ON the 28th, April, Milton Pena placed the following comment on this NV Blog:
'It’s Gerineglicide
Derek, it has been happening for more than a decade and it has
worsened by the Pandemic.
'I read that the life span of
the elderly have been shortened by TWELVE years as a result of
becoming ill with this virus and dying of it.'
On the 29th, April, Blanco Posnet posted:
'I'm no conspiracy theorist, but I'm
beginning to wonder if that Bunteresque Johnson, and his sidekick, Dom Cummings,
aren't exploiting this national emergency to kill off the elderly and the
baby-boomer generation in order to cut the social security/pension bill. It may
be a kind of “Shock Therapy”, disaster capitalism, approach to cutting public
expenditure.'
Social Care is a poor relation!
YET, what is happening in the social care sector is not new. For donkey's years under different governments social care has been the poor relation of the welfare sector. You can call it 'Gerineglicide' if you like. Or as I would prefer 'constructive manslaughter'.
It is 'constructive manslaughter' and not murder, since the intent is not to kill the victim, the mens rea required for murder
does not exist because the act is not aimed at any one person. Rather it is systemic in that it is built into the procedure for looking after the people at the end of their lives.
Most government including the current one under Boris have promised to resolve the problems of tackling social care, but have yet to come up with a satisfactory plan. The public have allowed this to happen partly because they are confused and think that their end of life care will be tackled by the NHS.
Clean plate club & one step nearer the grave!
People are closing their eyes to what's happening, and have been for ages.
Alan Bennett in his diary entry in 1995 describes events at a care home his mother was in, in Somerset:
'The turnover of residents is quite rapid since whoever is quartered in this room is generally in the late staged of dementia. But that is not what they die of. None of theses women can feed herself and to feed them properly, to spoon in sufficient mince and mashed carrot topped off with rhubarb and custard to keep them going, demands personal attention of a helper per person. Lacking such one-to-one care, these helpless creatures slowly and respectably starve to death.'
A neighbour of Mr. Bennett's mother has some difficulty:
'Joined the clean plate club, Lily,' says the girl who is feeding Hilda, her neighbour. 'Aren't you a good girl?'
Mr. Bennett says Hilda doesn't want her sweet and 'it is left congealing on her the tray while tea in lidded plastic beakers is taken round, which goes untouched also.' And he adds: 'So another mealtime passes and Hilda is quite caring and with no malice or cruelty at all pushed one step nearer the grave.'
Whose fault is it?
Not the government's surely?
Alan Bennett says: 'Her own a little. Her relatives, if she has relatives. And the staff's of course. But whereas a newspaper might make a horror story out of it, I can't.'
What would Milton Pena or Blanco Posnet do? Or, come to think of it, Charles Charalambous and those who signed his Woke Manifesto for trade unionists and other lefties, do about this?**
Alan Bennett concludes: 'Demented or not, if Hilda were a child there would be a story to tell and blame attaching. But Hilda is at the end of her life not the beginning. Even so, were she a Nobel Prize winner, or not a widow from Darwen but the last survivor of Bloomsbury, yes, then an effort might be made. As it is she is gradually slipping away, which is what this place is for.'
We need something better than slogans, rhetoric and virtue signalling to tackle these complicated questions. Essentially the problem in this country with regard to elderly people is a largely cultural one, as Alan Bennett's considerations suggest.* Milton Pena is a Chilean-born surgeon who arrived in Britain with his family in 1974 after being forced to flee General Pinochet’s brutal regime. Being Chilean he will probably have found it hard to understand the English attitude to old people as expressed by Alan Bennett and all too deeply embedded in our Anglo-saxon attitudes. * 'Untold Stories' [2005] by Alan Bennett
CARE HOMES across Western Europe
have been ravaged by coronavirus and in Spain alone there have been more
than 16,000 deaths, many around the capital Madrid. The true number may
never be known, but families are asking why so many of their elderly
relatives were lost.
Around lunchtime on 8 March, Rosana Castillo met up
with some close friends not far from her house in Lucero, a
working-class neighbourhood in west Madrid, and, as they did every year,
joined a protest to mark International Women's Day. They gave each
other a warm hug, held hands and marched to chants of "Down with the
patriarchy" and "Feminism will win".
