Is the care home market heading for a crash?

[Spiro]

Have just read this on the BBC news website.

http://www.bbc.co.uk/news/health-35126532

This is not good news for anyone whose loved one is in a care home.

 

[Kevinl]

There's an interesting article on this subject on the link below.
I think the killer quote is " At Care UK, for example, the number of self-funding residents has risen from 26 percent to 32 percent in a year. These private homes are more profitable and account for most of the new investment".
I can see a situation in the future where homes will only take self funders or LA rates and a compulsory top up from the person or the family to the self funding rate.
K

http://nhsfightback.org/2015/12/07/uk-private-care-homes-facing-closure/

 

[AlsoConfused]

I can see a situation in the future where homes will only take self funders or LA rates and a compulsory top up from the person or the family to the self funding rate.

At that stage everything falls apart because surely no government and no local authority could survive a situation where sizeable numbers of elderly, frail, mentally incompetent people are put out on the street to fend for themselves.

The only solution that could work will be for the state to take back responsibility for running care homes; it's the only solution because it's the cheapest and (by a small but significant margin) the easiest to organise.

 

[Kevinl]

The only solution that could work will be for the state to take back responsibility for running care homes; it's the only solution because it's the cheapest and (by a small but significant margin) the easiest to organise.

The problem is it isn't. Government employees have such (relatively) good terms and conditions of employment, pensions and all the rest is the only way is to outsource to private companies who's employment conditions are far below what the government as a reasonably fair employer would feel obliged to give to their staff.
There's a thread on here from DMAC (link below) where their foray into being a carer shows how it works in the private sector, no goverernment employee would be treated like that.
K
http://forum.alzheimers.org.uk/showthread.php?88138-Carer-and-care-worker&p=1208940#post1208940

 

[Risa]

I wonder what will happen in the future if it is becoming more common to rent properties. Unless there is some sort of special tax or insurance policy there is no way people will have the amount of money in savings to pay for care homes privately. Also I think people who own homes now and are in their 40s and 50s are becoming a lot shrewder about protecting their children's inheritance.

 

[fizzie]

I agree that the Government need to take back care homes - it is going to be the only way forward so one would hope that they are already planning for this hahahahahahahahaha

 

[nitram]

"Also I think people who own homes now and are in their 40s and 50s are becoming a lot shrewder about protecting their children's inheritance."

Several other countries have filial obligation.

 

[Kevinl]

Also I think people who own homes now and are in their 40s and 50s are becoming a lot shrewder about protecting their children's inheritance.

The LA's are becoming a lot shrewder with the deprivation of assets rules just look at the 2014 regulations, what may have worked in the past won't necessarily work in the future. It's spread all over here and the finance pages of any newspaper how to go about "protecting an inheritance" companies specialise in doing it, how much longer will it last? Not long in my opinion.
K

 

[Spiro]

At Care UK, for example, the number of self-funding residents has risen from 26 percent to 32 percent in a year. These private homes are more profitable and account for most of the new investment".

So much for the Dilnot Commission and the care cap.

With people living longer and not always in good health, an insurance based scheme that covers everything - health and social care - seems to be the only solution.

In Europe, in countries which have compulsory health insurance, the majority of people rent. They spend their money on their health, not on investing in property!

 

[Kevinl]

In Europe, in countries which have compulsory health insurance, the majority of people rent.!

We do too it's called National Insurance and currently you pay 12% of your wage and your employer pays 13% (depending on income and assuming the UK average) so an amount equivalent to 25% of your wage goes into a compulsory health insurance scheme. I understand Gordon Brown took the ring-fence off this money and it now goes into the general government income pot so isn't actually used for the purpose intended anymore.
To be fair home ownership only became the norm when the (hated by many) Mrs T made it possible for council tenants to buy and the lowed tax rates made it possible for the rest to at least look at buying. I have 3 children who all rent but I rented til I was their age so what's new?
K

 

[Rageddy Anne]

So if the Care Home market crashes, what are our alternatives? Any ideas or suggestions welcome.

 

[nitram]

"So if the Care Home market crashes, what are our alternatives? Any ideas or suggestions welcome."

Perhaps, like the banks 7 years ago, it will be deemed 'too big to fail'.

 

[Ann Mac]

So if the Care Home market crashes, what are our alternatives? Any ideas or suggestions welcome.

No idea In this area there is already a massive crisis. L.A. run homes all now closed, private homes can pick and choose, and they choose not to take nursing EMI patients because of the greater costs incurred by paperwork and additional staffing. The local hospitals' elderly assessment ward is filled with pwd's, who need EMI nursing care, who need a permenant placement. And because there simply are no facilities for EMI nursing care left in this area (and very few in other local area's) pwd's are being 'shipped out' all over the place - I've been told that people have been sent to Manchester, Liverpool - and even London. If my Mil's condition now deteriorates to the point where we cannot cope - well, tough, we will have to, somehow - there is nowhere for her to go. We basically just have to get on with it. I've been told that I can scream about 'duty of care' as much as I want - the fact is that there are no placements for that type of care, there wouldn't be even if Mil could afford to pay £10,000 a week - they just do not exist in this county any more.

