You could be forgiven for thinking that Andy Burnham and I have little in common. I certainly cut the better figure in a black t-shirt and jacket, his politics sit some way to the left of mine, and I'm definitely no Everton fan.
So I was sorry to hear that his father Roy died this week in a care home after years with Alzheimer's. The prime minister has been open about what it took his family to get his dad the care he needed and how this experience shaped his view of social care in the UK. As he said during his speech in July on social care, when someone in your family is receiving care, you look at everything through new eyes.
I too have experience of the care home sector and from three different perspectives. Professionally I have been involved in arranging and providing finance to get them built for over a decade; my mother has spent the past 3 years in a wonderful private care home near where I live and most recently over the summer I helped my elderly uncle move from his own home via hospital to a private care home.
My uncle’s experience of the social care system coincided with the prime minister’s first major policy announcement on social care – aptly enough on how he was planning to drive reform. My uncle’s journey was a textbook case of exactly what the reforms are meant to prevent: limited help available at the point of crisis, with the NHS an open-ended stop-gap.
My uncle had been living independently alone at home despite ill health and dementia for several years until June this year. He was fortunate to have a strong support network, with four visits a day from a local care agency supplemented by support of friends and family, but as his dementia progressed and his health deteriorated, it became clear that he could no longer stay at home. So he was admitted to hospital where he spent around two weeks and where the staff and care were both outstanding. The well documented strain on the NHS was, however, all too clear. He experienced a lengthy bottleneck in A&E of over 24 hours and once admitted, scans and tests took an age to get done, with his slots frequently cancelled or deferred. A disjointed system of record keeping and communication between departments ensured that any progress through the system was slow.
As the fortnight progressed it became clear that my uncle would not be returning home and I began to discuss local authority care home options with the hospital team. While perfectly feasible in principle, the team told me it could take weeks or months to navigate the system and find a place, during which time my uncle would have to remain in hospital.
A protracted hospital stay clearly wasn’t going to be good for his quality of life – to say nothing of the cost to the NHS of keeping him in a bed. A senior nurse advised me that I should look to get my uncle out of hospital as soon as possible as that would be best for his health. Our only option at such short notice was to find him private care and my uncle was in the fortunate position of being able to afford the expense. We found a place in a recently opened home just a few miles from where he had lived and all the arrangements were made to move him in. Sadly, he died there three weeks later in comfort and dignity, a long life well lived.
Andy Burnham’s reforms are ambitious and aim to treat social care as the support that is integrated into the NHS with an emphasis firmly on the home-and-community end: helping people live at home as independently as possible, for as long as possible, with co-ordinated support that reduces reliance on both hospitals and care homes. From the perspective of social care workers, the aspiration is clearly to build training and progression routes within the care sector to gain parity with staff in the NHS. Social care does not live in its own silo and the health service cannot be restored while this is left as it is.
From what I witnessed over the summer, there is a huge gulf between the service, experience and journey available under the NHS and that under the private system. Quite how our country goes about bridging that gap in any way at all without hiking tax rates (and without keeping the private sector involved) will be an interesting one to watch – all the more so if the PM has to dangle the prospect of a tax rise before the voters shortly before a general election… After countless failed attempts at reform, let’s hope his ambition is equal to delivering the change that the social care sector needs. That’s where Andy Burnham and I do agree: his dad and my uncle deserved better than the system we have today.