Why UNISON needs to campaign on Integrated Care Proposals

On the face of it ICPs or Integrated Care Partnerships (or Services) proposed for England make a lot of sense. Anyone who has looked after an elderly relative or been in a carer role will know the frustrations of care falling between two stools. ‘Who does what?’ is often the question, and beneath a shallow surface, ‘who pays for what?’. But the model is flawed and lacks scrutiny. Like most ‘good ideas’ it has fallen into a bureaucratic framework which means ‘form’ is taking precedence over function.

The form in this case is the Health and Care Bill currently at Committee stage in Parliament. Whilst there are always concerns about the role of private companies in NHS provision some have sought to argue that the Bill in fact rolls back some of the damaging privatisation provisions from the 2012 reorganisation of the NHS.

A lot will depend on the new bodies who will inherit commissioning from the clinical commissioning groups, but there are few safeguards to prevent increased private sector involvement in NHS service delivery – though CCGs have hardly been the bastions of supporting in-house NHS or local authority services either.

At best the Bill is Janus faced. On the one hand it arguably removes some tendering requirements from NHS commissioners – something they have protested has been a costly waste of time – but on the other it could lead to unregulated procurement without tenders. Contracts for Cronies anyone?

The Men of Atalissa

Services for adults with learning difficulties have been decimated by austerity driven cuts and the introduction of charges. A Mencap report in 2012 found that one in four adults with a learning disability are stuck at home due to cuts to day services across England, leading its Chief Executive to express concern that 'progress towards greater participation of disabled people in the community and mainstream society risks being undone by a failing system that has long been ignored and is now creaking under the pressure of increased demand and budget cuts’. A powerful New York Times video documentary ‘The Men of Atalissa’ - about a community of men with learning disabilities in Iowa - highlights the danger of abuse and exploitation when social services provision is inadequate.

Elderly care on 'brink of disaster'

The Independent reports on the catastrophic effects of Government cuts on social care. From 2005/6 to 2012/13, the number of people aged 65 and over in receipt of social care services dropped by a 27.2 per cent, from 1,231,000 to 896,000, despite the age group growing by one million. £1.2bn (over 15%) has been cut from social care for older people budgets since 2010:
http://www.independent.co.uk/life-style/health-and-families/health-news/catastrophe-looms-as-cuts-force-elderly-to-fend-for-themselves-9171682.html

Care workers must be paid for travel time

UNISON has welcomed a recent Employment Appeal Tribunal decision – which confirmed that under the National Minimum Wage (NMW), hourly-paid care workers must be paid the NMW, both for travel time between assignments and also for time spent sleeping on overnight stays - as setting a “very clear benchmark” for what is expected of employers in the care sector. This is a massive boost for UNISON’s campaign in support of an ethical care charter which is attracting growing support from councils across the UK:
http://www.lrdpublications.org.uk/publications.php?pub=LR&iss=1705&id=idm7223928
http://www.unison.org.uk/upload/sharepoint/Research%20Material/Final%20Ethical%20Care%20Charter%20PDF.pdf

UNISON survey reveals Scotland’s care crisis

Workers tell the human stories behind the cuts as a UNISON survey exposes the shocking reality of Scotland's care services.
   “It’s getting worse. I don't know where its going to end, no one cares about the patient or client anymore”, one worker told the 'Scotland: It’s Time to Care' survey which was published today.
  Another warned: "“Clients are losing out, care is not given properly, clients are missed out or forgotten about, no one cares or listens to staff or clients.”
  Poignantly one worker said “I feel worthless.” If that is how they feel, what about the people they are desperately trying to care for?

The human cost of cuts in social care

The Guardian reports on new research which finds that 'half a million fewer old and disabled people are receiving care and support from the public purse than would have been the case before the financial crash' in 2008. Care organisations have identified a £2.8bn shortfall in funding necessary to meet people's needs assessed as moderate:
http://www.theguardian.com/society/2013/dec/16/cuts-care-funding-austerity

Hurricane Austerity hits community & voluntary sector

New research by UNISON highlights the devastating effect of cuts in council budgets on community and voluntary organisations – both vulnerable clients and workers in the sector are bearing the brunt of cuts which have removed 20% of spending from adult social care since 2010:
http://www.theguardian.com/society/2013/nov/06/budget-cuts-hit-community-services

The contract culture in social care is a national scandal

‘The government have made such swingeing cuts to council grants that forces social care providers into cutting pay and conditions. Many employees are now being paid below the minimum wage. That's because they are not being paid for travel time, use their own cars without being paid reasonable mileage rates and have to pay for mobile phones and uniforms,’ says Heather Wakefield, UNISON head of local government, in a Guardian report which examines the downward spiral of budget cuts, underfunded contracts and attacks on care staff wages – exemplified by the Future Directions dispute in Rochdale:
http://www.theguardian.com/society/2013/oct/22/council-funding-cuts-care-homes-minimum-wage

Social care is coming apart at the seams

Yesterday’s report by Leonard Cheshire Disability which highlighted the increasing use by councils of short 15 minute care visits to elderly and disabled people echoed longstanding concerns of UNISON members working in the homecare sector. The realities of frontline working in homecare are spelled out in UNISON’s groundbreaking ethical care charter which also sets out best practice for the commissioning of homecare services. The False Economy website gives voice to the too often unheard views of people who require homecare services but are faced with worsening levels of provision as cash strapped councils struggle to meet demand for social care.

