Covid care-home scandal shows why we need a National Care Service – Susan Dalgety
Uncle Arthur looked quizzically at the life-size plaster-cast statue of Our Lady that dominated the wood-panelled hall.
“I don’t think this place is for me,” he sniffed, refusing even to look at the bedrooms before turning, slowly, on his heels and heading for our hired car outside.
Arthur, a 79-year-old man with several underlying conditions, not least loneliness, finally found a nursing home he could tolerate. But throughout his year-long stay he never came to terms with paying £850 a week for dull, badly cooked comfort food and a room decorated in 1980s Travelodge chic.
He died in that room in July 2007. His death certificate said cancer and heart disease, but it should also have read “loss of hope”. He refused to eat and drink during the last two weeks of his life. He had lost his voice, but not his stubborn determination to die when he decided it was time to go.
The medical care he received during his stay was minimal. There were never more than two qualified nurses on duty during the day, and only one at night. A local GP, who had several care homes on his books, popped in once a week to carry out a desultory check on residents.
Uncle Arthur’s personal and most of his medical needs were met by a group of care assistants, doughty women of all ages and accents, who went from helping him downstairs to enjoy an afternoon in the lounge, to wiping his bum when he could no longer move.
A man who had been a leading member of the team that convinced the Bank of England that the new-fangled machines that dispensed cash from a hole in the wall were not the work of the devil, but the future, spent the last year of his life trapped in a beige room that reeked of despair.
Thousands of residents in care homes up and down the UK have just died in rooms that reek of that same despair.
Their death certificate may or may not have Covid-19 as the cause of death, but each are victims of the same underlying cause – national neglect.
As care home staff earning less than £10 an hour struggle to cope with the pandemic, it seems everyone in charge, from government ministers to NHS senior managers, turned their back on Britain’s most vulnerable elders.
And it didn’t matter whether a care home was in south-west England or the east coast of Scotland. Indeed, in a rush to empty Scotland’s hospitals to prepare for the influx of Covid-19 patients, 900 elderly patients were discharged, with a third sent to care homes without first being tested for the virus.
And it was only last week, and under immense pressure as the number of deaths in care homes mounted, that Jeane Freeman, Scotland’s Health Secretary, agreed that all new residents should be tested for coronavirus on admission.
Only a future investigation will establish whether failing to take this decision earlier led, in part, to the spiralling number of deaths.
An army of working-class women
But the numbers speak for themselves. Last week, 338 care home residents died, compared to 276 patients in Scotland’s hospitals. And if it had not been for the resilience shown by poorly paid, under-valued care staff, the death toll could well have been be much higher.
There are no high-tech ventilators, no dashing young intensive care doctors, no awestruck TV crews filming in Scotland’s care homes.
Just an army of working-class women doing the best they can to save the lives of their residents, or to make their last hours as comfortable as possible.
These women, some who moved into their workplace to live full-time with residents, were even denied adequate protective clothing, many having to make do with home-made masks and aprons.
And some have made the ultimate sacrifice. Five care workers have died of Covid-19 so far in Scotland, with at least one of those deaths reported to the Health and Safety Executive (HSE) which investigates workplace deaths.
The Prime Minister, still breathless from his own brush with the virus, announced on Thursday that we are “past the peak” of the first wave. I prefer the First Minister’s more cautious, less bellicose approach. She is right to warn us that it may be too early to lift any of the current restrictions. If we need to spend May in lockdown to save lives, then so be it.
But there will be a time when this is all over. There will be many lessons learned, much work to be done to create our new normal; many sectors, from education to hospitality, all competing for their government’s attention and its diminished resources.
A National Care Service
First in that queue must be social care, because if a society is judged by how it treats its elders, then we have failed miserably.
Collectively, we fear old age, pretending even as our hair turns white that we are still young.
Governments baulk from asking us to pay more tax to pay for care in our final years, knowing we will resist in the privacy of the voting booth. We dismiss the contribution that care workers make to society. Worse, we pay them a pittance.
Four years ago, the Scottish Government made a commitment to ensure social care staff are paid the Real Living Wage (£9.30 an hour).
A report by the Resolution Foundation, out this week, shows that despite the Government’s pledge, nearly half (43 per cent) of Scotland’s frontline care staff still do not get the pay they deserve, or were promised.
And inadequate funding for a hotchpotch of providers – councils, the private sector and charities – means that the quality of care suffers as budgets tighten.
There are currently 12 million people in the UK aged over 65, around one million in Scotland. In 20 years’ time, that number will jump by 40 per cent.
We are living longer than ever before, changing the shape – and demands – of our society.
Getting older is inevitable but ignoring the needs of our elders is not. We need a national care service to match the best of our NHS now.
Before it’s too late for all of us.
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