Spaniards, then, could still
venture freely outside and coronavirus, which had already killed several
hundred in Italy, felt more like someone else's pain. Castillo, a
60-year-old retired primary school co-ordinator, had seen a few people
on the underground wearing surgical masks as a protection, but thought
most of them were probably tourists. "We weren't really talking about it
here," she said.
But it was preying on her mind. She had visited
Carmela, her 86-year-old mother, hours before at Monte Hermoso, the
care home near the square where the women had gathered. Arriving at the
main gate, Castillo was told she could not come in. A worker said two
residents had contracted Covid-19, the disease caused by the virus, and
visits had been suspended.
Castillo had seen Carmela, who had
advanced Alzheimer's, three days earlier, when her mother was discharged
from hospital after a week's treatment for breathing difficulties. The
doctor told her Carmela was going to be fine, that her case was not
related to the virus even though she had not been tested.
To
Castillo's frustration, the worker said nothing else and went back
inside Monte Hermoso. As she exchanged phone numbers with some
relatives, Castillo saw another worker rushing away, covering her mouth
with a piece of cloth. They had known each other for a long time but
when the woman left, without stopping to talk, Castillo became
suspicious. "At that moment," she told me, "I felt something wasn't
right."
It was already widely known, first from China, then Italy, that
elderly people with existing health issues were especially vulnerable to
the virus. Yet in Spain, where a fifth of the population is above 65,
or some 8.9 million people, the government of Prime Minister Pedro
Sánchez had announced little in response.
As Castillo followed
news of the outbreak, she wondered if enough was being done to protect
her mother or, indeed, anyone else. Unable to visit Carmela, who had
lived there for five years, her only source of information came from
infrequent, and usually very brief, phone calls from Monte Hermoso. No
matter how much Castillo asked, few things were said.
Consuelo
Domínguez, a long-time friend, coincidentally, also had her mother
living in Monte Hermoso, a red-brick, private centre with large windows
and rooms for up to 130 residents. She, too, struggled to get details.
Both daughters knew some staff had gone into isolation with coughs and a
fever, the most common symptoms of Covid-19, and were pretty sure there
was more going on.
Coronavirus was spreading in Spain at an
alarming speed and, on 14 March, the prime minister imposed a state of
emergency with a nationwide stay-at-home order. No-one was truly safe.
On that afternoon, Domínguez received an unexpected call from Monte
Hermoso. The worker was "very tense," she said, "you could feel it."
Surreptitiously, Domínguez was told that 70 people had been infected
with the virus and at least 10 patients had already died. "I was
frightened," she said. Domínguez called her friend. "I couldn't believe
it," Castillo recalled. "We weren't being told the truth."
Castillo and Domínguez alerted journalists and, on 17 March, Monte
Hermoso became national news. Only then did the Madrid government
reportedly become aware of the devastating outbreak. Nineteen people
were already dead.
In the evening, Castillo received a call from
Monte Hermoso. Her mother, who shared her room with another woman in
similarly poor health, had a fever. "It shocked me," Castillo said. She
knew Carmela was unlikely to survive.
The relatives created a WhatsApp group, and
disturbing messages flowed in. "Staff were very nervous... Some
[residents] were even a little bit delirious," said one of a visit two
days before they had been halted. Aurora Santos, whose mother was also
at Monte Hermoso, recalled seeing residents unwell in the cafeteria
around the same time. "We didn't know anything the management had done,"
she told me, "the protocols they had followed, nothing".
She
joined Castillo and Domínguez in gathering information. They believed
patients with symptoms had not been separated from those without, before
the virus spread rapidly through the home. Staff who had been in
isolation after falling ill were reportedly not being replaced, while
those who continued to work were having to do longer, exhausting shifts.
Lacking adequate protection, workers had to make face masks at home.
"We were trying to help, our loved ones were there," Domínguez said.
"Why weren't they being honest with us?"
