Coronavirus: social, economic and other changes as a result of the pandemic

[Dave2002]

Today there are possible proposals for Social Care - as a consequence of the Covid-19 pandemic.

Issues such as this - https://www.theguardian.com/politics...e-news-updates

[Bryn]

Today there are possible proposals for Social Care - as a consequence of the Covid-19 pandemic.

Issues such as this - https://www.theguardian.com/politics...e-news-updates

Currently following the Johnson statement and resulting questions on the BBC News channel.

[Dave2002]

Currently following the Johnson statement and resulting questions on the BBC News channel.

More obfuscation and mindless support from some of his "followers". Yes - there is a need for action and funding - but there are so many issues about how this might get done. The proposals are probably not the "right" or "fair" or even sensible way to do things, but since when has the PM really worried about such things?

[oddoneout]

My concern is not so much how the money is raised (I am aware of the various issues about payment v income levels) but what happens to it once raised. This government has not shown any ability to manage public finance well or with integrity as far as I'm concerned. Since so many care homes are money making rather than purely service providers the opportunities for yet more money being siphoned straight onto favoured persons' pockets would seem legion.
My understanding is that a major problem for years has been the defunding of local government so that councils cannot meet their obligations let alone their wishes to provide "fit for purpose" care for those for whom they have responsibility. Is there any mention of directing funds back to where they are a)needed and b) more likely to be used as needed/intended?
This

The system will be made fairer, so that people who pay for their own care do not have to pay more than state-funded individuals for equivalent care.

from the No 10 summary is either a deliberate misdirection(I would go for lie) from the outset or betrays a lack of understanding about the extent to which self-funders subsidise the public funded, which again comes down to inadequate funding of councils. I would be more than happy for someone to prove me wrong on both counts.
The level of vacancies in adult social care pre-covid was a cause for concern; the departure of EU and other staff post Brexit and the looming no jab no job deadline has simply added to that. A rise in pay might help - but how will that come about if councils are cash-strapped and the investment companies continue to put dividends and executive pay before staff pay?

[Dave2002]

My concern is not so much how the money is raised (I am aware of the various issues about payment v income levels) but what happens to it once raised.

There are enormous issues about the quality of care. Care can either be provided in someone's own home, or in a care home. There are significant issues with both methods of provision.

Providing high quality - or even satisfactory quality of care in a care home - requires well equipped and secure premises, plus 24 hours/day staff. Some of the staff - such as cleaners "only" and maintenance staff have to be good enough, but others do require specialist knowledge. Part of the reason why care homes are expensive is because of the 24 hour coverage, even if some staff are doing fairly low paying jobs, but the additional costs due to some staff needing to have additional professional skills also make these services more expensive.

It's hard to know what goes on inside care homes, though some are undoubtedly not good enough. Those may be the ones which many local authorities would choose for financial reasons - though there's no hard and fast rule. Some local authorities are prepared to pay for very high standards of care, but others do not.

There can be an attitude of "these people are old and demented, they won't notice" etc. and there are enough reported cases of abuse in care homes to indicate that problems can arise. On the other hand some are indeed excellent, but without continuous vigilance by those who care about their relatives it can be hard to be sure. Family members are also not always too helpful either - some might have an attitude that "he or she won't notice - and it'll cost more to pay for a 'better' home" - thinking that "their" inheritance might be reduced or wiped out if someone goes in to an expensive care home.

[Cockney Sparrow]

Apologies I cannot join the conversation at present (sunny day, busy…busy)

Just to say I felt I’ve hardly seen a better or more successful edition of Newsnight (BBC2 TV) last night – dealing with the tax rise and NHS/eventual Social Care funding announcements today. (Minimal contribution - time, etc- from statutory government MP (I see PPS to Coffey SOS Work and Pensions; ERG member) showing he can handle Kirsty Wark and would make a good minister (wouldn't he - surely?).

https://www.bbc.co.uk/iplayer/episode/m000zhzt/newsnight-07092021

Great analysis – the regressive effect and sheltering of housing assets – higher the property value, much higher %age of shelter from care costs. Also other aspects of the policy, questions to be answered (or eventually, found out) and the political context.

