The debate on rising aged care costs neglects the enormous social and economic contribution of the home care sector to society and to the sustainability of the health system, the head of the largest peak body for care services in the UK told a Sydney conference on Thursday.
Chief executive of Care England Professor Martin Green warned Australia against following the path of state-funded home care in the UK, in which chronic underfunding of home care has led to a “major crisis” in that country.
Professor Martin Green, chief executive of Care England
Professor Green said major players had chosen to exit the market or were on the brink of failure due to unsustainable funding from government. Just this week the UK’s largest home care provider had been put up for sale.
The home care sector played a critical role in keeping people out of residential care and hospital and without it the healthcare system would be stretched further, he said.
“What people don’t seem to realise…is that services provided in home care are the absolute foundation of the whole system.”
“And if you undermine your home care services and indeed your residential services, what you will find is that your already pressurised healthcare will be at the point of collapse. That is bad for citizens, and worse than that, it is bad for the economy,” he told the Future of the Home and Community Care conference.
Professor Green said in some parts of England, the care sector as the dominant employer was the powerhouse of local economies – a fact that was overlooked in discussions on curbing aged care costs.
“What we don’t make enough of is the economic value of social care to economies… The only thing that anyone ever wants to talk to you about is how much care costs, what they don’t do is tell you how many people are employed in care and what the contribution of those care workers are to the general economy.”
In the UK there was a substantial imbalance in funding levels between health and social care, which created significant inequities for older people, he said.
“We spend about £117 billion a year in the health service and only £8 billion in social care. But if we look at the current population it is predominately about people who need to have their long-term care needs managed,” said Professor Green, who is also chair of the International Longevity Centre.
“This skewing of resources to one bit of the system and not the other is one of the major challenges we in the UK face.”
Ageism within the system
He said ageism in the healthcare system was also a concern.
“We have an Equality and Human Rights Act in the UK, and enshrined in that Act is the notion that older people have the same rights as everybody else in the system, and yet we see time and time again ageism at play and people who are older not getting the same level of support that young people get.”
There was also limited support from the medical community, which he said stemmed from ageist attitudes.
While the UK’s Care Act 2014 promised to deliver a raft of reform measures, including a shift from crisis to wellbeing, from dependency to independence that mirror the Australia’s agenda, Professor Green cautioned against the widening gap between politic rhetoric and reality without appropriate resourcing.
To meet the challenge of long-term sustainability, Professor Green said that UK care providers were looking to diversify their funding-base and attract clients that could contribute more to the costs of their care.
“One of the things that we have to do is get much more connected to the people who use services and show them the value of what we do.”
Like Australia, he said another major challenge in the UK was the low pay and recognition of the care workforce. In the UK, large numbers of home care workers are hired on zero-hours contracts and without paid travel time, he said.
“If you consider the complexity of the work that they do, it is absolutely scandalous that they are neither paid nor respected to be professionals delivering that level of service.”