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Who cares about social care?

When the nation stood at 11am for a minute’s silence to honour all the NHS and care workers who have died in the Covid-19 pandemic, it felt like a tragic but important counterpoint to the Thursday night claps for essential staff on the frontline in this battle.‌

But just an hour and a half earlier, yet more sombre news of the wider death toll emerged in the latest Office for National Statistics. The grim rise in deaths in care homes was shocking, with more than 2,000 in the week ending 17 April, double the previous week. And while many now think the peak for hospital deaths was earlier this month, it seems fatalities in social care settings are still rising.‌

To his credit, Matt Hancock appreciated the need for more transparency and will from Wednesday include care home stats in the daily death figures. But today the most ominous chart at the No.10 press conference was the one showing ‘deaths in all settings’ for the UK, with the line now firmly above France (which includes care homes in its stats).

Hancock and his advisers were repeatedly questioned about the awful new statistics. Shortages of protective equipment for care staff, a lack of testing and the timing of a ban on visits from relatives were all raised. Hancock certainly looked uncomfortable, though at least he had some good news in that testing was at such a high capacity (now 73,400 a day) that he could expand testing to all care home staff and residents with and without symptoms.

That 73,400 figure is actually pretty impressive, given it is higher than South Korea’s and comparable now to Germany’s. I understand that the separate target of 25,000 daily tests in the NHS labs has nearly been reached too. So if he misses his 100,000 target this week, the health secretary will still be content that his personal ‘goal’ has dramatically driven up numbers. (Meanwhile, in Germany there are signs that even a well-tested country can risk a second wave if it eases the lockdown too early).‌

Hancock also stressed today that far from ignoring care homes, he had been alive to the danger in January, when medical advisers pointed to the high risk posed by coronavirus to the elderly.It was something he had been “focused on right from the start”. Yet many critics think the UK took its eye off the ball, through the lack of protective equipment for care homes and the fact that it took until this month to start testing every resident with symptoms.

Testing chief John Newton also had some intriguing information suggesting that the asymptomatic spread of the disease in care homes had been surprising. Intensive studies had shown now “there were significant numbers of residents who were asymptomatic who had the virus”. New tests for everyone mean that better ‘infection control’ can now be implemented (sorting the riskier cases from the others). But when Newton said we’ve “massively” increased the amount of testing available to 25,000 care home residents and staff, that’s still a small proportion given the 400,000 old people living in care in England.

Once again, the lack of early and widespread test capacity is likely to feature in any public inquiry. But the bigger problem was one alluded to by both Hancock and Newton: the complexity and extra pressures of dealing with a sector that is made up of thousands of individual centres, many privately run.

Under both Labour and Tory governments, many councils have been forced over the years to close old people’s homes and hand responsibility for provision to the private sector. This was made worse when social care budgets were slashed by £7.7bn since 2010. The Tories seemed so badly burned by Theresa May’s ‘dementia tax’ policy in 2017 that the party steered clear of any further proposals.

One positive move was turning the Department of Health into the Department of Health and Social Care in January 2018. But a change of name couldn’t change the structural problems of a fragmented, chronically underfunded, underpaid, undervalued and understaffed (by at least 100,000 workers) system.

It took the Tory leadership campaign last summer for Jeremy Hunt to utter this telling line: “I think, having been responsible for health and social care, that some of the cuts in social care did go too far.” Despite rising demand, spending on adult social care actually fell by about 10% between 2010 and 2013.‌

Hancock knows he needs to do more than sport a ‘CARE’ badge to fix the social care crisis that is now being all too savagely exposed by the coronavirus crisis. There are around 140,000 beds in the NHS, but 411,000 people living in care homes. A cross-party consensus is needed on a national care service with more long-term funding, respect and political attention.

That would be a fitting legacy for those older people due to lose their lives in coming weeks, and give a new meaning to Hancock’s tribute to “the nation’s fallen heroes”.

Quote Of The Day

“The thing is, I think that’s unreasonable as a question, actually.”

Matt Hancock, asked to apologise for rising care home deaths

Tuesday Cheat Sheet

Nearly a quarter of coronavirus deaths in England and Wales were in care homes, with more than 4,300 deaths recorded in a fortnight, the Office for National Statistics revealed.

Matt Hancock said he hopes to have in place the staff and technology to run a contact tracing operation to slow the spread of coronavirus by the “middle of May”. With any lockdown easing dependent on such a plan, it’s the first clue to a date for a shift in policy.

Hancock unveiled a major expansion of free coronavirus tests. They will cover not just all residents and staff in care homes and NHS hospitals without symptoms, but also all people over 65 with symptoms, or people who need to travel for work and have symptoms.

Downing Street refused to confirm whether Boris Johnson would be facing Keir Starmer at PMQs on Wednesday.

The Scottish government recommended people cover their faces while in some enclosed public spaces, such as shops and public transport. But Prof Angela McLean, the government’s deputy chief scientific advisor, said there is “weak” evidence of a “small” beneficial effect from face coverings.‌

British Airways is set to make up to 12,000 workers redundant as it is expected to take “several years” for the airline industry to recover from the coronavirus pandemic.‌

Theresa May urged ministers to consider rising domestic abuse and mental health, as well as the economy, when deciding how quickly to lift restrictions. “We cannot have a situation where the cure for the disease does more damage than the disease itself,” she said.

Ministers have asked the chancellor for £70m to help domestic abuse victims during the coronavirus crisis, HuffPost UK can reveal.

What I’m Reading

Boris Johnson And The Optimism Delusion – Atlantic

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