TODAY in the Financial Times Peter Cave writes a letter in reply to Pro. Andrew Oswald*:
'Professor Andrew Oswald asks for a cost-benefit analysis of the virus inspired restrictions, taking into account wellbeing and intergenerational unfairness (letters, November 3). That request raises two questions.
'First, how do you do a cost-benefit analysis of wellbeing and fairness? Many of the vulnerable and elderly underwent war and postwar deprivations that that would horrify many of today's young. How will analysts take such lack of wellbeing and unfairness into account?
'Secondly, while analysts analyse away, what should be done right now? Sheild the elderly and vulnerable? Leave other lives unrstricted? They forget that many elderly sweep the streets, clean the hospitals and work in factories: some are well-trained carers, nurses and doctors. Who would do their jobs? Further, many live in crowded multigenerational housing, unsheided.
'I conclude that we are back to medical and care services, underfunded for years, lacking capacity to deal with the many increasing Covid and non-Covid demands, unless restrictions are imposed. No cost-benefit analysis can magically show that conclusion to be false.'
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* Pro. Oswald wrote a paper entitled'The Case for Releasing the Young from Lockdown: A Briefing Paper for Policymakers'::
"The UK is ‘locked down’ because of coronavirus (COVID-19). No clear exit strategy currently exists. This paper suggests a possible way forward that combines elements from economics and epidemiology. The paper proposes as a policy a ‘release’ from lockdown of the young cohort of UK citizens aged between age 20 and 30 who do not live with parents.
"The paper calculates that there are approximately 4.2 million UK individuals who fall into this 20-30 age-band and who live outside the original parental home. Of those, 2.6 million work in the private sector, so unless some corrective action is taken they are likely to be extremely harshly affected, financially, when compared to employees in the public sector.
"The paper argues that a young-workforce release of this kind would lead to substantial economic and societal benefits without enormous health costs to the country. In this way, the nation might begin to move forward in the footsteps of the young."
The ombudsman found that Havering council in East London allocated Mrs Y, who has
advanced dementia, its standard rate for live-in care in November
2018 in the knowledge that none of the agencies on its provider list
met this rate. This meant she had to cover the shortfall using
her own savings. This was in breach of the requirement under the Care
Act for a personal budget to be sufficient to meet the needs a
council is required to meet.
A council breached the Care Act by setting an arbitrary upper limit for a woman’s live-in care that failed to cover the costs of meeting her needs, the Local Government and Social Care Ombudsman has found. The ombudsman found that Havering council allocated Mrs Y, who has advanced dementia, its standard rate for live-in care in November 2018 in the knowledge that none of the agencies on its provider list metthis rate. This meant she had to cover the shortfall using her own savings. This was in breach of the requirement under the Care Act for a personal budget to be sufficient to meet the needs a council is required to meet. The failingwas one of a number of faults by the council uncovered in the investigation including:
failing to meet Mrs Y’s eligible needs for home and day care following an assessment in September 2018, which resulted in her having to meet the costs herself and her daughter, Ms X, having to contact the council to say her mother’s condition had deteriorated;
failing to arrange overnight care for Mrs Y after a reassessment in October 2018 concluded she needed this, which led Ms X to set this up herself;
waiting six weeks to carry out an urgent assessment of her capacity to make decisions about her accommodation and care, during which she was left at risk;
not backdating payments for care Mrs Y should have received to the correct date;
causing Ms X “unnecessary stress and frustration” by requiring her to chase the authoritynumerous times for responses to communication, copies of documents, financial assessments and to start a direct payment application.
Full reimbursement
Havering has agreed to the ombudsman’s proposed remedies: to establish how much Mrs Y has paid to cover the shortfall in her care and reimburse her in full; reassess her personal budget, taking account of the cost of available care and providing Ms X with a written apology and £250 for the failings and the trouble she had been put to. It also accepted his recommendation to consider whether other service users have been affected by arbitrary upper limits on care rates and take any necessary action to address this, andamend procedures to ensure it doesn’t set arbitrary limits on any care provision. Until July 2018, Mrs Y had privately funded her homecare. Then her funds fell below the threshold for help with care fees,leading Ms X, who manages her mother’s paperwork and finances, to contact the council requesting an assessment.