Monte Hermoso, it turned
out, was not alone. In fact, nobody seemed to know the true scale of
what was going on. For years, Carmen Flores, head of the Patients'
Defenders ombudsman group, had warned about precarious conditions in
some of Spain's 5,417 care homes. "The amount of messages we were
getting those days was insane," Flores told me. "I was thinking: You
can't let these people rot."
Three in every four homes in Spain are privately run and many
patients, like Carmela, have some of their costs publicly funded. José
Manuel Ramírez, president of the federation representing social care
managers, said fees received by the residences had not changed in the
past decade, a result of years of austerity in Spain.
Many
companies had to carry out savings somewhere to make a profit, claimed
Flores, who also alleged that some lacked equipment even in normal
times, while many operated with minimum staff. (Workers' unions also say
staffing was insufficient, which Ramírez rejected.) A worker at one
care home where more than 90 patients died told me: "For a long time we
had been saying something serious would happen. The conditions were
unsustainable. This isn't a surprise at all."
Crowded hospitals
were having to turn away patients from care homes and send them back,
often to die. Many residences did not have oxygen bottles, crucial in
treating a disease known to cause severe respiratory problems, or even a
doctor - Monte Hermoso, Castillo said, had one doctor, who most days
worked only in the mornings.
The Spanish government had
centralised the purchase and distribution of medical material amid a
worldwide run, so the homes asked officials to send tests and protective
kits. However, Ramírez alleged they were not given priority, and
pictures emerged of carers wearing gowns made of plastic bags. "There
was nothing that could be done without support," he said. "It was a
catastrophe."
The army was deployed to disinfect 1,300 care homes and Monte Hermoso
was one of the first. Margarita Robles, the defence minister, said
patients, in some places, were found abandoned without care, sometimes
dead in their beds, the bodies left for funeral services to retrieve. "Un horror," Flores told me.
Almost
6,000 people have now died in nursing homes in Madrid, after showing
Covid-19 symptoms. Spanish public prosecutors are investigating possible
crimes including manslaughter for neglect, mistreatment and
abandonment.
"I think there was a lot of wrongdoing," said
Castillo. "These people couldn't shout or say they were unwell. They
died in silence and alone." Monte Hermoso has not replied to interview
requests by email; when contacted by phone, an employee told me they
would not talk to journalists.
Return to work 'fumbled presentation' by Boris by Brian Bamford
TODAY the editorial in the Financial Times took a dim view of last Sunday's Prime Minister Boris Johnson's TV address and his plans for a phased economic reopening and scheme for rebuilding public confidence. The FT editor writes: 'The fumbled presentation, and impression that not all elements had been fully thought through, undermined the impact. they also risk widening the social and economic divide between those who can work from home and those compelled to return to their workplace.'
The restart in the government's 'Plan to Rebuild' does have some credible grounds for easing-up on the lock-down so long as the physical distancing rules are intact.
But the Sunday statement lacked clarity and provoked confusion as today's FT editorial showed: 'Making the statement without explaining sufficient, safe transport would be available - or whether workplaces could be guaranteed "Covid-secure" - suggested a more cavalier attitude towards the welfare of blue-collar workers than stay-at-home "knowledge" workers.'
For example men in some blue-collar jobs are already more than twice as likely as the general workforce to have died from Covid-19 according to official figures. The Office of National Statistics found that the highest mortality rate amoung men working as security guards, with bus and taxi drivers, chefs and retail staff also among those more affected.
Francis O'Grady, the Trade Union Congress's general secretary, warned of 'chaos' if people were forced back into work tomorrow as promised especially if their workplaces had not been prepared for proper social distancing. At the same time, it seems, there has been haggling between business leaders and employers about a return to work.
The FT which had previously excused the government's earlier errors before it later introduced the lock-down is now arguing: 'Mr Johnson's breezy assertion that workers should explore cycling or walking, and avoid public transport, betrays a metropolitan middle-class failure to appreciate how much more difficult that may may be for those in rural or small-town areas.'
Now the FT is saying: 'After earlier mis-steps, the government had a chance to prove it was getting on top of coronavirus policymaking, but has flunked it.'
