Thursday, 1 September 2016

Special Pleading

I thought this piece of nauseating special pleading from the private sector in the Guardian was interesting and ably demonstrates what happens if they're not able to make a big enough profit. It's happened in the NHS, could it be where we are heading?  

Why my company is handing homecare contracts back to councils

In the last few months, my company – Mears – has taken agonising decisions to hand back a number of homecare contracts to local authorities, especially in the north of England.As painful as this has been for the people we have been providing care for – and for our care workers – we hope others will follow our lead and help to end commissioning practices that should have no place in 21st-century Britain.

Exiting contracts in this way is always the last resort and follows many months of trying to develop a different solution with a commissioner. But, ultimately, it may be the only means to drive the essential change in services that are life-critical to our most vulnerable citizens. We are not happy with the disruption this creates, but we feel that we have to take a stand to lead positive change in the absence of leadership from elsewhere.

The contracts we have exited are those where simple mathematics shows that the charge rate a council wants to pay will result in a provider either not meeting the requirements of the “national living wage” for care staff, or not delivering the service needed by the user.

In the homecare world, generally, councils only pay for “contact time” – the time a care worker spends with a service user. They don’t pay for the time it takes the worker to get to the property or move on to the next. They don’t pay for any of the time the worker must spend on training, or for the worker’s “on-costs” to ensure they are looked after if they fall sick. Nor do they help pay into their pensions. In recent years, councils have also shortened call lengths in order to cut costs, and many people have lost a service altogether.

The “national living wage” is, of course, the bare minimum we need to pay – and rightly so. Being a care worker is an increasingly skilled job, requiring staff who can provide highly intimate personal care as well as support with medication. It is not for the faint-hearted and requires talent, dedication and strength. It is no surprise then that there is a national shortage of care staff. In the last 12 months alone, a lack of homecare capacity in the community has caused delayed discharges from hospitals to increase by 40%.

At a time when the NHS is creaking at the seams, there is an inherent short-sightedness in a system that focuses on cutting support for individuals, reducing call lengths and keeping charge rates for providers below sustainable levels.

Unfortunately, many care providers still choose to accept very low charge rates from councils. This could be due to a lack of understanding of the minimum wage law, but is often simply caused by local businesses feeling they have no choice but to accept the terms offered, or risk going under. These businesses are often small and rely on a single contract just to exist.

I have huge sympathy for councils on this issue, especially as many have been forced to cut other services to protect social care budgets. However, there is no excuse for setting charge rates that will almost certainly lead to breaches of the minimum wage or poor service. The last few governments have talked about reconsidering how we, as a society, fund social care – but nothing material has happened. Ultimately, this means we are failing to examine how we want to look after older and vulnerable people who need our support. All demographics point to an increasingly elderly population over the next 10 to 20 years, many of whom will be living with multiple long-term conditions. Surely it is a measure of a good society that we provide proper care for those people, at a time when they need it most?

If we had given even 1% of the time spent discussing Brexit on trying to reach a solution to the social care crisis, we might have one by now.

Real integration of health and social care is important, but it is a long way off in most parts of the UK. In those places where it has been achieved, it is not all plain sailing. Our first priority should be ensuring that the care system is sustainable.

We must move away from a system that pays the provider for the minutes spent with a service user, to one that rewards quality and the impact on that person’s life. Having due regard for those we rely on to carry out that work is just as essential; care staff should command the same respect as doctors and nurses, and a career in care should be rewarded appropriately.

There are councils, such as Torbay and Wiltshire, that are moving to fundamentally different ways of working that are positive and take these factors into account. At Mears, we are doing everything we can to support positive changes to working practices, better conditions for the workforce and greater focus on the service user. At times, however, we feel like a lone voice.

It has been said that to care for those who once cared for us is not just a responsibility but an honour. Now is the chance for society to prove that.

