THE recent BBC documentary on Scottish care homes during the coronavirus provided an insight into the experiences of tireless staff and residents’ families during this unprecedented crisis. The brave and heart-rending testimonies helped to humanise a story that is too often reduced to statistics.
There have been 4,200 deaths in Scotland where Covid-19 was named as the underlying cause. More than three-quarters of all deaths were of people over 75, a significant proportion had underlying health conditions.
It’s worth remembering that most people who had coronavirus did recover. For these efforts, NHS staff were rightly praised and, I’m sure, encouraged when millions came together to clap for them every Thursday evening.
In contrast, the efforts of the care sector went largely unnoticed, despite thousands of patients also recovering and statistics from the Scottish Registry showing a similar percentage of deaths in hospitals. Care homes get their fair share of criticism, and rightly so in some cases. However, in spite of operating on a far smaller budget than the NHS, they have proven to be a much safer place for vulnerable older people than hospitals or at home due to well-trained staff and high hygiene standards. They have also been invaluable in freeing up intensive care beds in hospitals for younger people who might have needed them.
Nevertheless, few in the sector now expect praise or gratitude. Rarely do people acknowledge social care unless it directly affects them.
Along with greater public support, the NHS also receives significantly more money every year. The councils who control care home fees bear the brunt of cuts, and funding continues to fall, even as the numbers of elderly increase and their needs became more complicated.
This under-funding costs the NHS a fortune, which is not realised or appreciated by the Scottish Government. Thousands of older people languish in hospital beds, where they are often exposed to other illnesses, because there is no one to care for them at home, there is not enough space in care homes, or due to the poor communication that exists between the health and care sectors. The cost of an older person occupying an NHS bed is around £3000 per week, even when they don’t need medical care. The Government somehow expects the care sector to look after vulnerable older residents, many with dementia, for less than £600 per week.
This lack of funding meant the sector was seriously ill-equipped to manage when over 1,000 patients, some who had already tested positive for Covid-19, were discharged from hospitals into homes to free up beds, without a proper testing regime in place.
The Government says protecting the care sector and workers is an "absolute priority”. However, recent activity suggests otherwise. This month, Scottish Conservatives wrote to the nation’s top prosecutor accusing the Government of failing in its legal duty to protect care home residents. Politicians continue to refuse to set a date for a public inquiry.
Whilst £100million of extra funding has been allocated to local authorities, many refuse to fund independent care homes to the same level as their own facilities. When it does reach homes, it only scratches the surface of the additional costs spent on agency staff and overpriced PPE.
Further, the new post-Brexit immigration rules coming into force that severely restrict overseas workers are set to compound the long-standing hiring challenges the sector already faces.
Care sector workers have given everything during this crisis for the residents. We have stuck to the guidance at pace, with consistency and integrity. It’s high time the Government responds to the needs of care home residents and their families as well.
The way we treat the vulnerable is a reflection of the state of our society. After all this pain and misery, there is now a once-in-a-lifetime opportunity for the Scottish Government to recognise what is really going on in care homes, review policies and processes, and push for the same long-term, legally-binding, and sustainable funding that has been granted with the spending commitment to the NHS.
If they fail to act, the damage caused by the foreseeable second wave of the virus, or indeed future epidemics could be catastrophic.
Dr Sanjeev Kanoria is a former NHS surgeon and the Founder and Chairman of Advinia Group which has thirteen care homes in Scotland.
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