Today I rung my eldest lad who works on the shopfloor at a fibre glass company in Burnley, he hasn't yet gone back to work and is expecting to be furloughed for the next few weeks. It's not going to be easy to return to anything like normal.
THE
juxtaposition of my
article There’s No
Pockets In A Shroud
with articles dealing with the iniquities of local councils might be
taken to mean that I think that this is the main issue to be solved
with regard to the social care of those who require
it
due to age, infirmity or accident. That
is not my view and I have some sympathy with local councils who have
to implement a social care system they did not establish and are
expected to do so without the necessary funding, by cutting their
budget in other areas of operation. That some will resort to dodgy
practices tells us more about the integrity of the officers and
councillors involved than about how the flaws in the present system
can be remedied.
As
I tried to stress we have a system of social care in England
which has a strong resemblance to the health system we had in the
1930s and which was found wanting. In other words our social care
system is funded partially by central government, partially by local
government, partially by individuals who
are unfortunate as to need to make use of it, and
partially by those who work in it via
poor pay and poor conditions of service.
The
1930s health care system was swept away by the coming of the National
Health Service
in 1948. This was (and is) both universal
and comprehensive.
It is based upon the principle of shared
risk
and shared
funding.
In
other words we acknowledge that we can all become ill or have an
accident, and so all of us should pay our share to fund it. ‘Our
share’
means not that we all pay the
same amount,
but that those who earn more, pay more. In other words it is
redistributive.Some
fortunate
people
will be able to boast they ‘never
had a day’s illness in their life’and
someunfortunate
people will have child born with chronic condition.
It
is unrealistic to expect to fund a similar universal and
comprehensive system of social care via further taxes on income so we
must look towards implementing
taxes
on wealth, specifically taxes on inherited wealth.In
this context the term universal means free at source to everyone
regardless of income or wealth, and comprehensive means both
residential and non-residential support. Universal
means the rich, the poor and everyone in between.
For
most of us our ‘wealth’
is tied up in the house we live in. House price inflation
comfortably outstrips the general rate of inflation of the cost of
other goods and services, and
has done for many years.
Hence those fortunate enough to be a house owner have had to do
absolutely nothing as the cash value of their house increases, nor
have their beneficiaries after they die, so I see little moral
objection to a tax on inherited wealth. Unless
that is you think personal greed is a virtue.
Under the move, passengers entering the country will have to provide an address where they will self-isolate for 14 days.
Airlines UK, the trade body for UK registered airlines, has confirmed
to Sky News that the move will be introduced by the government for
anyone arriving into the UK other than from Ireland, to ease the spread
of COVID-19.
The announcement on travel is reportedly set to be made by Prime
Minister Boris Johnson when he sets out a road map for easing the coronavirus lockdown in an address to the nation on Sunday.
ACCORDING TO SKY NEWS today under the measures, which are expected to come into force in June,
all passengers arriving at airports - including returning UK citizens -
will have to provide an address where they will self-isolate for 14
days.
Ports will also be included, according to The Times.
The report states that authorities will carry out spot checks, and
those found breaking the rules face a fine of up to £1,000 or even
deportation.
A Home Office spokeswoman said: "We do not comment on leaks. The
focus remains on staying at home to protect the NHS and save lives."
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.
A
care home resident was forced to pay an unlawful top-up fee after
Tameside Council made changes to the fees it paid her home, a
Local Government Ombudsman investigation has found.
THEinvestigation, whose findings have been strongly disputed by
the council, was launched after a man complained that his mother had
had to pay additional costs for her care after the authority cut the
fee it paid her home.
The woman, Mrs Y, who had dementia, moved into the care home in
October 2010, in a placement arranged by the council. Under the
contract, the authority was responsible for meeting the weekly fees
of £470.70 a week, incorporating a £381.70 basic fee, £30 for an
en-suite bathroom, £9 for a larger room and a £50 quality premium
for the home. Mrs Y made an assessed contribution of £113.20.
In 2012, Tameside reviewed the rates it paid for residential and
nursing care placements and decided to introduce a new quality
framework for homes to address an oversupply of beds in the borough.
Under the framework, care homes providing a high quality of care
received an enhanced payment from the council.
