the responcibilty of the NHS why shouldn’t we make them responcible , why shouln;t we expect them to be efficient, why should we let them get away with murder.
why should we turn a blind eye to the failings of the NHS ???
THE nhs COSTS US ALL BILLIONS if you look at your stoppages in your wages or salaries you will find that the National Insurance costs more than all the PAYE put togther.
if one paid this amount of money to , say BUPA wouldn;t one expect good value for money or at least them to deliver a reasonable service ??

Surely that is the whole ethos of WHICH? CONSUMER, why don’t we apply it to thePUBLIC Sector and PRIVATE sector provivions alike.and stop being biased against the PRIVATE SECTOR

ekc = emma says:

Hi Gerald,
There is absolutely no reason why we should not expect them to be efficient. The NHS is one of the best things achieved and we should expect it to be efficient. That is my whole point. It does cost us all a lot and since the employer is supposed to pay slightly more in contributions than the employee you are right it costs more than the payee put together. But as mentioned before when governments squander money on a lot of things in the NHS to cover up unemployment for one than this big machine gets too big to run efficiently. Creating jobs out of thin air, upping up the wages of GP’s by some 50% etc etc is costing us all dearly. It has a ripple effect that unfortunately is felt by the most vulnerable the hardest, the elderly in care homes.. My Father in Law went to a care home which had a committee of elderly residents and the home was run very well indeed. This a very good way of running them but they are very far and few between.
BTW I work in the private sector and feel biased against the public sector as they forever want more forgetting that the private sector will have to pay for it.

Gerald says:

Dear Emma,
The NHS Act of Parliament states ” Nursing Costs are the responcibilty of the NHS” and should be FREE to all . I don’t think you appreciate that the NHS with the aid of the Council Officials are insiduously making the Public Pat for this care through “Means |Testing” this is illegal and numerous Court Cases have found them guilty already why do they still persist I wonder,

The Proproitors of all Care Homes are responcible (Good and Bad) for the running of their homes and surely the Public will penalise them if they don.t like what they are being givenby taking their custom elsrwhere this is what is the Public’s right under freedom of choice isn’t it Try and get this service from any Public Sector provision.

Bye the way I was refering to the National Insurance Taxes as opposed to the Pay as you earn Taxes TOTALs for the Country.

I an pleased to hear that you work in the Private Sector, be Proud of what you do, if you really compare qualities in the Publice and Private Sectors by listening to a broad spectre of clients over a long period you might find numerous people who consider we are doing a good job. Please do not listen to the knockers of this world, they have no intention of giving us n unbiased opinion

Just rember the Publice have voted with their feet and funds to come to the Private Sector in spite of all the efforts of our Public Servants to the contrary

Keep up the GOOD WORK

All Best wishes

Gerald

emma says:

I totally agree with you Gerald. Means testing is a nasty thing but it goes on unfortunately. Unfortunately not all old people have the luxury to choose a private care home and it is those I feel sorry for. I am proud to be in the private sector and am sick to death of all the moaning done by our public workers. (we have to work till 67, they want to bow out as early as 55 in some cases for one).

J.Redcliffe says:

8 October 2017

This phrase ‘ there’s no money to go round anymore’ begs the question of who is to be sacrificed. There is no immutable law that says it has to be the most vulnerable, unless you mean that it might be the most politically rewarding
Why not take money from the rich? Answer – because they will exert financial and political pressure. Simple really. Old people are not politically organised. As long as they are seen to be the responsibility of their family there’s no political disadvantage in ignoring them. Get them cared for on the cheap and everyone else will be happy – heaven forbid that income tax should be raised
Apply a generous means test and support people who have worked hard all their lives so that they can have decent care without having to be dependent on aging children (in their 60’s) Just tax their capital gains on their houses when they die, in the normal way. Not all elderly people are rich , as some people seem to think so why should they be treated punitively once they reach retirement age?

J.Redcliffe says:

8 October 2017

I would like to hear of more care homes where the residents have a say in how things are run. In fact I would go further and ask why people approaching the time when they know they are going to need care don’t get together and set up their own homes, possibly with ‘start-up’ support from the government. That way they can be with their friends and not be bullied and ill-treated by under-paid, poorly trained staff. Care homes need not be profit-making companies, they could also be co-operatives and new forms of non-profits. Now is the time to be thinking about alternatives.

ekc says:

Hi Ariadne,
Well for a start of salvage what we can of the NHS before it all falls in the hands of private firms who will only have one goal which is to make the shareholders happy which means high costs of insuring oneself. (so short term gain for the politicians but long time suffering for all)
Secondly streamline it by getting rid of the burden of too many managers at a high cost.
Thirdly some of the managerial wages are astronomically high and need to come down which can be achieved by various means.
Fourthly stop closing down all hospitals that are not big enough and centralising everything, this may be easier for the consultant but costs more in the form of so many other things. Bigger is not better as they always seem to think.
Private patients from abroad have to pay upfront for treatment as we would if we go abroad.
These are just some of the top of my head, if I sit down I could think of a lot more, the way the food is run, the cleaning companies are run, the wards are run. The list is endless. It has been allowed to get out of hand by failings of the governments to keep a close look at it all.

malcolm r says:

I agree with cutting out wasteful managerial layers. We should also stop paying outrageous fees to doctors who perform an A&E shift. However I believe in centralised hospitals – the medical benefits of concentrating excellence in both staff and facilities on one site far outweigh the convenience of having a local hospital. Much of A&E could better be dealt with at one level by GP health centres. Uninformed view, of course.

ekc says:

Malcolm centralising for excellence is great, however an awful lot of hospital care is for routine stuff and can easily be dealt with locally thus avoiding the demolishing of local hospitals and creating ever bigger centralised ones. All this centralising leads to transport problems for a start of.

malcolm r says:

ekc, agreed. I was not against local general hospitals, but centralising specialist activities – e.g. heart, lung, cancer and the like.

