John’s Blog No.83 – Elderly Care

This is getting increasing media attention but official proposals and reports are continuously delayed probably because no one knows how to tackle the problem or even define it. This could be the nub of the matter, because like many of the current problems today the approach is from the wrong end, starting as a cost cutting exercise and what can be afforded on what is left. One needs to start at what are the, needs, how they can be met, the best way of meeting them using all the resources available, then what are the costs and how and what can be met? The current approach is fragmented, haphazard and illogical, with conflicting responsibilities between Central and Local Government, NHS and Social Services and the various charitable organisations, including Families, with major dependence on the latter. There are also very basic Social and Moral issues involved, who is responsible is it the State, Community or Family, what is a reasonable lifestyle or a pointless one, who decides on a vegetative state and where does individual choice or wishes occur and be allowed. Needs and numbers are easier to assess, one can start by defining the levels of care from simple homecare to more complex ones, social clubs, retirement homes, sheltered housing, residential care, nursing, hospital and Hospice needs. Numbers can start at existing ones with more detailed studies on future trends and projections. Costs for care can be high as they involve large labour and building costs on the one hand and undervalued and underestimated family, charity and community costs, which could all be better integrated, with considerable savings. For example luncheon and social clubs play an important role but are the first to be axed. Councils set residential care costs at some £23,000 per person per year; private suppliers put this much higher, but what is a realistic figure, how much is affected by rules, regulations, licenses etc, created by rogue incidents or accidents and are too severe. Can permanent staff be relieved by volunteers in afternoons etc.? Can Diferent homes meet diferring needs without upset. Care assessment could be on a much wider basis, involving GP’s, family, communities and charities and is too closely connected to commercial considerations, mainly of cost. Retirement homes could be planned to include social needs, instead of just living compartments, and include Housing Associations to give simpler transition and progression as care needs increase. A lot could be done with a little thought. Contributory funded pension schemes could play an important part in elderly care, in addition to investment in buildings. After retirement, from age 80 on, Fund disposition tends to be uncertain and currently is pessimistic resulting in surplus; good fund management could ensure this allowing money release to meet care costs. This should not be used by the State for cost cutting, but as a means to ensure adequate and extra provision to members in place of any proposed Capital levy. One of the major problems in Economic policy is liability postponement, which is placing an ever increasing burden on the working population, nowhere is this more apparent than in the State unfunded Pension system. National Insurance contributions need fundamental change; they should be forward savings for retirement and an Insurance for working people, a return to the basic concept, but modernised. Members contributions should mean something and not just thrown into the welfare pool. The need for extra contributions for pensions is being implemented, but not recognised as individual personal savings, which together with NI contributions should be used for the sole benefit of members and embrace Public Sector and all other pension schemes. This could create aims, objectives and rewards for those in work.