Mrs Y’s care home was not admitted onto the quality framework,
meaning it could charge council-funded residents what it chose.
However, the council also reduced the fees it paid for her care to
£382, from March 2013. The council told Mrs Y’s son, Mr X, that,
as the home had maintained the same fee of £470.70 he would have to
make up the £88.70 shortfall as a top-up payment – but as he did
not have these funds he began paying the top-up from his mother’s
savings from March 2013 and informed the council of this fact.
Though Mr X believed it was not in his mother’s best interests
to move from the home, he asked the council to assess the risk of
moving her to another home. However, the council said it would only
reassess her needs if it had been decided that she should move, and
Mr X appeared unwilling to consider this. Failure to follow law
The ombudsman, Jane Martin, found that the council had failed to
act in accordance with the law and government
guidance on choice of residential accommodation arranged
under section 21 of the National Assistance Act 1948.
The guidance states that a resident may only top-up their
council’s fee if they have a deferred payments agreement or are
subject to the 12-week property disregard, otherwise any top-up must
be made by a third party. Neither condition applied to Mrs Y, but the
top-up came out of her resources.
Also, Martin pointed to the fact that a top-up requires the
agreement of all parties, but said it had been “effectively forced”
on the family, as Mr X felt there was no option but to make the
top-up because of the risks of moving his mother to another home.
The ombudsman also said the council was at fault for not
reassessing Mrs Y’s finances after changing her care fees, to check
willingness and ability to meet the new costs.
The report also said the council failed to adhere to the terms of
the contract governing Mrs Y’s care, which contained a “legitimate
and reasonable expectation” that the council would meet the
contractual fees agreed on admission unless there was a change in her
needs.
Mrs Y died in March of this year. ‘Significant injustice’
The ombudsman said that Mrs Y and Mr X had suffered a “significant
injustice” because of the council’s actions, and recommended that
it:
reimburse Mrs Y’s estate for
the full amount of the third-party top-ups that have been made;
provide Mr X with a full written
apology;
pay Mr X £250 to recognise his time and trouble in
pursuing the complaint.
The ombudsman’s report also suggested that a further 160
residents may have been affected by the council’s changes to care
commissioning, as they were resident in homes that were not admitted
on to the council’s quality framework.
But Tameside council strongly disputed the findings and
“categorically denied” that it failed to act in accordance with
the law. A spokesperson for the council said that the report was
fundamentally flawed and raised questions about whether the ombudsman
herself had “unlawfully exceeded” her powers.
The spokesperson said: “The council reviewed its commissioning
arrangements to ensure that only those homes that offered the highest
standard of care get paid a quality premium rate. This was not about
cost cutting.
“Tameside council continues to pay one of the highest care and
nursing fees across the North West of England to support the most
vulnerable in our community. The purpose of this change, made
in 2012, was to raise and maintain the quality of care in Tameside
care homes whilst ensuring they remained financially sustainable.”
Claims rejected by council
The council also rejected the ombudsman’s claim that 160 other
residents may have been affected. “This is inaccurate as the
information provided by the council makes clear that the number at
its highest is no more than 10, who we are in the process of writing
to directly,” said the spokesperson.
“As the majority are in the same home, it is important this is
kept in proportion, and that the poorer quality homes do not, as a
result of this finding, believe they have been given the green light
to charge what they like.”
Speaking in response to the case, Janet Morrison, chief executive
of charity Independent Age, which campaigns strongly against the
wrongful use of top-ups, said: “Too many families now find
themselves paying top-up payments, sometimes amounting to be hundreds
of pounds a week, for essential care. The root cause of this problem
is a residential care system that is chronically under-funded.
“Families are increasingly having to subsidise local councils to
meet the costs of care it is really the responsibility of councils to
meet, so we need the government to protect people from paying unfair
‘top-ups’ as part of the shake-up of the rules from April 2015.”
WHENTheresa
May
called a General Election in 2017 one proposal in the Tory Manifesto
was immediately dubbed a ‘Dementia
Tax’.
At
present councils
pay for all or part of a person’s social care if they have less
than £23,250 in capital.
This applies if a person is in a residential home or nursing home.
