I suspect that this Budget is not turning out to be the career-defining moment that the new Chancellor hoped it might be.
With the number of cases rising every day, businesses taking ever greater precautions and talk of shutting schools and postponing the Six Nations Championship, Rishi Sunak’s first major set-piece is understandably dominated by managing the fallout from Coronavirus.
Besides, there are the small matters of being barely six weeks into the job, being lobbied by every vested interest, and being the subject of a constant stream of speculation.
One thing is for certain, should the Chancellor revive the old tradition of having a stiff drink at the Despatch Box, no one is going to hold it against him.
Amidst this maelstrom, this Budget is a fundamentally important moment for the nation to address its major, and systemic, problems. So, if I may indulge in some lobbying of my own, I’d like to speak for a cause that is close to my heart but is also far-reaching: improving dementia care.
Whatever the shorter term priorities, we must not allow dementia care to slip down the Government’s agenda. This is not an issue that will go away by itself if we quietly ignore it, nor is it one for which we are remotely equipped at the moment. The number of people with dementia in the UK is currently forecast to rise from 850,000 to 1 million by 2025, with the burden on the nation’s finances increasing daily.
However, while the number of those needing care continues to rise, the number of qualified care providers does not. Approximately 440,000 care workers leave their job every year and there are around 122,000 vacancies at any one time. It was also interesting to see the alliance of free-marketers and those on the left criticise the new immigration rules that risk reducing the number of skilled care workers and exacerbating this problem.
The practical upshot of this staffing crisis is that, right now, there’s a dearth of UK providers offering a level of care that our dementia patients need and deserve, because they cannot get the skilled staff that they need. And things may get worse.
Sadly, too many of us are aware that specialist 24/7 support is often required for dementia patients and without this, many are left under-stimulated and over-medicated, isolated and confined to a single room in their own homes. This is a miserable life, and not one we should be content to provide for anyone.
So, what needs to be done?
The Queen’s Speech pledged £1bn more for social care (presumably including dementia) and there are many calling for higher pay for nursing staff to improve care staff retention and this is often top of the list of ways to encourage workers to stay in the sector. There are also more radical suggestions, such as the Labour Party’s National Care Service.
However, I believe the key approach to tackling this crisis is to ensure that we offer top-quality training. Clearly, too many of the workforce do not see care as a real career, and hence leave to do something else. To change that means putting a much greater emphasis on education.
I know many CapX readers will be wary of occupational licensing and I agree – after all, in some cases exams and qualifications only serve to protect those within the industry. However, current dementia care accreditation is the simple matter of a two-day course – it requires little investment and even fewer reasons to stay in the industry. I also believe that creating stronger accreditation systems will engender pride in the vocation beyond that which is naturally created by looking after the most vulnerable in society.
Better training is something that the University of West London (where, for full disclosure, I am Chancellor) is trying to bring about at their Institute of Ageing and Memory and their MSc in Dementia Care. We hope that formalising and improving the dementia care training process creates a virtuous circle where care becomes a career more frequently. This, in turn, demonstrates to those considering a career in caring that this is time well spent, again improving the overall staff numbers.
Naturally, more training is no panacea. However, if the Government is serious about tackling the dementia care crisis, improving training, and the incentives to undertake it, should be the first place to look. This may be costly, but training programmes provide life skills, in contrast to the sticking plaster impact of simply raising wages or the extreme proposal of nationalising large parts of the care industry.
With one eye on the public finances it is hard to simply demand greater funds for dementia care training. However, within the health and social care system that we have, this is the Government’s (and the Chancellor’s) best course of action.
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