Speaking during a visit to Goole in Yorkshire, Prime Minister Boris Johnson said his government discovered that “too many care homes didn’t really follow the procedures in the way they could have” during the Covid-19 pandemic.
Naturally, Johnson’s comments sparked outrage amongst sector leaders and those on the frontline, with Nadra Ahmed, the chairwoman of the National Care Association, saying Johnson’s remarks were “a huge insult” while others highlighted how ‘out of touch’ he was of the realities of working in social care. For the most part, we saw the sector yet again needing to defend itself from an unfair attack, whilst highlighting the slow response of the government and the deficiencies in some of the guidance that was issued.
Critics have argued that the Prime Minister’s recent remarks are a sure sign of the government making early preparations of shifting blame elsewhere for their failures in tackling the outbreak, particularly as any future public inquiry will investigate how the UK came to have one of the highest coronavirus death toll in Europe, with the proportion of care home deaths 13 times higher than in Germany.
With confidence in care homes already dwindling, as recent PLMR research revealed, his comments may be more damaging than he realises.
Expectedly, the sector has been calling on Johnson to retract his comments, which they call a “slap in the face” to care workers who have sacrificed a lot to care for some of society’s most vulnerable people.
But the best the sector got was the Prime Minister offering up his spokesperson to try and change what he said – a lot of “what he meant was…” and “he was pointing out…” was used.
For the spokesperson then to reiterate six times in one lobby briefing with journalists that the PM “thinks that throughout the pandemic care homes have done a brilliant job under very difficult circumstances” is difficult to accept.
When questioned as to why Johnson didn’t just say that if that was what he meant, his spokesperson simply replied, “I have nothing more to add,” suggesting that Johnson and his team stand by those comments.
The bigger picture
Indeed, taking the line of the blame game, and so confidently, is an interesting approach, given the mountain of evidence showing that central government complacently allowed for circumstances which meant that the virus could spread more easily in communities, and ergo into care homes.
No.10’s excuse, however, is that they “put in place a comprehensive action plan to protect care homes, including rigorous testing, and additional funding.”
But critics will be quick to highlight Public Health England’s infamous comments in February 2020, when they said it was “very unlikely that people receiving care in a care home or the community will become infected”. This was despite international evidence already highlighting that elderly people with existing health conditions (i.e. those who make up a large portion of the adult social care population) were amongst those most at risk of catching the virus, and dying from it. As the situation developed elsewhere in Europe, the UK only had to look as far as Spain and Italy to see where the impact of the virus would be truly felt.
Routine testing was long regarded as one the most effective ways to prevent the spread of the virus into care homes. In March, the World Health Organisation stressed that countries must “test, test, test”. But routine testing in care homes for people aged over 65 only began this week.
Further, No.10’s comments neglect to mention that their “comprehensive action plan” was published on April 15 – two months after the first case was documented in the UK, 98,476 people had tested positive and more than 12,868 people had died. By this point, many care homes across the country had already suffered the wrath of the virus, and its long-term psychological impact on the frontline.
Indeed, some of the homes PLMR works with had already experienced a severe outbreak and recovered before this action plan was released, and an analysis of official figures revealed that the UK recorded the highest number of deaths on 8 April. For many, the guidance was too little, too late.
It wasn’t until June 7 – two months after the plan was originally published – when the government announced a Covid-19 Care Home Taskforce to oversee the implementation of the social care action plan and care home support package ‘to help end transmission in the community and advise on a plan to support the sector through the next year’.
Blow after blow
Critics will see this as another blow to a sector that has long been left behind. The evidence that the NHS was a priority during the pandemic, to the detriment of social care, is overwhelming.
Johnson’s comments tap into the clear lack of general understanding of the outbreak and the dangers of trying to sum up complex topics into meaningless soundbites.
“Clumsy and cowardly” is how Mark Adams, chief executive of charity Community Integrated Care, described the PM’s comments. With 31% of people now less likely to seek residential care for an elderly relative than before Covid-19, Johnson’s comments will do little to help positively change people’s views on the state of the sector.
Time for meaningful reform
In his maiden speech last year, Boris Johnson said his government will “fix social care once and for all” but his government’s actions throughout the pandemic saw him prioritise the NHS time and again. The cost, critics say, is almost 20,000 care home residents in England and Wales dying with coronavirus.
But will his blame game backfire? While sector leaders and some politicians are up in arms over his comments, ultimately his remarks may resonate with the families affected by the spread of the virus in care homes. Indeed, many have already blamed care providers publicly, be it on social or traditional media. Add this to the general lack of understanding around testing and the asymptomatic spread of the virus, and trust in the sector is damaged.
Those working in social care will be the first to take some degree of responsibility for the crisis, as many will have to live with the fact that the people they cared for tragically died despite their best efforts. The psychological burden will stay with them long after the virus is gone. But the government too must take accountability for its failure to support social care.
Critics agreed with the PM’s comments that reform is much needed, but Johnson must work with providers – and not against them – to facilitate a social care plan that works for all. Reform has too often been couched in terms of preventing well off older voters from needing to sell their house to pay for care. Politicians rarely consider the need to invest in upgrading the care home estate to more modern homes; investing in the pay and conditions of the million strong workforce; and ensuring that training and development is high quality and spans both the health and care ecosystems. This all requires significant investment above and beyond today’s levels before you even factor in changing the means testing threshold or accounting for a rapidly aging population.
The sector has been waiting a long time for reform, with a social care green paper promised in 2017. One may ask whether things would have been different if this government, or its predecessors, had made meaningful changes to the sector and not empty promises of ‘we’ll do it one day’.
It should not have to take a pandemic and tens of thousands of lives lost for social care reform to become a pressing priority, but these deaths should not be in vain. The government must work with providers to build a social care system that is fair for care givers and care recipients, transparent and accountable, and funded to a level that enables investment in improving the environment and technology available.
The days of courageous carers being underpaid and undervalued must end. The Prime Minister has the power to do it.