The cost is then recouped from their estate after their death. May
also wanted to recover from
their estate the
costs of care given to people in their own home, to raise the
protected sum
to £100,000 and
axe the Winter Fuel Allowance for more affluent pensioners.
These
proposals went down like the proverbial ‘lead
balloon’.
They
were attacked by both Labour and the Liberal Democrats. The
Tories could reasonably argue that this was a better deal for
relatively poorer people who needed residential care and
would mean that the costs of care given in the home would be recouped
only
from
the more wealthy. Strictly speaking of course that’s not quite
true.
Until someone finds a foolproof, (and fire proof?) way of putting
‘pockets
in a shroud’
it will be the beneficiaries
of the estate
who will have their inheritance reduced.
Social
care today is in the same state as health care was in the 1930s, a
hodgepodge of partly national and partly local provision, and funded
partly by those who have the misfortune to need long term care, often
with pressure applied to their spouse or family, and partly from the
public purse. Unlike the NHS which is ‘free
at the point of delivery’
social care is not built around a ‘shared
risk model’.
Such
a model would
recognise that throughout
our life we
all
run a small risk of requiringsocial
and
residential care
due to age, infirmity or accident, hence we should all
make a contribution to funding that
care
for those who need it.
The
simplest and
most effective way
of doing this is via the tax system. But here we have a choice we
can either raise the money through a tax on income or through a tax
on wealth, specifically
a
tax on inherited
wealth. When
the costs of care are recouped after
someone’s death the burden falls on the estate not
the deceased individual. If you doubt this you might like to
consider that a dead person does
not
own their own body, so
how can they be said to own property or
other assets?
Switching
to such a funding model would go much further than Labour’s 2010
proposal for a ‘National
Care Service’.
Labour shied away from a fully tax funded system as being too costly
to be a sustainable model on
the basis that it would put too high a financial burden on the
decreasing proportion of the population that is of working age (p126
below).
I fail
to see that a tax based upon inherited wealth would not be
sustainable.
The
distinction between social (or personal) care and medically required
care is an artificial one. Dementia is a chronic medical condition;
it results in sufferers requiring social care in their own home. Why
should the necessary care for both the condition and its side effects
not come from the same source?
May’s
‘crime’
was to try to have an adult conversation with people who prefer not
to think about the problem of funding care for older people and send
to parliament people who are similarly reluctant to talk about it.
In
2019 the lesson was learned, no
one wanted a caning for talking out of turn.
The
Tories pledged an extra £1bn, the Lib Dems £3bn and Labour £10bn
by 2024 to
fund in home social care for all who needed it and to ensure that
carers were paid at least £10 an hour with no ‘zero
hours contracts’.
These
are significant sums of money, but even Labour’s proposals leave
the question of funding residential care for those who need it
unresolved. This
matters because the available funding has an impact on the quality of
care which is provided. Nothing illustrates this more sharply than
the spectacle of the owners of ‘run
for profit’
residential homes asking to be provided with kit to protect staff and
residents against coronavirus, and being told it is their
responsibility.
We
need a politician with vision and determination to keep fighting for
a universal and comprehensive care model for those who need it due to
age or a chronic medical condition funded by a tax on inherited
wealth, in the face of short sighted claims that it is a ‘death
tax’
or a ‘tax
on the sick’.
As I said earlier, ‘there’s
no pockets in a shroud’.Even
though I am unlikely to be the recipient of inherited wealth it seems
to me it would
be
better to have the
certainty 80%
of something rather than run the risk of 100% of nothing!
The
Covid-19 pandemic is the latest crisis to expose western economic and
social orthodoxies as wholly inadequate for meeting modern global
challenges which also include climate change, poverty, war and the
mass displacement of people. In the UK, massive state intervention
has been necessary, not least to ameliorate some of the effects of 40
years of austerity which intensified following the 2008 global
financial crash. Our population has been exposed, not just to a
deadly virus, but also to the importance of key - previously
undervalued - workers (producers) and the impotence of markets.