Assoc Editor of the Telegraph wielding a verbal stilleto knife at the proposals (cf their front page today, shown on Newsnight – and there's Johnson thinking his old, generous (£££) employer might have been his friend). Also given the tax rise and policy is so regressive (later conveyed so clearly in the programme) Nick Watt reported that red wall MPs were in a state of crisis, regarded as likely unwhippable and possible flight risks (resign seat, defect to other party - ??hmm, maybe…..) Watt reports one such described it as their worst day in politics and having been in tears). Whats the old adage… if you can't comfort the afflicted………..

Also, this morning on Woman’s hour - the first part of the programme a very informative interview with Camilla Cavendish. (I largely switch off these days, glad, on this occasion it was on). Emma Barnett had dropped her sub-shock jock mode and Camilla talked a lot of common sense, informatively describing the principal shortcomings of care - and explained how politically difficult it had been (she worked on policy for Cameron). Proved by the issue being a good part of May’s loss of majority.
https://www.bbc.co.uk/programmes/m000zdtk (Availability on iPlayer, oops - Sounds may be delayed - I think (not listening, really) that another segment of the programme, not on these issues, might be in process of checking/ sanctioning for release as it seemed to be in trenchant terms....)

Cavendish has written a book, written reports for Cameron (and Johnson) and visited the systems in Germany, France and Netherlands and amongst many points said that 15 minute segments for care in the home is just not good enough so Social Care needs to be about decent outcomes for care staff to deliver and clients receive - and not just Treasury accountants looking at returns on each extra £ of funding (no doubt in terms of extra costs/hospitalisation/mortality rates per extra £ spent).

I keep coming back to a thought that a social insurance system such as in France, Germany, New Zealand etc would likely deliver much better outcomes for Health and Social Care than the NHS under government/Treasury control and the consequent bureaucracy that such control requires or allows…… However, we haven’t even had a national conversation before these latest changed which are just handed down, and likely being written out in greater detail over the coming weeks. Consequently, any fundamental change to the basis of funding and delivery, even if it was to be addressed, would end up being deferred for decades…. Meanwhile thousands are waiting for treatment and care, and care staff are being taken advantage of by poor wages and unreasonable, deeply unsatisfying and harmful work demands.

In 2004 I was the recipient of care in the home for about 4 months. I was lucky to have an experienced carer but on her non-working days of course others came. They were all “on the run”, described how they were paid minimum wage, not for travelling time and nonetheless wanted to do their best for their clients but felt there was so little time to meet their social and care needs. I speculate I wouldn’t be eligible for care now, but if I was there would be some anxiety (though I had neighbours and family coming back from work in an emergency). There are currently instances of care companies finding they have no staff for that evening’s most essential care delivery and social services having to trigger an emergency response. How can a system in that position go forward while it waits 3 years for the extra (unknown amount) of funding? (No doubt the answer from the Employment Secretary would be – “go recruit British workers – all those coming off Furlough any day………”)

[oddoneout]

The so-called plan announced yesterday isn't a plan when it comes to Social Care and the continued lack of a functional link between health services and care services means that pre- covid/brexit existing problems will simply be perpetuated, but with knobs on due to the various effects of those two events.
Talk about removing cross-subsidy of self-funded/publicly funded care home places without adequate funding to enable the council payments to rise the several hundred pounds a week necessary is just that - talk.
My neighbour's mother broke her hip recently and spent 3 weeks in the general hospital(she has several other health issues which hindered her recovery) and has now been spending time in the town hospital which does rehab for such cases. She has been signed off as ready to go home - with a care package in place - but the care package cannot be delivered as no staff - and her daughter cannot deliver what is needed and has no agency to simply remove her mother. So an elderly lady who wants to get back home can't, blocks a bed which means that back in the general hospital there are further bed blockers waiting for her rehab bed to come free, thus preventing operations being carried out as there aren't any beds on the ward...
Putting extra money into the NHS to try and tackle the covid-caused backlog will only go so far if the care isn't available for those who need it(and it won't all be elderly etc) post-operatively. I can't help thinking that solving at least some of the care (and support) issues should take priority since it would prevent many hospital admissions in the first place, prevent the boomeranging of those discharged without adequate/any care in place who then come back as emergency admissions shortly after discharge, and reduce the number of beds blocked by those who no longer need to be, and should not be, in hospital. I know that some hospitals set up network arrangements to bring services together to try and resolve such problems, with some success I believe, but it is a patchwork set-up and potluck if you are in an area that does so.

