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‘There is a gulf between heath and social care’

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Some older people have a great time. Take Des O’Connor for example. If he’s not on a sunbed, he’s hosting Countdown or murdering Frank Sinatra songs. Say what you like about Des – he’s happy.

Some older people have a great time. Take Des O’Connor for example. If he’s not on a sunbed, he’s hosting Countdown or murdering Frank Sinatra songs. Say what you like about Des – he’s happy.

As indeed are many other older people who are enjoying their well-earned retirements cruising the Mediterranean, walking in the countryside or laughing at the way young people dress. This is the kind of retirement we all look forward to. Good health, a decent pension and your partner and friends to have the same kind of luck so you’ve got someone to play with.

But it could easily go the other way. And it does for plenty of people.

Last week The Sunday Times did an ‘inside story’ on the care standards in a nursing home for older people. It found poor food, dangerous practice around lifting and handling, and people left to sit in soiled or wet clothes. We know this is not representative of all homes but we also know that poor care happens. It’s hard to get the staff apparently – particularly staff whose first language is English, according to the report. The pay is poor. There is, it seems, money to be made in this industry, just not by the people doing the nursing.

I mention this in the light of the recent report on delayed discharges. This claims nearly a million days of acute hospital inpatient care were lost this year due to delayed discharge – a 30% rise on last year. The reasons cited were a lack of community services, a lack of investment in aftercare and supported housing and underfunding.

Put the stories together and we have a picture of disinvestment in social care – low pay, low morale and, in some places, low standards. There is an inevitable pressure on beds and an obvious lack of coordination between health and social care.

Nowhere is our governmental tendency to ‘talk the talk without even putting our shoes on, let alone going outside and walking any walk’ more apparent than in how we organise the care of older people.

It is astonishing that we talk about what we can ‘afford’ in terms of health service investment, salaries for carers or even pensions as if funding older person’s care is an afterthought or, worse, a charity. Yet the wealth we enjoy – ours is the fifth largest economy in the world – was built on the labour of the older generation.

But of course it isn’t just about financial investment, is it? We have constructed a culture that views care work as low skilled and poorly regarded.

The delayed discharge report highlights the defective relationship between health and social care. But the root of the problem is about the way we think about and value care, particularly the care of older people. It is depressing that, despite the commitment of so many good nurses, we find ourselves too often providing substandard care.

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