Making money out of the old and sick

I ran a workshop for the management team of a chain of private care homes a few years ago.  They were concerned about their internal communications. They had a number of homes scattered across a wide area of the North East with a staff of workers technically described as unskilled, though Lord knows I couldn’t do the job.  The staff worked irregular shifts, many had English as their second language, almost none had access to a computer.  The standard internal techniques were obviously not going to work so we spent some time looking at  creative alternatives.

I was struck by the huge pride the staff took in the quality of the care they offered and by how beleaguered they felt as an industry.  They believed they were demonised as heartless profit-seekers,  maximising income by grabbing  granny’s life savings and offering her workhouse conditions cared for by untrained staff on minimum wage.

My workshoppers evidently didn’t fit that pattern.  They cared enough about their staff to spend time and money thinking about how to communicate with and train them.  They were proud of the  standard of care in their homes.  I went away chastened that I had bought into the stereotype too.

I’ve  thought of them again recently: when the debate started about whether the public sector should bail out the failing private provider Southern Cross; when the row over the private Castlebeck  home blew up; and when I read an interview with the magnificent Diana Athill in today’s Guardian under the heading “You can’t make money out of old people“.

Athill has lived in a care home she describes as “a dream” for more than a year and it does sound idyllic.  Crucially, in her opinion, her home is run as a not for profit Trust rather than a business required to clear a profit for shareholders.

You can believe as I do, and as my workshop showed, that not all private care homes are Castlebecks, that not everyone who works in the private sector  is a rapacious monster, and not everyone who works in the public sector is a selfless angel.  You can argue that the cost of providing high quality care for a rapidly aging population is  too high to be met out of general taxation alone.  But if your prime concern is to ensure that older people have a dignified, safe, comfortable home in which to see out their final years it’s hard to argue with Athill when she says:

You don’t set up an old people’s home as a private company unless you think you’re going to make a profit.  You can’t make a profit out of old people … Where need is serviced by the third sector it is civilised.  When it’s serviced by people trying to turn a profit, it’s not … If life is miserable in the main tranche of care homes, it is because the private sector is unsuited to this work.

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