Alan Long is executive director of Mears Group PLC


The first two comments:-

We also need to consider the specific circumstances of the organisation i.e. validate their contention rather than simply accepting it as fact. A quick check via Companies House beta service indicates Mears Limited agreed £20m in dividends which was in excess of the profit they made for the FYE 31/12/15.

To what extent should we expect social care operators to cut their cloth according to market conditions? Would they have paid £7.20 if it wasn't mandatory? Is it unreasonable for us to expect them to display social responsibility i.e. dip into their reserves whilst LA's are experiencing unprecedented financial pressures.

I worked many years ago in care management roles, when most of our domiliciary support was an inhouse homecare service. The business game, the discredited business models with microcommissioning, any qualified Provider imposed by the Department of Health were starting to fragment services, frequently taken away clinical judgement from Social Workers and Occupational therapists.

Under the unnecessary Town hall austerity cuts of George Osborne and the failure to ring fence, protect and fully integrate Social Care budgets with Health care, our nation has been largely indifferent to the crushing blows to the frontline carers in domiciliary support and care homes. I hope history will judge the perpetrators harshly. Cuts of 30-40-50 % to town hall, as well as robbing of the very vulnerable members of our communities of vital support, as support centres, community projects, shopping services close, the race to the bottom, to get it all at the cheapest possible price has brought in horrendous work practices. 

The Local Government Association has warned, the ADSS has warned. UNISON put together the ethical care charter, with little interest, sadly not even strong Labour Councils like Liverpool sniffed at it. Here Councillors know all to well the consequences of failing to pass a balanced budget.

I plead with all influential people and politicians of all persuasions, to do the sums, to integrate health and social care, to look at the basis of the Ethical Care charter and build it into all social care employment contracts, to ensure a transparency by all providers in their pay conditions, travel. Local Authority commissioners, desperate to stretch out what money they have, brutally treated domiciliary care agencies and care homes, who in turn have been forced either to walk away from contracts or impose shameful working conditiions. It is in the public record that HMRC named and shamed a Crossroads service in the East Midlands, a non for profit charity group with a long history of public service, with not even paying the minimum wage to its front line staff.

Please all politicians left, right or Centre, can we look again at the Ethical Care Charter developed by UNISON. We as a nation owe it to frontline careworkers, which will give stability in recruitment and retention, less of a turnover of staff, retaining well trained, motivated staff, which will greatly assist the tens of thousands of people who rely on that support and care hour by hour, day by day.


  1. It's over. The blog needs to be closed down. The blog has been a useful anger outlet for some of you but it's now time to move on. If anyone can name one big win we've had as a result of the blog il conceded I'm wrong

    1. 09:14
      Why don't you just go and buy a lollypop.

    2. I agree. The blog should be axed. We can't influence anything through this.jim can I take over from you? I've a few ideas on marketing the blog

    3. I don't understand why you're having a go at Jim. Has he ever said the blog could change things? Go and start your blogs by all means I'm sure Jim wont lose sleep over it. Carry on Jim.

    4. Astonishing comments. When did the writing of a blog become the means of securing change when trade unions, professional organisations, political parties and media pressure fail to do so. The blog is what it is. Read it and comment or ignore it as you see fit but I think your expectations of the power or purpose of the written word need revising.

    5. There not having a pop at Jim their raising the points of how this blog influences nothing. The napo chair debacle was the last straw For me. It's not Jim. It's the blog. I agree a new marketing strategy is needed. This blog has lost more battles than napo. Ian and Dean are victorious. Chivalry road is rocking. The TR TRAIN is at full steam ahead. E3 is rolled out.Where still heat moaning about things.

    6. Let's have a vote. Poll closes at midnight tonight. The options are to close down or keep the blog.

      I vote keep the blog

    7. Axe the blog

    8. We vote close the blog down

    9. Close it down please

    10. to 9 14 and 10 03 etc- for god's sake you lot (or are you just one bitter reader?)just bog off. You are boring. The blog has never been a business, but a support system for staff who are angry, confused, frightened, exhausted, feel alone; a lifeline and a public service for those need to give vent, not a private slickly marketed business.

