Goodbye Southern Cross, Hello Open Public Services


So Southern Cross – the largest private care home provider in the UK will be closed.

What of the 31,000 residents who live in their properties? Well, the government has given us its assurance that they will be ok so that’s alright then.

Or not.

Goodbye, Hello

m kasahara @ flickr

On the day that the Open Public Services White Paper was published  (which can be found here – pdf) – which couched in the comfort of positive words like ‘choice’ , we would do well to heed the warnings of the way in which social care was sold off in chunks, from public to private and reflect on whether it is better to allow care homes to ‘fail’ in order to prove that the strongest will rise to the ‘top’.

The problem is that Southern Cross WAS the strongest. It did rise. It also speculated on property and ownership transferred away from the core business base of providing care and homes for those who needed both.

But on a more pressing issue, what will happen to those who live in Southern Cross homes and work for Southern Cross homes.

As the Independent says

Analysis by the GMB union revealed the names of 80 landlords who own 615 of the homes, many of which are subsidiaries of larger companies registered overseas. This makes it much harder to obtain financial information about the companies as rules governing accountability and transparency, especially in “tax havens” such as Jersey, Cayman Islands and British Virgin Islands are significantly more lax.

In addition, the GMB was unable to trace more than 120 landlords, which mean thousands of people are living in care homes where the identities of the owners and directors are unknown.

In the absence of full company accounts and other relevant information, such as the names of directors, it is “nigh on impossible” to assess whether they are suitable to run care homes funded in large part by public money, according to Andrew Craven, GMB statistician and researcher

At least the ‘Department of Health’ spokesman says

“Whatever the outcome, no one will find themselves homeless or without care. We will not let that happen. Today’s announcement does not change the position of residents. The Care Quality Commission will continue to monitor the services provided… We have been in constant contact over the course of discussions and remain ready to talk to all parties.”

That’s reassuring. Or not. Would that spokesman or anyone in the Department of Health want that level of uncertainty lying over their head or the heads of one of their parents? The residents of the homes will not know who their landlords are or whether they are fit to run care homes at all. Of course no-one will find themselves homeless – it will be the local authorities, the elected local authorities who will have to spend and fret themselves out of this one – nothing to do with the Department of Health’s reassurances – unless the Department of Health is going to compensate those local authorities for the time and cost they spend to ensure the welfare of residents of Southern Cross homes that may close.

As for the CQC, I think we have established that it is unfit for purpose and unable to regulate a care industry that has grown too large and too costly to be regulated efficiently. How about an idea? The Department of Health invests very heavily directly in the CQC so that they can provide at least twice-yearly, unannounced inspections together with a host of lay visitors attached to every single residential and nursing home?

No, the Department of Health is weedling out of this crisis as it will weedle out of the cost of ensuring that the residents of Southern Cross Care Homes are not made homeless.

Now, I want to link some of these issues to the Public Service White Paper that was published yesterday and particularly one or two sentences I picked out.

Firstly

In the context of rolling out more extensive ‘choice’ in other areas of government, the paper says

‘We will ensure that individual service providers are licensed or registered by the relevant regulator for each sector (e.g. the Care Quality Commission) so that those choosing services can known that providers are reliable, without stifling cost”

Does that not lead to a tiny little shiver down ones spine? The CQC is being held up as a reason to trust in this extension of ‘choice’.  Has noone mentioned the cost of good quality regulation, either.  It’s worth reading this post at The Small Places for more consideration of the way the CQC regulates social care services. The CQC has failed to regulate and the care sector is failing to deliver on personalisation so far. The care sector has had time to learn as well. We had direct payments for many years and before that the ILF (Independent Living Fund) which allowed payments to be made directly to adults with disabilities to choose care. The system should be sophisticated enough by now to deliver good quality, equitable services but it has taken many years even to reach this point. There’s a long long way to go.

Secondly

“The wider public sector has much to learn from local authority successes in commissioning, for example, in adult social care”.

See, look at us, government, we’re a success! Success. This is the end-result of success. Adult care commissioning is not a success. It has not extended choice unless of course (and I think I’ve found the key) success is based on the principle of privatisation and provision of contracts to the those who deliver at the lowest cost regardless of quality. That is the adult social care ‘success’ that the government is lauding in the Open Public Services White Paper.

We are dazzled by words such as ‘choice’ and ‘open government’  but they have no meaning outside ‘lowest cost’ and ‘discharge of responsibility’.

Think of Southern Cross. Think of Adult Social Care. It’s coming to our homes, our hospitals, our high schools and our highways.

So much for my week of positivity!

6 thoughts on “Goodbye Southern Cross, Hello Open Public Services

  1. It is interesting to read your story about these changes in nurshing home care and social care in the UK. Currently, in the U.S there is some debate being generated around the public and private sector especially when it comes to human service delivery. One of the things that comes to mind throughout this debate in social welfare is what is a sustainable(economically and socially) framework for governments, nonprofits, and private companies to act within the social sector?

    Obviously, with the comments you have made we have discongruency around the world in terms of how we make ends meet and provide superb care. I would love to hear your thoughts.

    • I feel uncomfortable with the idea of health and social care being in the profit-making sector pretty much conclusively. I don’t think shareholder profit can be equated with good quality care as when choices come regarding budgets and profits, the companies will seek to line their own pockets. Maybe non-profit, social enterprise type organisations are the key. The problem is that the government is constantly after the ‘lowest cost’ solution and companies bend over backwards to try and deliver for the large contracts at the expense of good quality care. I think there are genuinely discussions regarding whether good care needs to cost more and I don’t think it necessarily does but the companies that enter the market have to have an ethical base and the problem with capitalism is that it doesn’t insure sufficiently against the amorality of money.

  2. I agree, it’s all profoundly depressing that the mixed provision model which has so badly failed in social care, some 20 years after its implementation, is being rolled out across the welfare state.

  3. Took my first phone call from a relative about Southern Cross today. I gave some fairly bland reassurances as we have literally no idea what’s happening but guess that the homes in this area are fairly big and fairly full so may well be going concerns. I think we’ve identified the landlords in some of the homes as other care home groups. On the other hand, someone may arbitrarily decide that the concentration of homes in this locality may need to be thinned out for sound commercial reasons.

    I’m surprised how sure WAG and DoH are so sure that there will be no significant disruption in view of the fact the best they’ve been able to offer is some press releases. The WAG release helpfully listed the bits of legislation that made wading in to save things local authority and quango responsibilities (ie. not their responsibility). Amazing how the politicians appear so completely confident that despised, inefficient public services will be able to pick up the bits from this striking example of market failure, and are apparently so confident they don’t need to check with us.

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