In a CHP exclusive, Dr Sanjeev Kanoria, Founder and Chairman of Advinia Healthcare, calls on the government to take decisive action on long-term social care funding and reform.
Stay at home. Protect the NHS. Save lives. This was the government’s message to the British people throughout the COVID-19 pandemic. And rightly so, had we not listened, there was every possibility that rising infection rates would have overwhelmed hospitals and our heroic health and care workers.
However, as COVID rates fall and restrictions ease, the endemic problems our health services have faced for years are coming to light. Indeed, we must ask, after millions of us have made every effort to protect the NHS, is it still able to look after us?
Hospitals are currently facing a huge backlog. The number of people waiting to start NHS hospital treatment has grown to nearly 5 million, the highest number since records began. Since the start of the pandemic, 50,000 fewer people started cancer treatment than in a ‘normal’ year, sparking fears that many will only be treated when it is too late to save them.
The delays are frightening, but not surprising. These problems existed long before March 2020.
Since the 80s, the UK population has increased by over 10 million. People are living longer and with a growing number of long-term chronic conditions such as diabetes, heart disease and dementia.
However, in the same period, the total number of hospital beds has more than halved. We now sit 25% below the EU average, at around half the capacity of France and a third of that of Germany. For a population of nearly 67 million people, we have a woeful 170,000 beds.
Efforts were made to increase capacity during the pandemic – half a billion pounds has been spent on Nightingale hospitals like the 4,000-bed facility at London’s ExCel centre – but many of these remain unused because there are not enough trained staff to fill them. We have one of the lowest proportions of doctors (2.8) and nurses (7.86) per 1,000 in the OECD.
It is admirable that, in an attempt to address this crisis, the government has committed to spending a further £84 billion on the NHS over the next two years. But once again, it seems as though the cheaper, safer, and more efficient option to invest in older care services is being ignored.
The lengthy waitlists for operations, or bed blocking, is to a great extent from a lack of available care services. In total, 2.7 million hospital bed days are occupied each year by older patients who are medically stable enough to leave but have nowhere to go. The cost of this is estimated to be £820 million annually.
In the decade before the pandemic, while health care budgets went up every year, social care budgets have been savaged with multi-billion-pound cuts. We have only 465,000 care home beds in the UK, 55,000 less than in 2015. To put this in perspective, there are currently 3.2 million people over 80 in the UK, and over 900,000 living with dementia. These numbers are expected to increase dramatically over the next decade.
Recent reports highlight that 6,500 care homes are at risk of closure over the next 5 years, a further 140,000 beds. Already, some of the UK’s largest providers like HC-One are downsizing and offloading assets. None of this is surprising with some local authorities paying less than £100 per day for residents which is totally insufficient to cover staff, food and accommodation costs.
The combination of a rapidly aging population and further closures of care providers could be devastating. With nowhere for older people to be cared for, they will end up stranded in much needed hospital beds, at risk of picking up worse illnesses than they came in with and costing huge amounts of public money. The cost of an older person occupying an NHS bed is around £3,000 per week, about 80% more than in a care home.
Social care reform has been promised for several years now yet was once again ignored in the recent Budget. For the sake of the NHS, older people and those who need to be treated in hospitals, the government must take decisive action to address the crucial issue of funding while looking ahead to finding a longer-term, cross-party solution to adult social care which will not only free up NHS beds and staff but will prevent people going to hospital in the first place.