After #NHS299 - the fightback starts now

As the dust settles on the magnificent UNISON-led demonstration through Manchester on Sunday, the big question on activists lips is “What next!” That is the right question and the answer must be that we build on the momentum of the energy and passion shown by the 60,000 people snaking through the city centre demanding that we fight to save the NHS. This is a fight which everyone has a part to play.

Future Directions workers - striking against a race to the bottom

Yesterday 115 UNISON members in Rochdale commenced a 10 day all out strike in an escalation of their campaign to reverse cuts in pay following outsourcing of adult social care services to Future Directions a community interest company 100% owned by Calderstones NHS Foundation Trust.

New phase of strike action launched in Rochdale

This week more than 100 UNISON members in Rochdale are stepping up their fight against pay cuts. The adult social care workers have already taken 15 days strike action and on Sunday they launched a further five days all out strike action in an attempt to secure concessions from their employer - the Future Directions community interest company.
   Anne Marie Hetherington a Personal Assistant said 'we want to negotiate a fair deal but Future Directions will not budge. We would rather not take strike action, but we care and need to provide for our families, our community and our service users and that is why we will take more strike action if that’s what it takes.'
   A march and rally is taking place in support of the strikers at 12 noon this Thursday 29 August. Asembly point is the Butts in Rochdale Town centre and speakers include Maureen Le Marinel UNISON President and Heather Wakefield national secretary for local government:
http://www.unisonnw.org/rochdale-future-direction-workers-announce-further-5-days-of-strike-action/

Burnham thinks big for the NHS

Good stuff from Andy Burnham in today's Guardian profile not only acknowledging Labour's mistake when in Government of allowing the private sector into the NHS but setting out ambitious plans for integrating social care into the NHS: 'Once the market takes a hold on the system it will destroy what's precious about it. We had been building a policy that had been saying it doesn't matter who provides healthcare as long as it's free at the point of delivery. But I'm saying it does matter.'
http://www.theguardian.com/politics/2013/aug/09/labour-risks-defeat-coalition-warns-andy-burnham
http://www.theguardian.com/theguardian/2013/aug/09/andy-burnham-interview-thinking-bigger

14 years of NMW & the enduring problem of low pay

According to a Joseph Rowntree Foundation report published yesterday, the national minimum wage (NMW) of £6.19 compares with a wage of £8.62 to £9.91 necessary to provide a socially acceptable standard of living.
     Alan Manning of the LSE acknowledges the enduring problem of low pay despite the existence of the NMW for the past 14 years and reports on an initiative to revitalise the minimum wage concept including possible sector specific strategies in areas like retail and social care where poverty pay is endemic:
http://blogs.lse.ac.uk/politicsandpolicy/archives/34433

Baby boomers & social care

#ULGC13 #UNDC13 Heather Wakefield UNISON National Secretary for local government took part in today’s The Big Questions on BBC1. The subject for debate was social care and other participants included a representative of right wing think tank Reform.
http://www.bbc.co.uk/programmes/b02zcc5h

The Outsourcing of Social Care – death by a thousand cuts

The New Statesman investigates outsourcing of social care services in the London Borough of Barnet and its findings will be familiar to service users and care workers throughout Britain – budget cuts, reduced pay and a worsening of service provision for the most vulnerable people in local communities:
http://www.newstatesman.com/politics/2013/05/secret-cuts-part-one-social-care

NHS residential care under threat in Northern Ireland

Public opposition in Northern Ireland to plans to privatise NHS residential homes has led to a temporary reprieve, with the Health Minister Edwin Poots MLA delaying the Government’s 'transforming your care' proposals which would have closed 18 NHS care homes:
http://www.belfasttelegraph.co.uk/news/local-national/northern-ireland/northern-irelands-care-homes-fight-goes-on-29246739.html

UNISONActive Analysis: A Coalition of Care

Con Dem Secretary of State for Health – Murdoch’s little helper Jeremy Hunt – claimed to have solved the crisis in care last week.

He said “This is a watershed moment for our country...and we will give everyone the protection they want in their old age and save the family home.” Sad to report but his magic bullet has missed the target.

Putting the dignity (and radicalism) back into social care

A UNISON seminar of members working in social care and home care has called for dignity for service users and dignity for the staff who serve them.
  The call came 24 hours before UNISON warned that the home care system is in crisis following a Care Quality Commission Report into homecare services in England which found that as many as a quarter are failing to meet quality and safety standards.

Council care services ravaged by closures & outsourcing

'Cuts passed on to local authorities by central government since the last spending review have caused a raft of closures, and outsourcing of the remaining council-run homes and day centres. Local authorities are shouldering the burden of austerity, and with it the backlash from unpopular decisions' writes Lorna Stephenson in a Red Pepper article documenting the crisis engulfing social care in the UK:
http://www.redpepper.org.uk/care-in-crisis/