Kevin Saving on
Can Gerry Robinson Fix Dementia Care Homes?
(Part 1, B.B.C.2, 9 p.m., 8.12.2009)
No, he can't.
The BBC has, in its wisdom, made a two-part series in which a businessman, (sir) Gerry Robinson, has been 'parachuted in' to 'fix' dementia Care Homes. The corporation presumably felt that they would be commissioning some 'compelling tv' (after the formula of the well-known chef and restaurateur who 'fixes' down-at-heel Eateries).
It is certainly arguable that we - the great British public - ought to be grateful to be in receipt of any programme which is neither stale American 'soap', Reality Television, Games show or, indeed, culinary opera. It seems typical, however, that the only solution which can be envisaged is a 'business solution'.
Part of the problem in the care sector is that it is top-heavy with 'consultants' ('drafted in' from industry) who are only able to visualise in terms of 'profit and loss'. These apparatchiks appear to have 'target-fixation' and to struggle with the delusion that everything can be resolved via the deployment of an appropriate graph. The trend reached its apotheosis in the early years of the present century when (for the first time ever) the NHS employed more administrators than trained nurses.
Let's get a few more statistics (each cited in 'The Gerry Robinson Show') out of the way. Currently, over a quarter of a million Britons reside in care Homes - a figure which is expected to quadruple within twenty year's time. The average cost of keeping one person in such a Home is £39K per annum - the vast majority of which is 'subsidised' out of the public purse. The gross turn-over ('gross' in both senses) is £6.5 billion -for an industry in which the 'profit margin' is usually calculated at 30% p.a. Care-workers see very little of this cash bonanza: the typical employee is either an older woman or a migrant worker, subsisting on pay which barely exceeds the national minimum. Unsurprisingly, the staff turn-over is horrendous.
This is a situation which has been stimulated - 'encouraged' is not too strong a word- by the policies of successive 'New Labour' governments intent upon closing Local Authority Homes, and promoting immigration in order to artificially 'deflate' wages.
Fix this, Gerry Robinson.
Our, quite personable, entrepreneurial guru affects not to see any problem in businessmen making money out of their charges. Actually, I do. The NHS (the world's largest market - or 'cash cow' - for the multi-national pharmaceutical companies) is widely acknowledged to be in the process of being bankrupted by their ever-more egregious demands. GPs and hospital consultants are regularly being 'incentivised' to prescribe medications of dubious efficacy. Quite obviously, the only possible solution to the outrages being perpetrated by 'Big Pharma' and private medicine is the immediate, compulsory nationalisation of the pharmaceutical industry in Britain. Just don't bet on it happening anytime soon...
Fix this, Gerry Robinson.
Sir Gerry - technical retinue in an unseen retinue - wanders benevolently around several Homes, chatting amicably to residents, care-staff, managers and owners. Sometimes, the accompanying soundtrack becomes a little more 'up-beat' when he encounters situations of which he can be more approving (like 'Miravale', one of the ten percent of establishments rated as 'Excellent' by an independent audit). Elsewhere, he sees elderly people marginalised in their own lives, and care-staff frustrated by their workload, working conditions and the increasing bureaucratisation of their profession. At one point heremarks: 'You're actually quite angry about this'. Amazing!
Western industrialised civilisation has reached a curious juncture in which it is medically capable of prolonging a citizen's life beyond the limit of their continued, economic, 'usefulness'. It has, thus far, completely failed to find a role for the 'valued elder' comparable to those found in supposedly more 'primitive' societies - where a grandparent, or great-grandparent, can 'help out' with child-care (or simply dispense the knowledge accrued over the passage of eighty-plus years). In our strange times, we seem to be quite prepared for both parents to work long hours, assigning the care of their children to complete strangers and consigning their own parents/grandparents to institutions which are demonstrably unfit for purpose. Look around you. Once again, we're building the kind of huge, multi-bedded behemoths which -it was once supposed - had 'gone out' with The Workhouse.
Fix this, Gerry Robinson.
It's all-well-and-good for a multi-millionaire to spend a few days seeing 'how the other half live'. If sir Gerry was really so passionate about care provision in this country (and, yes, we're been told that he 'lost' his father to dementia) he would have elected to make his career within it. Instead, he chose to immerse himself in the world of corporate finance. Consequently, he can never know how it really feels to have a genuine vocation gradually eroded by the realisation that you (and the 'service users' you look after) are just small cogs in some entrepreneur's scheme to enhance his own property portfolio. He can never experience the desolation of tending mute, late-stage ATD (Alzheimer's Type Dementia) patients curled-up in foetal balls. He cannot begin to empathise with the equal victims of dementia care: the shadowy, exploited figures (far below the media's fickle attention span) who are spat at - or scratched with faeces-covered finger nails - and for no greater crime than having the requirement to change a confused, elderly person's soiled garments. All this within an environment in which any expression of displeasure (even to the extent of registering 'distaste' facially) is not an option; an environment upon which numerous 'Do-Gooders' feel free to pontificate - but within which they are never, ever, obliged to roll up their own, immaculate, sleeves.
Robinson does have the grace to admit that 'this is all new territory for me', before adding 'we're in the Dark Age of dementia care'.
Well, Gerry, you got that one right.
Kevin Saving © 2009
Click here for part two of this article
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Kevin Saving was involved in what is now known as the 'care industry' for upwards of a quarter-of-a-century. He has been employed in the N.H.S. and in Local Authority (social services) care Homes and Day Centres. He has worked in private nursing Homes (both as care assistant and registered nurse) and has managed a unit for persons diagnosed with 'Asperger's syndrome'.