Beryl says:

The debate seems to have run full circle with some really disturbing accounts of elderly care. As we are all tending to live longer it automatically brings with it added problems. In previous times the responsibility of care usually fell on female offsprings but times have changed since most women in this country now have to work to meet family monetary demands. However there are always exceptions as we have seen and those fortunate enough to be able to afford to stay home should still take on some responsibility of care for their elderly.
There are other issues however which need to be addressed.
Elderly people can become very set in their ways and often are very reluctant to move closer to relatives who sometimes are themselves retired as has already been indicated which increases the burden on them.
Care homes are increasingly being sold off to the private sector which are not always as well regulated as the public sector. I have first hand experience of a disabled relative living in a public/privately run care home. The home is comfortable and clean and seemingly we’ll run but the standard of care leaves a lot to be desired with frequent staff changes, other staff would be better suited to working in the military, staff confined to offices working on computers instead of mingling with residents, other staff using company vehicles intended for residents transportation thereby saving on petrol costs. All these things are rarely picked up by the CQC as medical staff will always support each other and non medical staff are afraid of losing their jobs if they become whistleblowers. They usually decide to move on and so the situation persists.

Gerald says:

Dear Beryl,
The question of who should or should not care for the elderly is left up to the Great British Public and should not be decided by Beurocrats after all we are supposed to be a Democrasy.
I have been in the business (and proud of it) for over 30 years, I have seen the Public making their choices (and paying as necessary) over this period of time and as you say the Public Sector Council run homes have been seriously lacking and nearfly all have been closed down in spite of many Councils subsidising them for years.The whole process is called freedom of choice which I would suggest is the Public prime motivator.
For an indicator of how ell the Public Sector regulates itself one only needs to look at the Mids StaffsHospital cover up by CQC and other childrens Hospitals where many children and old people died needlessly through further cover ups numerous wistle blowers inside and out were totally ighnored and harrased before someone listened, I can assure you ththat this abmissmal siuation would not have been condoned if it was the Private Sector. you really have got your assumptions the wrong way around.
Bye the way I really do not think the Cheif Exec, from a Private Company would have been given the lead role in the NHS (as happened to the Mid Staffs chappy) do you?

wavechange says:

Beryl – Which has looked into care homes. Search for the Conversation: “Care homes are failing – but is it too hard to complain?” I think you are right to be concerned about the private sector too.

emma says:

Hi Gerald,
Privately run homes can be much more efficient if the owner is not just in it for the money. Unfortunately a lot of them are, which goes at the cost of the people that need taking care of.
Publicly run homes have the problem of complete and utter inefficient bureaucratic leadership which means usually a badly run home.

Beryl says:

I entirely agree with the majority of your response Gerald and understand your frustration and concerns but my “assumptions” are very much based on facts. Your views are quite correct in as much as we are a democratic society where freedom of choice is encouraged and respected.

Unfortunately in the real world there is always going to be people who for one reason or another (there is usually money involved) will take advantage of the sick and vulnerable (and incidentally their relatives!) As you know with your long experience this is a fact of life and nothing is entirely black or white.

The NHS is struggling financially with currently a third of hospitals millions in debt. Millions of £’s of taxpayers hard earned money is being spent on private care in privately run care homes. Do you know what % of this is being spent on patient care and what % lines the pockets of shareholders which could easily contribute towards our struggling NHS hospitals? We are not allowed this info as it comes within the remit of commercial confidentiality (similar to patient confidentiality as you can no doubt relate to working in the profession and restricts staff members in both the public and private sector blowing the whistle on negligence.) A large % of privately run hospitals are owned by foreign companies anyway, (many of them American.) Do we really want to revert to an American style health system?

Thank goodness as a result of The Mid Staffs debacle there have been changes made to the CQC Executive Committee who seem to be doing a much better job but I reiterate the onus is still on the patient or their relatives who have the unenviable task of challenging the system when mistakes are made. I too have had cause to complain to them in the past and have had partial satisfactory results but only through perseverance and persistence.
Let us hope that the CEO from the private company does a much better job ………….only time will tell!

Beryl says:

Cheers for the info Wavechange. As a comparative latecomer to Which? conversation I missed out on the previous debate on Care Homes but will certainly search the “archives.”

malcolm r says:

Gerald, “I can assure you that this abysmal siuation would not have been condoned if it was the Private Sector”. As far as I am aware, Southern Cross, the Bristol care home and Whitstable as examples were in the private sector and mistreated their patients disgracefully? This seems to cut across both public and private sectors, so perhaps it is more related to bad people and management?

wavechange says: