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Picture of By Jo Phillips

By Jo Phillips

Don’t care

This week Jo discusses the fear of privatising the health service, but points out that in some cases it already is.

Imagine how up to £20,000 a week could be used to support a troubled, often violent and unhappy child. Specialist support staff to help with education, mental health and complex behavioural problems. A team of people on hand to help try and rebuild a broken young life. Now imagine that instead of using public money for that sort of intervention it instead goes into the coffers of an unregistered, unregulated children’s home. That in itself is appalling but even more so is that the local authority responsible for the 14 year old in question applied to the Family Court to move him to a different private children’s home, under what is known as a Deprivation of Liberty (DoL) order. That means the boy will be constantly monitored by at least two staff who can lock him in, and physically restrain him if he tries to run away but because the new home is also not registered with Ofsted it should be unlawful to place a child under 16 there. However, Judge Steven Parker, used his power to permit the placement, and the restraint because, he said, there was no alternative to keep the boy safe while also commenting that local authorities are “being left to the mercy of the private sector.”

The details of this case were revealed by the BBC with unprecedented access to the Family Court at a hearing in Liverpool and is just a snapshot of the horrifying crisis – and costs – facing local authorities responsible for vulnerable children and adults. Councils are on the brink of bankruptcy, struggling to recruit and retain social workers and other key support staff while private companies are coining it from the gap in the market and the knowledge that all to often there is no alternative but to swallow their huge fees and hope for the best. 

Last year England’s fourth largest provider of residential places for looked-after children, Outcomes First Group which is owned by private equity company Stirling Square announced it was closing 28 care homes due to ‘market challenges” giving local authorities just a month to find new placements for children.

A recent investigation by The Observer found that councils had placed hundreds of children in their care in unregistered homes. The providers had received nearly £105m from English councils last year. And that figure continues to rise as does the need for residential placements.

At the other end of the scale, care of and for the elderly is equally profitable for many companies, pushing local authorities and families to the financial edge with fees averaging £70,000 a year. Analysis from the University of Oxford found that virtually all care homes forced to close in England by the Care Quality Commission are run on a for-profit basis and CQC data shows that in September 2023 more than 85% of all care homes in England were operated by for-profit providers.

We fear privatisation of the health service, but we should also remember that by stealth and through desperation we’ve already privatised health and social care for the most vulnerable and voiceless in society, while operators make a pretty penny by just not caring.

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