By Leon A Smith
September 23, 2011
I have read in the news this week that the National Health Service have “reviewed” their £11bn IT project and have decided to scrap it allowing hospitals to choose their own computer systems! It has been decided that there is “no confidence that its plans will be delivered”.
The implication is that a very significant chunk of this spend will have been wasted. Is it me or is this nothing short of an outrageous scandal. How many IT projects has the National Health Service scrapped in its history? How many IT projects have governments/the civil service scrapped in the last decade. When the whole of this capital is added up one just wonders how many hospitals that would have built and for how many years they could have been run. Billions of pounds are wasted by government on abortive schemes. Vast amounts of money have been wasted through the inappropriate use of the PFI funding system which we, the tax payer, will be paying for generations to come. Where is the sense in all of this? And whilst all of this is happening local authorities, as a consequence of government policy, are now being squeezed to the extent that they are endeavouring – and in some cases succeeding – in cutting contractual payments to providers of care for older people
The recently published Dilnot Commission made an extensive range of recommendations regarding funding of the longer term care of older people. There will, however, be significant costs to government if the proposals are to be accepted in full. It is difficult to see at the present time and in view of the current financial pressures that government is faced with, that they are going to be able to implement more than a fraction of the Dilnot recommendations. Yet little responsibility,quality management, and leadership have been shown in the billions of pounds of waste referred to above which could have easily covered the cost of implementing Dilnot in full for a number of years. Ultimately, who suffers? It is vulnerable adults, vulnerable children and other needy sections of society who will not receive what they may reasonably have expected to in terms of care, purely for financial reasons.
Everything is not the government’s fault. And of course society has its own important part to play even if it doesn’t necessarily have the word “big” before it! I have always argued that responsibility for caring for older people in the community must be a tri-partied responsibility shared between government, community and users and their families. The challenge of course is to make sure that the balance falling on these parties is a fair one. Dilnot has recommended the current financial eligibility criteria for care for older people should be lifted from the current £23,250 to £100,000 – ie anybody with under £100,000 in assets is entitled to receive support from local authorities. And of course even at £100,000 an enormous section of the community will still remain ineligible because they own properties whose value is in excess of that figure. Yet nevertheless it is difficult to see that the government will increase this ceiling significantly above the current £23,250. Even a slight increase, however, will bring further people into the net – meaning additional costs for government/local authorities. One wonders where this money is to come from.
As a provider of care here at Nightingale many of our residents are supported by local authorities yet we are being constantly harassed and pressured by these authorities to accept a unilateral reduction in what they are paying us for care. If ever there was an example of the Big Society (albeit I am not totally sure what that means) it must bet the role that the Jewish voluntary sector plays in looking after its older people. But what thanks do we receive from those who govern us – only to punish us by cutting their payments which, in turn, forces us either to cut our services, which we are not prepared to do and/or sadly to ask the community to dig even deeper than it is already doing.
As the Rosh Hashana appeals drop onto your door mat, do please respond generously. No doubt you will receive many appeals – all of them deserving, however there is no greater need than the support of older members of our community in need.
I wish all readers (if any) a Happy & Healthy New Year and well over the Fast.