Spain has today [17/O4/20] launched criminal investigations into 37 care homes after grieving relatives of thousands of elderly coronavirus victims claimed 'they were left to die'.
The
Public Prosecutor is also looking into 124 private cases whilst the
country's 'Patient Ombudsman' is investigating another 200 complaints.
These
claim that the elderly in care and nursing homes were not tested for
COVID-19, were not provided with health care and their families were not
allowed to take them home.
One relative told the Spanish press: 'They have been left to die.'
If negligence is found, charges of manslaughter or criminal neglect could be filed against owners, local authorities or staff.
However,
health chiefs say the prosecutor would have to take into account the
exceptional circumstances of the coronavirus health crisis, the lack of
previous experience and the pressures staff were under before deciding
to take any court action.
More than 19,000 people have died from
COVID-19 in Spain. It is being estimated that at least 11,000 old folk
in care, nursing or residential homes have been victims but it is not
known how many of these are included in Spain's official death toll.
The
Ministry of Health has asked all regions to supply precise details of
how many people have died in nursing homes but admits that not all of
the information has yet been supplied.
Dolores
Delgado, Spain's attorney general, says the investigations are being
carried out in eight autonomous communities, including Madrid (19
investigations).
The others are
Catalonia (seven) with five in Castilla-La Mancha, two in Castilla y
León and Murcia; and one each in the Canarias, Valencia and Cantabria.
The probe follows confirmation that the
Military Emergency Unit had found the abandoned corpses of elderly
residents when disinfecting care homes.
The establishments under investigation have not been named.
The shocking toll of deaths in nursing homes has included more than 20 in one centre alone in Madrid.
The Ministry of Defence says it has so far disinfected 3,800 care homes across Spain.
THE
sister of a friend of mine is notorious for her habit of putting
things off until the last possible moment. If reminded of
something she has to do
she inclined to reply
that she will do it ‘When
she gets round to it’.
Having heard this once too often, for her next birthday he bought
her a circular ceramic plate inscribed with the word ‘Tuitt’ in
large letters. She didn’t
take the hint!
I
was
reminded of my now deceased friend this morning whilst listening to
an interview with Matt
Hancock the
Secretary
of State for Health
and Social Care.
The
government it seems has a plan to
deal with the UK outbreak of Corvid19 and
they will implement it, ‘when
they get round to it’.
At
present the UK has 5000 ventilators, a piece of equipment likely to
be needed by about 1 in 20 of people who show symptoms of Corvid19.
Tomorrow he is going to contact manufacturers to urge them to
construct more. He will tell them, ‘The
NHS will buy all that you make’.
You might have felt more reassured by this if he had
said it three weeks ago.
No
wonder a senior government source recently
found
it necessary to say, ‘the
perception that ministers are reluctant to make difficult and costly
decisions to battle the virus is wrong’.
Oh really? Then
why are people who think they have the symptoms of Covid19 and being
told to self isolate not being tested? Testing and tracking recent
contacts is the way to limit the spread of the virus.
Thankfully
Hancock
did
say that aiming for herd
immunity
by allowing the SARS2 virus to infect 60% or so of the population is
no longer part of the government strategy. The
fact that it got
so far as to bepublicly
discussed
by medical professionals alarmed at the prospect
does
not give confidence that the overall strategy of Johnson’s
government is well thought out.
‘The
strategy of the British government in minimising the impact of
Covid19
is to allow the virus to pass through the entire population so that
we acquire herd immunity, but at a much delayed speed so that those
who suffer the most acute symptoms are able to receive the medical
support they need, and such that the health service is not
overwhelmed and crushed by the sheer number of cases it has to treat
at any one time.’Robert
Peston
12 March 2020.
Hancock
made much of the government’s strategy for protecting ‘the
vulnerable and elderly’.
