A better kind of care

Posted by Alexander Hay

Viewing the issue of long-term care in financial terms misses the real issues.

http://owl-group-staging.s3.amazonaws.com/upload_datas/29395/landscape_large.jpg?1289924542As befits our cash-strapped times, the debate on long-term care is being framed in terms of money.

The long and the short of it is: Long-term care costs a fortune. Ergo, if the taxpayer doesn't pay for it then the elderly will, often by selling their homes or by tapping into the finances of their children and even grandchildren.

One hopes the government has a 'vision', but on that we must wait and see. Care Services Minister Paul Burstow will today announce plans to resolve the issue, with local councils expected to be told they must provide personal care budgets for all eligible cases by 2013. But given the way council tax receipts vary from council area to council area, the measure might not be the solution it's hailed as.

This being the ConDem parliament, there will also be a stress on voluntary aid as part of the Conservative Party's other 'vision', The Big Society, or trying desperately to get public services on the cheap as it is otherwise known.

Still, however, the matter is framed in financial terms. It's not whether Mrs Grimwood will get the care she needs, so much as whether there's enough money to throw at the problem. While it's admirable of politicians to acknowledge that they care enough to hurl money at something (if they could), it misses the point as ever.

Money isn't everything. In fact, viewing it in financial terms risks dehumanising the problem. The last 13 years have seen buckets of lucre tossed at any number of governmental hobby-horses, but more than three trillion in debt seems not to have made a difference, especially if you're old and can't quite make it up the stairs like you used to.

Treating the needy as helpless financial dilemmas misses out the hidden issues at play. For example, the 700,000 children and young people who care for disabled relatives, including the elderly, across the country. While it's easy to dismiss the 'yoof' of today as knife wielding apes with no taste in clothes or music, the truth is that tiny 8% saves the taxpayer an absolute fortune.

In fact, from an accountancy perspective, those kids are saving us money in every department. Bespoke, personal hands-on care? Free 'n efficient. Helping ageing family members to stay healthy and making sure they're not cold? Free 'n efficient. Spotting problems before they burden the NHS or social services? Free 'n efficient. Checking on older relatives on the way back from school? Free 'n efficient. True, it comes at the cost of childhoods and one's education, but think of the money saved! We have debts to think of, after all.

Then there is the strange but novel method of 'paying attention'. Well-funded as the NHS is, there is something inevitable about stories of old patients dying in terrible conditions or reports that reveals two thirds of elderly hospital admissions are not cared for properly. Again, this is because we view the issue through the prism of cost and ideology. No amount of busybody volunteers or government cash will improve anything if no one actually takes the time to see if the man in cubicle four is able to stand up or make it to the toilet in time. In crudely fiscal terms alone, that will save a fair bit of money in the long term.

In any case, the answers are right in front of us, and so we don't notice. Centralised and bureaucratic approaches, no matter how well meaning, never quite do it as well as they could. But assuming 'greater social engagement' will answer these problems is wrong too. The elderly don't need to be patronised, just noticed a bit more often. 'The Big Society' is no answer for small, individual and everyday tragedies either.

Perhaps as we live ever longer, the health issues that come with ageing will become less and less challenging too. But for now, we have a lot of 'Boomers' who are about to retire and bring even more care needs into the equation. So let us ask how we will help these people, but let us not forget either that this is a human problem in search of a particularly human solution.

Or we could follow the Japanese route and just build robots to do the dirty work instead. It might not be cheap, but by goodness, it will be EFFICIENT!!!

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Alexander Hay

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