The
government’s initial laissez-fair response which sought to develop
a Darwinian “herd immunity” has been forced to evolve quickly,
take heed of progressive voices such as the TUC and now includes
measures to underwrite the incomes of tens of millions of people –
not out of benevolence but in order to maintain consumer demand and
the stability of financial institutions in the short-term.
When
organs of monopoly capital such as the Financial Times1
begin speculating about a post-pandemic economy requiring “radical
reform” in which “public services [are] investments rather than
liabilities… [when we must] look for ways to make labour markets
less insecure” and “redistribution” is necessary, it becomes
obvious that conditions are ripe for fundamental change. Things
probably will never be the same again but our movement needs to be
clear that minor reforms do not represent the sum total of our
ambitions – even if, in the early days of an anticipated backlash
or intensified class conflict, they appear to represent a welcome
alternative to the default prospect of a period of much longer and
much harsher austerity.
Aims
for a post-pandemic consensus
Many
workplaces, from hospitals to warehouses, supermarkets to schools and
mail depots to care homes are unable any longer to be managed through
a system of strict command and control. Workplace pluralism has
broken out and is now recognised as necessary to optimise
organisational efficiency and safety which is essential for the
effectiveness of the public response to a national crisis and
represents an opportunity for a renaissance of trade union activity.
Taking
the existing provisions of the TUC
Campaign Plan,
Charter
for a new deal for working people
and considering the spirit behind the motions submitted to the
postponed 2020 Annual Conference of the TUC North West, the Executive
Group has considered the appropriate immediate tasks. These assume
that the TUC and affiliated unions will form a functional part of the
interventions required from civic society if we are to emerge from
the Covid-19 pandemic with a renewed relevance and appetite to
deliver progress for the people we represent:
A
stronger voice at work
The producers in the economy have
assumed a new significance and found renewed respect throughout the
public health crisis. Medical and social care professions, shop and
distribution workers, engineers and other workers in the fields of
education, communications, sanitation and transport; public sector
employees engaged in welfare, justice, housing, social work and
beyond; and thousands of other jobs and vocations which were
previously undervalued at best or exploited, and even demonised at
worst, but are now held in higher regard by society at large. Their
workplace voice is being heard more clearly and with more confidence
than at any time since the peak of collective bargaining influence in
the mid-1970s with examples including the demands for personal
protective equipment in hospitals, the practical and academic
arrangements for schools to remain open for those who need them but
closed for the majority of students and the social distancing regimes
which are now routine in factories, depots, warehouses and shops.
Going forward, a recalibrated industrial
balance tipped in our favour is essential; backed up with a range of
new and legally enforceable, collective workplace rights to secure
effective mechanisms for regulating relations between workers and
employers of any size. International Labour Organisation conventions
and publications such as the Institute
of Employment Rights’ Guide to a Progressive Industrial Relations
Bill provide a
template for such an initiative to be progressed by the TUC and
supportive organisations, consistent with existing policy and in
conjunction with affiliates.
Employment,
security and flexible working
The lockdown announced on 23 March has
exposed a range of inefficiencies in traditional ways of working and
forced a reconsideration of how technology can assist workers rather
than be used to replace them. Video conferencing and digital
communications have become commonplace and have replaced physical
meetings - saving time, stress and significant levels of pollution
from unnecessary travel on congested transport networks.
The process of “furloughing” (Job
Retention Scheme), introduced in no small part as a product of TUC
lobbying, challenges a whole plethora of assumptions about the role
of the state and its relationship with industry, incomes policy, the
markets and maintenance of some sort of temporary order in the wider
economy. Moreover, the scandal of precarious employment, bogus
self-employment and casualisation more generally, now needs to force
a fundamental re-think about job security – not least because as
many as 11 million workers are expected to fall between the gaps in
the government’s emergency provisions.
Globalisation and global markets have
proven unable to provide an adequate response to the crisis, as
exemplified by the absence of a domestic manufacturing sector capable
of responding as quickly and effectively as required, for example, to
produce medical ventilators, clinical gowns, masks and other types of
PPE. With UK business investment2
and productivity3
continuing to decline and global debt to GDP at historic levels4,
the recovery from the crisis requires significant state intervention,
specifically in respect of long-term domestic industrial development,
research, skills and job creation, including new Green Jobs, towards
a policy of full employment.