      Start your own blog 'business' if you must, and stop reading this one. No one is making you read it, and no one is stopping you from moving on, but I think I know which one most people will continue to turn to.

    11. The sins of this blog may run deeper than the travails of Napo and TR. Rumours persist that JB was on the grassy knoll in Dealey Plaza, that he's hiding Shergar, and why, oh why, did JB fail to save Cock Robin.

    12. Ml amongst all you jibber jabbering I take it you want the blog to continue. The blog does need modernisation. Jim needs to groom a successor. We need a market strategy so hits cab hit 10k a day. If we achieve this we can draw on advertising monies. This will then give us true influence

    13. Voted end the blog. It's had its day

    14. 'The only thing worse than being talked about is not being talked about'- Wilde

    15. There are only two reasons I can think of for anyone spending so much time and energy trying to stop comment and destroy this blog.
      1. They have a vested interest, and don't want information or opinion found on here to be presented in the public domain.
      2. They're not intelligent enough to understand the value this forum holds for other people.
      With the continuous (haven't anything to say) postings, I'm of the opinion it's the second reason.
      Maybe you should do as advised earlier and get yourself a lollypop, and perhaps a copy of the Beno, and read something more suited to your abilities.
      And as for the blog having no influence? It's certainly got influence on you, and enough influence on you to continually log on and embarrass yourself by making really idiotic comments.

    16. Still being influenced to log on and comment I see?

    17. 4 hours to go til the poll closses Ending the blog is winning by too

    18. Just like the EU Referendum, any poll is indicative only and the management reserve the right to ignore any result.

    19. Management or dictator? You need to share the power Jim. Let me have a stake in the blog and I will take it to the next level. I will bring a halt to TR. I will stop E3 from happening. I will reform napo.

    20. No thanks. Go away, you are clearly deluded and if necessary I'll re-introduce comment moderation.

  2. I find the Guardian article pretty sickening. To me it reads, "give us more money, and we'll carry on delivering services in the same inadequate way they're delivered now. There's just not enough profit in the deal we have now to make it worth our while".
    But it's not just those that are the recipients of private sector social care that suffers. It's those that are charged with delivering it at the coal face that suffer too.
    A quote from a participant of the long running 7up series once said, that the real damage to an individuals life comes from not being able to achieve the things that individual is capable of. He wasn't talking about fulfilling your maximum potential, but just doing the things that you know you are capable of.
    For many that now find themselves in a world of employment dictated by maximisation of profit, the deflating and damaging feeling of not being able to carry out your daily work in a way or to a standard that allows you to achieve your own capability, must have a considerable inpact the life of that individual.
    There's areas of society that the private sector just don't belong, not just because the quality of service they deliver is piss poor, but because of the damage caused to the individuals employed to deliver those services.


    1. Good point. Every carpenter wants to make bespoke furniture, every artist to produce masterpieces etc. Nobody WANTS to do a half arsed job in any area of work. The contracts above, and the new contracts to which Probation staff are working, are all the professional equivalent of flat-pack furniture and, increasingly, there are parts missing so you can never achieve a satisfactory outcome even when the aspirations are low. I left Probation because I no longer wanted to maintain an illusion for the benefit of Sodemall's shareholders. I think many feel the same way. AS a result, recruitment and retention remains a problem in all of these areas of work. People don't want to get up every day to go to work at a job that disappoints service users and practitioners alike. They want their 40 hours a week to MATTER.

  3. When public sector staff strike – the tabloid outrage at the planned doctors' strike, the latest example – they are condemned for putting the taxpayer, patients, etc, at best to inconvenience and at worst to risks of various types.

    Here is Mears whose profits in the first six months of 2014/5 were £18.7m, an increase of 11%, complaining about being exploited by councils who are simply insisting that care providers pay the minimum wage and travel time. These are also HMRC requirements.