Any
impact that this might have had in suggesting that there really was a
well co-ordinated strategy was diminished by the fact that the news
had
been allowed to emerge last night from a journalist.
The
effect of drip feeding us bits of information about ‘the plan’
merely makes the government look shambolic and secretive. My
impression of Hancock’s performance this morning is that he has
been promoted to one level above his competence. We need clear
information both about the government’s overall strategy and the
scientific evidence upon which it is relying in making its political
decisions.
Telling
a significant proportion of the population they must stay indoors for
three to four months for their own protection is a big ask. It is
far more likely to be accepted if we are given clear information
about why it is necessary and
what it actually means in practice. I find it difficult to believe
that I would be putting myself at significant risk if I took a stroll
around the park each day and
avoided being close to anyone.
I
think I would be more at risk in accepting a food container into my
house without first wiping it over with dilute bleach and
then washing my hands.
Those
of us who are old enough to remember the Falklands war will recall
the nightly TV briefings put out by the Ministry
of Defence
and read by Ian
McDonald.
His matter-of-fact delivery on the latest developments gave the
bulletins an air of authority, somethingwhich
was entirely lacking in Hancock’s answers. I’m
not sure that anyone in the present government is sufficiently
trusted by the public to take on the role of keeping us informed.
The announced closure of seven care homes in Northern Ireland by Britain's biggest care provider 'Four Seasons', has once again raised the question about the suitability of capitalist spivs and speculators to provide essential social services and health care for the elderly.
For some months now, Four Seasons have been warning the government that the care sector is in difficulty as care fees fall and staff costs rise. However, it is also known that Four Seasons, controlled by 'Terra Firma' a private equity company owned by Guy Hands (pictured) is paying more than £50m a year in interest on debts of £500m. Four Seasons say that the seven homes facing closure are "not viable".
Only four years ago, Southern Cross, another care home provider, was also calling on the government to step in after the company claimed that they had insufficient funds to stay in business. At that time, Southern Cross had 750 homes and 31,000 residents. It was claimed at the time that cuts in fees that local authorities were paying towards the cost of some elderly people in care, had led to the company sustaining losses of £311m in 2010. Yet, a major cause of the company's inherent financial problems lay in the decision by the U.S. owned private equity group, Blackstone, who owned Southern Cross, to sell off all the freeholds to their properties to raise cash. This move, made Blackstone Chief, Stephen Schwarzman, almost £500m when the company sold its interest in Southern Cross in 2006. However, it also meant that Southern Cross had to rent back their properties from 80 different landlords.
Guernsey based, Guy Hands, fomerly of the Japanese bank Nomura, is a legendary dealmaker. Along with the financier Hugh Osmond, Hands is considered one of the main architects of the debt-fuelled pub boom which saddled pub companies with high levels of debt in the years running up to the credit crunch. Both of them bought the large tenanted pub estates of the major brewers, using borrowed money, and then hiked up the rents and the beer prices paid by the tenants. As a result of the increased income which they generated, they were able to remortgage the pubs, extracting tens of millions of pounds of profit for themselves, after they sold out. Many of the tenanted estates ended up as Enterprise Inns and Puch Taverns. When the credit crunch hit in 2008, many publicans went bankrupt. Terra Firma is also known for its disasterous take over of EMI Records, that embroiled the company in litigation on both sides of the Atlantic.
Relatives of the resident in the care homes in Northern Ireland, have called on Guy Hands to discuss with them the human costs of his speculative deals and shenanigans. However, Hands prefers the seclusion of life in the tax haven of Guernsey, where he has lived for the last six years. Hands insists that living in Guernsey has nothing to do with money and is more about lifestyle.
Since the privatisation of care for the elderly under Thatcher, we have seen one crises after another when it comes to the running of elderly care homes. With monotonous regularity, the people running these care homes have asked the government to bail them out or to intervene to help them. Likewise, people continue to ask whether it is right and proper that profit should be put before people and that care homes should be owned by speculators like Hands and Schwarzman.
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