[Serial_Apologist]

The so-called plan announced yesterday isn't a plan when it comes to Social Care and the continued lack of a functional link between health services and care services means that pre- covid/brexit existing problems will simply be perpetuated, but with knobs on due to the various effects of those two events.
Talk about removing cross-subsidy of self-funded/publicly funded care home places without adequate funding to enable the council payments to rise the several hundred pounds a week necessary is just that - talk.
My neighbour's mother broke her hip recently and spent 3 weeks in the general hospital(she has several other health issues which hindered her recovery) and has now been spending time in the town hospital which does rehab for such cases. She has been signed off as ready to go home - with a care package in place - but the care package cannot be delivered as no staff - and her daughter cannot deliver what is needed and has no agency to simply remove her mother. So an elderly lady who wants to get back home can't, blocks a bed which means that back in the general hospital there are further bed blockers waiting for her rehab bed to come free, thus preventing operations being carried out as there aren't any beds on the ward...
Putting extra money into the NHS to try and tackle the covid-caused backlog will only go so far if the care isn't available for those who need it(and it won't all be elderly etc) post-operatively. I can't help thinking that solving at least some of the care (and support) issues should take priority since it would prevent many hospital admissions in the first place, prevent the boomeranging of those discharged without adequate/any care in place who then come back as emergency admissions shortly after discharge, and reduce the number of beds blocked by those who no longer need to be, and should not be, in hospital. I know that some hospitals set up network arrangements to bring services together to try and resolve such problems, with some success I believe, but it is a patchwork set-up and potluck if you are in an area that does so.

Manchester seems to have had some success with integrating NHS and social care services, from what one was hearing in the fairly recent past. Of this is so, one wonders why any lessons aren't being taken up across the piece.

[oddoneout]

Manchester seems to have had some success with integrating NHS and social care services, from what one was hearing in the fairly recent past. Of this is so, one wonders why any lessons aren't being taken up across the piece.

I suspect it would and could happen more widely elsewhere but such initiatives are often the result of an individual or group coming up with a better way of doing things and then, if they are lucky, getting the chance to put it into practice. Getting over the various bureaucratic and management hurdles and blockages of Trusts and other such admin set-ups, combined with ingrained distrust of interdiscipinary/cross-service working probably kills many attempts. Finance plays a part with different budgets needing to work together, which the increased fragmentation of NHS working renders very difficult.
A small scale example occurred many years ago when I was involved in matters to do with the town's hospital. Two senior nurses running pulmonary care services could see a way of making the existing arrangements more efficient for both the unit and the patients. The initial reaction was "no" which was then modified to "well there's no money". They invested their own money(I think it was about £50) on some basic stationery which ensured that all the relevant details for each patient were kept together and could be taken when doing home visits or clinics away from base. The time saved not having to try to find necessary/essential information when queries arose meant more time to spend with the people who needed them - in management speak improved productivity - and reduced preventable errors and misunderstandings.
This kind of bottom-up improvement using the knowledge of those who actually do the work is still not something that is utilised let alone welcomed by British management as far as I can see, and certainly I see that attitude at work more often than I think is sensible or justified . The model instead is those at the top having ideas which are then imposed on those who are expected to implement them, and whose warnings/ feedback about consequences and difficulties gets ignored. In the health and care fields this approach is more than frustrating, it has impacts on sentient living beings, not abstract balance sheets and output figures.

[teamsaint]

The health secretary has told us that one of the triggers for introducing, or in fact widening the scope of vaccine passports would be a variant that escapes the vaccine.

If anybody can explain the logic in this, please do let us in on the secret .
Because from here it sounds like the most spectacular nonsense.

[oddoneout]

The health secretary has told us that one of the triggers for introducing, or in fact widening the scope of vaccine passports would be a variant that escapes the vaccine.

If anybody can explain the logic in this, please do let us in on the secret .
Because from here it sounds like the most spectacular nonsense.

Logic, you want logic from this crowd? Have you learnt nothing over the past 18 months? I dunno - you'll be wanting a sensible fact-based strategy next.
And spectacular isn't the adjective I would have chosen in this case...
And I must caveat this by saying I haven't read the background, I'm just doing a kneejerk reaction precipitated in no small measure by having woken up far too early with a mind full of irritating things to deal with that have arisen as the result of others not doing the job they are paid for - an activity the current administration have taken to new, and to me frightening, levels.

