Tuesday, 15 November 2011

Why the purchaser/provider split is failing

Well, It's been quite a while since I've posted anything.. my excuses...life has been quite busy starting a new job and am finishing a dissertation among other things.

I've just spotted an excellent article on the Guardian which seems to hit the spot over just what is wrong in social care - in fact it echos a lot of what I said today to a new colleague who as it turns out his wife used to do some of my training when I was still in Social Services. It has led to me to post a response which I'd like to share here...

This is the real scandal in social care

The purchaser/provider split which came in in the 1990 act (but which has really come to maturity in the past 5-8 years as LAs ditched functions like in-house care providers and res. care homes) allows LAs to focus on driving down fees without having to worry themselves about the details of how this is achieved, or what corners are being cut to do this.The problem as pointed out is that lack of money in the system turns the purchaser/provider split into a destructive force which eats itself; it's not about getting quality care for a competitive price, but just about securing the lowest possible price to protect the diminished budget.

What we have is a failing market which is seeing a race to the bottom in terms of care standards.

A massive, massive issue to me, as I was only talking about someone to today is that the purchaser/provider split allows LAs to delegate responsibility and accountability. For instance if there is a scandal in a care home operated by a LA then the head of service and cabinet member are directly accountable... if it's with a private provider then they can simply blame a greedy owner, or bad management and point to the role of CQC.

Being able to escape this direct acvcountability means LAs can turn a blind-eye to just how margins are being cut and the impact of real cuts in the cost of care.

And being cut they are. I can't speak for now, but I began in Social Care in 2004 when providers were being paid £15 per hour for care...... when I left in 2009 the avearage was more like £10-12 per hour.