 

[Spiro]

We do too it's called National Insurance and currently you pay 12% of your wage and your employer pays 13% (depending on income and assuming the UK average) so an amount equivalent to 25% of your wage goes into a compulsory health insurance scheme.

Apologies Kevin, I meant private health insurance as opposed to National Insurance. As you rightly point out, Maggie T got the home ownership ball rolling.

 

[Kevinl]

The NHS has abandoned care of the elderly to the private sector, social services just pick up the bill when they have to, dentists are pretty much all private now and NHS glasses a long distant memory.
I can see a situation where GP's will go the same way (see link below), if GP's follow the lead of the dentists and pull out of the NHSI can see a situation where we could all be paying for GP visits.
If they did resign en-masse and 50% say they're prepared to what would happen?
K

http://www.dailymail.co.uk/news/art...caused-lack-funding-relentless-paperwork.html

 

[AlsoConfused]

Hi Kevin, perhaps a lot depends on where you live?

Where I live, there are at least 2 (possibly 3) NH dental practices within 4 miles, NHS glasses are freely available (the style range is limited obviously) and there's never been any muttering about privatising doctors. I also know the local sheltered housing complex (owned by a housing association) has empty flats.

 

[Rageddy Anne]

Hi Kevin, perhaps a lot depends on where you live?

Where I live, there are at least 2 (possibly 3) NH dental practices within 4 miles, NHS glasses are freely available (the style range is limited obviously) and there's never been any muttering about privatising doctors. I also know the local sheltered housing complex (owned by a housing association) has empty flats.

Now I'm dying to know where you live, so we can move there!!

 

[Pickles53]

We do too it's called National Insurance and currently you pay 12% of your wage and your employer pays 13% (depending on income and assuming the UK average) so an amount equivalent to 25% of your wage goes into a compulsory health insurance scheme. I understand Gordon Brown took the ring-fence off this money and it now goes into the general government income pot so isn't actually used for the purpose intended anymore.
To be fair home ownership only became the norm when the (hated by many) Mrs T made it possible for council tenants to buy and the lowed tax rates made it possible for the rest to at least look at buying. I have 3 children who all rent but I rented til I was their age so what's new?
K

Absolutely agree that the NI payments should be ring-fenced so they cannot be used on general public spending, but they don't just cover health/social care. They also cover the state pensions system and various welfare benefits. When you add up the cost of all that, and add in increasing life expectancy and the wonderful but expensive new treatments we all expect to have, current levels of contributions from wages are never going to be enough.

My 2 year old grandson has had five weeks of inpatient treatment so far plus significant amounts of outpatient support. His parents both work in NHS finance so have a better idea than most about the cost to the NHS of his treatment. It's absolutely mind-boggling and even with good jobs they would have had a hard time funding the care privately.

In most countries with publicly-financed health systems, there is some level of payment at point of use, with exemptions for low-income people. The one thing that does do is make people think more sensibly about how they use the system. Do you really need to see the GP for a minor problem for which paracetamol may be prescribed (80% of all prescriptions are free) when you can buy the same product yourself at the same pharmacy?

More controversially, life insurance companies will charge you more if you are a smoker, drinker, etc. Travel insurance companies will charge you more if you want to participate in ski-ing or similar risky sports. Car/home insurance will cost more if you make a lot of claims. Health is the only area where we are protected from the consequences of our actions/choices. Maybe that will have to change in the future?

 

[Witzend]

In most countries with publicly-financed health systems, there is some level of payment at point of use, with exemptions for low-income people. The one thing that does do is make people think more sensibly about how they use the system. Do you really need to see the GP for a minor problem for which paracetamol may be prescribed (80% of all prescriptions are free) when you can buy the same product yourself at the same pharmacy?

?

A Swedish friend who lives in the UK (and incidentally works for the NHS) told me that in Sweden everybody pays for visits to the GP, visits to A and E, and for prescriptions, though there is an annual cap on the amount. Her father who was over 90 and not well off had to pay for his prescriptions. People also pay something towards the 'bed and board' element of hospital stays. The amounts are not large, but as I understood it, virtually everybody has to pay, and I must say I was surprised, since Sweden is popularly supposed to be a socialist utopia. I doubt that any government would ever have the nerve to bring in any such charges here, even for small amounts, and even if it would help to make the sort of people who go to the GP or A and E for every tiny thing, think twice.

Personally I don't understand why there shouldn't be some sort of charge for prescriptions, if the person is not hard up. We have a friend with plenty of money who stockpiles free (repeat) prescription items - I once counted over 60 of various products*gathering dust in his bathroom. He is somewhat tight with money and I absolutely know he would not have taken all these if he had had to pay even a couple of pounds for them. I dare say this sort of abuse of free prescriptions is not at all uncommon.
*All of which were binned not long ago by a visiting ex-nurse friend!

 

[Boldredrosie]

What an interesting thread. I don't think care homes will ever be considered too big to fail. If they did a range of things would happen: people with care needs will be forced back into their families and those with no one will end up in NHS hospitals, diverting care from people who are acutely ill and the whole thing will be just awful for everybody.