[Cockney Sparrow]

Not examinung the issue in detail, I'm not sure what benefits it might have, although my first reaction is not to resist because its an infringement of my liberty. Not that I give up rights to privacy without a thought.

Partly I haven't researched it, because there is currently no proposal to introduce it. Even if they did, I can't imagine they would be able to require one for rail or tube/bus in or outside London - think of the chaos of workers (service workers especially) failing to turn up for work. The chaos of enforcing the requirement before or during travel would surely mean it wouldn't be included. (In any case governments prefer to legislate, get the headlines, and under resource enforcement - of pretty much everything. They rely on us being a rule compliant law abiding population.

The other reason is that I have no intention of going to theatres, galleries, shops, concert halls and opera houses until at least January 2022 nor use train, bus or tube services. I wouldn't go to other "mass" events in any case and will also avoid restaurants and pubs indoors. International travel is definitely off. By January, I will have sorted out personal matters, and when the time (risk factors) is right, and we are getting towards effective control/treatment and even an endemich status for Covid, I will be in a place to take my chance on Covid, in the sense that I realise I can't live like a Hermit for ever.

I don't place much faith in "trusting my fellow citizens". In any case I would need re-assurance on the risk management in the music/gallery venues - especially as to ventilation. Any passport could be forged, and we have seen its impractical to inspect them before entry, in all probability.


(I'm making one exception for my choir who have been excellent in minimising risk, and are working out how to achieve it in a local concert venue. And if I am to trust any group, I would trust them. I will accept residual risk, as I accept the risk in food shopping and medical appts).

Whilst cooking last night, there was a Radio4 programme about face recognition technology - the objections to its use. Very civilised discussion, covering the points in question.

https://www.bbc.co.uk/sounds/play/m000rvjt

It was followed by a similar quality programme "The Briefing Room" - on Vaccine passports - but I only heard the first 5 minutes. I must "listen again" :

https://www.bbc.co.uk/sounds/play/m000zmjq.

[french frank]

The other reason is that I have no intention of going to theatres, galleries, shops, concert halls and opera houses until at least January 2021 nor use train, bus or tube services.

More or less my position. I shall have to take a bus (first time) on the 29th, but they are still asking people to wear face coverings at the moment - which as far as I can see, people do.

Watched Tim Spector's latest video this morning. Team will be pleased to hear he was dismissive of vaccine passports, but although he didn't think another lockdown would be necessary, he thought mask-wearing/social distancing &c could be back.

https://www.youtube.com/watch?v=3Jj8Nplg1NI

[teamsaint]

More or less my position. I shall have to take a bus (first time) on the 29th, but they are still asking people to wear face coverings at the moment - which as far as I can see, people do.

Watched Tim Spector's latest video this morning. Team will be pleased to hear he was dismissive of vaccine passports, but although he didn't think another lockdown would be necessary, he thought mask-wearing/social distancing &c could be back.

https://www.youtube.com/watch?v=3Jj8Nplg1NI

I hope people start to feel comfortable being out and about more, over time. Analysing the personal risk is not easy, but I think we can , in all things not just health, sometimes be over cautious. I know I am sometimes.
By the way FF, I have today requested to cancel my licence fee, and cancelled my SKY subs. It will be interesting to see how that goes ,in a number of ways. Already had the first heavy handed response from the BBC.

I’m not too bad on numbers, but I suddenly realised after I made the decision, after reading a particularly slanted BBC news report, that my SKY £35 pm and BBC £12 could pay for a season ticket for the Saints . Or something else expensive like two days of plumbing services.

On reflection, I think the thing I may miss most about footy on TV, which is pretty much all I watch, will be chatting about it, here and with friends and colleagues. But there is the radio, and youtube clips are legal I think.

[french frank]

I’m not too bad on numbers, but I suddenly realised after I made the decision, after reading a particularly slanted BBC news report, that my SKY £35 pm and BBC £12 could pay for a season ticket for the Saints . Or something else expensive like two days of plumbing services.

(I haven't heard a peep out of TV Licensing for years. I think they just check the electoral roll each year, see it's still me living here and save their stamp)