Jude D’Alesio: We need a new social care settlement, but a copy of the NHS is not the answer

14 Nov

Jude D’Alesio is one of the youngest councillors in Britain, serving on Long Ashton Parish Council in North Somerset.

Losing my part-time job as hog roaster was not how I envisaged the beginning of my Easter holidays. Instead, lockdown created a surge the demand for care assistant roles in my home city of Cardiff.

I could lie to you and say that this was the job I had always dreamed of having, but truthfully I was not prepared to play my PlayStation for a whole summer and needed an activity to bridge the gap to until I resumed university in September.

However, I was not prepared for how much it would teach me about the politics of social care. Indeed, learning everything from how to wake a resident in the morning, how to talk to a person with dementia, how to feed someone in their bed, and how to detect when they about to fall over, was a world apart from my law degree.

But if I learnt one thing as a care worker during Covid-19, it is that we need a new settlement for social care in Britain.

The Prime Minister and the Chancellor were swift in their response to the pandemic in the industry, boosting funding for councils as well as pledging that the promise to do ‘whatever it takes’ applies as much to social care as the NHS. So far, the pandemic has ensured that this valiant defence of social care is replacing the previous treatment of care as the poor cousin of the NHS.

Ensuring that the most vulnerable in society are safeguarded is a noble aim, though Gordon Brown’s proposed ‘death tax’ in 2010 reminds us that a realistic solution is unlikely to emerge from the left. Contrary to what some may think, I found that many of the residents under my care, no matter how mentally impaired, were concerned about their finances. Once, I was asked by a resident to go the bank (unlikely to occur at 2am on a Sunday) so that they could pay for their meals, despite them being prepaid by the family. Elderly residents worrying about their care is funded should not be commonplace in Britain.

It must be acknowledged that care homes were only able to focus all their efforts on beating coronavirus due to much of the normal care bureaucracy, such as routine Care Quality Commission inspections, being abandoned. I quickly learnt that ‘inspections’ was considered a dirty word among my colleagues, who told ironic stories of being distracted all day by inspectors who were, unsurprisingly, concerned with completing their tick box exercises. If this fails to renew the Government’s impetus to cut stifling bureaucracy following the pandemic, I know not what will.

Another benefit which emerged in the industry was the rapidity with which elderly patients were discharged from hospital into care homes. By the end of my stint as a care worker, I learnt that it was not uncommon for a new resident to be arriving every week from hospital, and given that the inert process of discharging elderly patients to care homes was a bane for policymakers, I hope that this new vigour sticks.

There is a paradigm throughout social care of focusing incessantly on negative metrics resulting from regulation: weight loss, bruises and aggressive behaviour, for example. Care homes must become less custodial and prioritise quality of life and happiness, not adopt a box-ticking exercise.

Conscious of how a large portion of my work was spent filling in checklists, I soon learnt why many residents soon spiral into depression upon being admitted to a home. As such, I prioritised engaging in more interpersonal interactions with these people, who often had incredible stories from their childhood and profession – not to mention reassuring Conservative views!

Care homes have seen residency rates fall dramatically, with a simultaneous need to make them safeguard against COVID-19 which has squeezed profit margins (by the end of summer the place was half-empty, with the occupancy rate dropping every week).This coincidence of underlying financial weakness, falling revenues and rising costs means that many homes are on the precipice of closure. However, there is an understandable reluctance by the Treasury to countenance an expansion in the scope of the state.

A report by the Centre for Social Justice concluded that countries where the state has provided full free social care without restrictions have seen costs spiral unsustainably, forcing them to restrict eligibility and cut back services. Establishing a national care service is, unfortunately, not an option.

So, this is what I propose: a basic level of social care for everyone, funded nationally by taxation, but people buy out-of-pocket top-ups to purchase private insurance policies to cover additional care – a model backed by the CSJ. This will end the injustice of some having to sell their homes to finance their care while reforming the structure of incentives to encourage private investment.

Covid-19 has provided the impetus to reform our care system, and if I learnt one thing as a carer it is that change is needed. I hope I am not proved wrong in saying that the energy from Downing Street thus far signals that we have a government which will get social care done

Jude D’Alesio: The Budget must be centred on young people

30 Aug

Jude D’Alesio, aged 19, is one of the youngest school governors in Britain, and is a Law student at the University of Bristol.

When I listen to my grandparents complain relentlessly about the lockdown, I cannot help but feel slightly frustrated. Frustrated, because I have sacrificed a term at university to go into lockdown to save them from this virus!

The government’s imposition of a lockdown in the UK was aimed at protecting those most vulnerable to contracting coronavirus, principally the elderly. There is no doubt that this was the correct decision, and Prof Neil Ferguson stated that lockdown should have been imposed earlier.

Over 95 per cent of coronavirus deaths have occurred in those older than 60, and 50 per cent of all deaths have occurred in those over 80 according to the WHO. It is only right, therefore, that we seek to protect the elderly, the most vulnerable in our society, from the disease, and the country is certainly united in this goal.

It is undeniable, however, that lockdown has taken a significant toll on the younger generation, of which I am a part. In higher education, lectures have gone digital, and some teaching missed altogether. This especially disadvantages final year students, many of whom will be embarking on their careers with significant gaps in their knowledge, particularly critical in professions like medicine.

There is also the immense damage caused to secondary and further education by the lockdown. At least a whole term of work missed will prove acute in those at crucial points in their education, namely GCSE’s and A levels.

Being robbed of the chance to outperform your predicted grades after months of hard work will deny many the chance to attend the best universities. This can only be negative, as we want our younger generations to receive the best education possible to enable them to pursue their ambitions.

Families with the lowest incomes will be hit hardest by the effects of distance learning; not being able to effectively participate in online classes due to a lack of technology will inevitably create skills gaps among the poorest in our society.

For all these reasons, the next Budget should be focused on, and most beneficial for, young people: their education, their skills, their opportunities.

In many ways, the pandemic has breathed fresh unity into our country as we are united in fighting the virus. It seems fair, therefore, that everyone should in some way bear the cost of the current recession. However, as the lockdown came at the cost of young people, there are undoubtedly changes benefiting young people which can be implemented in the next Budget.

Scrapping the triple lock is a great start. The triple lock, implemented by the Cameron government, increases pensions in accordance with the Retail Price Index, average earnings or 2.5per cent, whichever proves highest. This could enable savings of £8bn a year, according to a leaked Treasury document.

The current main rate of corporation tax, sitting at 19 per cent, has been stagnant since 2017. Such desperate times surely call for a cut in the rate, in line with the government’s aim to make us more competitive post-Brexit. Additionally, the government’s plan to merge the Foreign Office with DFID, whether the correct decision or not, will undoubtedly produce savings.

The proceeds of growth, merely the beginning of a range of reforms, should be reinvested heavily in young people’s education and opportunities to redress the balance caused by coronavirus. This must include the £1bn ‘catch-up’ plan to enable school children to bridge the gap left by lost teaching. However, amounting to only £80 per student (IFS), further funding once coronavirus passes should be on the cards.

This is, of course, only a starting point, and many more steps must be taken to alleviate the portentous educational, financial and social burdens which have overwhelmed my generation. But, there have been clear losers during this pandemic and the next Budget should recognise as such.