Flexible working and home-working have
proven effective in ways that employers might not have previously
thought possible and, with a few exceptions, unions have been able to
secure pragmatic agreements on the use of discipline, capability,
performance management, redundancy consultation and other Human
Resource Management initiatives during the crisis. This reorientation
needs to be secured after the crisis subsides with a transformation
of management techniques and practices which are leveraged by
confident workers with a better understanding of industrial
relations.
Welfare,
tax and public services
The fragility of social care provision
has been brought into even sharper focus throughout the crisis –
not least in respect of the lack of coordination around the provision
of Personal Protective Equipment for an enormously undervalued group
of professional Carers. Though just one example of the failure of
market provision, this can provide the basis for a popular campaign
of nationalisation and insourcing of a wide range services which have
been removed from democratic control since the post-war consensus
made way for neo-liberalism in the 1970’s but which have been
demonstrated to be essential for societies to thrive and in reducing
inequality.
This requires a new way of thinking
about who contributes to society and how those contributions are
valued. Hedge-fund managers and financiers were nowhere near the top
of the list of “key workers” as identified by the government5
but to ensure that all citizens and corporations meet their social
responsibility obligations it is necessary to re-evaluate how taxes
on high salaries, profits and accumulated assets can contribute to a
transformational programme of societal and economic reform. Such a
programme does of course require sufficient numbers of trained staff
to collect tax owed and circumvent domestic and international
loopholes which currently allow and facilitate large-scale tax
avoidance and evasion.
Reforms of the type described can
provide a solid basis for root-and-branch social security reform in
the interests of families; sick, disabled or retired workers and the
professional staff who care for them.
EVERY TIME
I hear a Tory minister talk about ‘Our
NHS’ I wince a little.
The National Health Service
was the creation of the post war Labour government. But even that is
not quite true; the NHS as
we know it was the creation
of one man, Aneurin Bevan,
better known as Nye Bevan,
which is why we have an NHS facility named after him in Rochdale.
Certainly
there were other people who
deserve credit,
especially
William
Beveridge whose
1942 report fed the appetite for the state to take better care of its
citizens.
Beveridge
advocated a scheme that was universal
in that it was to cover all people and comprehensive
in that it would cover all needs. He assumed that it would be run by
local government and that it would be a social insurance scheme with
a contribution from the government of the day. Beveridge
also favoured
patients paying ‘hotel’
charges for their stay in hospital and charges for ‘appliances’.
His
scheme would have replaced the one that had gradually evolved so that
in the 1930s about
90% of the workforce had
social insurance, which
covered
the of the GP
service and sick pay. The
other 10% and all dependants
either had private insurance or made full out-of-pocket payments.
The costs of
hospital care
were met by private
insurance, such as workers'
contributory schemes. This
met the needs of about 10 millions of the population and
the rest paid means-tested charges. Local and national taxes funded
public health, hospitals and the
specialist clinics run by
local authorities.
Bevan
saw things differently and
effectively nationalised the health service.
He favoured a
fully
tax-financed system.
He
did this because funding based upon national taxation is inherently
more redistributive. He
also
regarded
free access to health care to be a citizen's right and not
something conditional on the payment of contributions. In
addition a tax based scheme neatly
sidestepped the problem of how, politically
and administratively, the non-insured could be turned away from a
universal service.
‘The
collective principle asserts that... no society can legitimately call
itself civilised if a sick person is denied medical aid because of
lack of means.’
— Aneurin Bevan, In Place of
Fear, p. 100
We
should be thankful that we have a tax based system. Imagine if you
felt ill and found that your insurance would pay for a test for
Covid19, but not for your treatment or care. It has happened in the
USA.
Imagine if you have just recovered from a stay in hospital being
treated for a Covid19 infection and then someone starts chasing you
for ‘hotel
charges’.
What
Bevan did not solve in 1948 was the question of who should pay for
the care of the elderly. Should it be the NHS and its tax based
system or local authorities who were free to make a charge. No one
else has shown the will to solve it since.
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