    Mears want more money despite signing up to a contract in the first place. It's their fault if they didn't do due diligence and risk assessments. Now because they can't squeeze money out of some councils, they will simply abandon the contracts. Seems it's too easy for them to walk away, unlike the MoJ with CRCs and the infamous 10-year penalty clauses. It's as the saying goes, they want to privatise all their profits and socialise all their risks.

    1. Yesterday amongst much media coverage about the declining numbers of prison officers, it was hinted at that despite being unlawful, prison officers may have to take the bullet, and go on strike anyway.
      It will be interesting to see if they do. But whether it's state delivered public services, or those being delivered by private enterprise, nobody can be in any doubt that they're all in a mess.

  4. Is Chris Grayling saying here that privatisation is good, except when he has to use privatised services????

    1. My new team will help solve the problems on Southern rail

      It has been a really difficult few months if you are a passenger on Southern railways. I am a daily commuter and know what pain this disruption will have caused. When I became Transport Secretary six weeks ago I made the Southern issue my priority.

      It’s true that its routes are being disrupted by totally unnecessary strikes and unofficial action by unions who are opposed to the continued modernisation of the railways and desperately cling to 1970s working practices.

      That is mainly why journeys have been disrupted for months. Train guards have been calling in sick in unprecedented numbers and at short notice as part of what is clearly an organised attempt to disrupt services — and that’s on the days without strikes. Southern’s parent company GTR and the unions need to reach an agreement soon so its passengers can travel on time.

      But this is also a railway that needs improving and upgrading and we have started that long-term project already. The opening of much of the newly rebuilt London Bridge station this week is one example — turning a cramped and congested station into a terminus fit for this century.

      This investment will help but it won’t solve today’s problems. The Brighton main line is operating at capacity, carrying twice as many passengers and far more trains than 20 years ago. Even a small problem can cause massive disruption.

      I have concluded urgent changes are needed. Currently, GTR runs the trains and Network Rail manages the tracks and signals. The tendency is for those involved to blame each other for problems and not to work together. That must change. I want the Southern network to be run by an integrated team of people working together to ensure passengers get decent journeys and problems are solved quickly. So I am establishing a Project Board, headed by a vastly experienced rail executive, to urgently plan how to create this team.

      This is not about corporate reorganisation or change of ownership. That would waste time better spent improving the railway. It’s about a joined-up approach to running the trains and the tracks and making things work better. I want this plan in place by the early autumn.

      But we will also target those daily minor problems that cause delays. A £20 million programme will help replace equipment likely to fail and renew the most problematic stretches of track. It will double the number of rapid-response teams to solve problems and increase staff on the busiest platforms to get passengers and trains away on time.

      In autumn older trains will be phased out with new 12-coach trains on the Brighton main line, while newer trains will replace the oldest stock elsewhere.

      I can’t promise to solve the problems overnight but by creating a new joined- up team, phasing out old trains and stepping up work on the things most likely to go wrong, we can get this railway into better shape.

      But we won’t get the service back to normal until the unions put the passengers first. Like every train built in Europe today our newest trains are managed by CCTV from the driver’s cab. We cannot avoid using state-of-the-art train systems just because the unions object. No guard is losing their job or having their pay cut. There is no reason to strike. I want to reshape this railway so it puts passengers first. So should they.

      Chris Grayling

    2. I find it ironic that having created so many train crashes in his time as a government minister, he's now literally been given his own train to play with!!!

      Just have to wait and see how long before he derails this one.


  5. Has there ever been a successful privatisation of a public service in terms of achieving better outcome for the service user? Privatisation equates to crap service, low wage low morale workforce, fat salaries for top cats, and unearned income for shareholders. Before being elected Cameron favourite slogan was 'broken Britain'... no Britain in 1916 is what broken looks like.

  6. We all know that HMPS calls the shots and is behind E3-the ludicrous plan for 60% of POs to be shunted into prisons-this is designed to free up prison offers to walk the wings while all the boring paperwork can be done by probation-shows the disregard that the profession is held in and confirms our second class citizenship credentials