“As long as social care is provided almost entirely by the private sector (under 10% remains in public hands) it will be impossible both to plan strategically and operate efficiently.
The private sector plays no effective collaborative role in the strategic planning of service provision (the duty of national and local government) modelled on expected demographic change over future decades. Indeed, private providers are essentially disparate and short-term focused – even handing back contracts mid-term when they prove or are predicted to be unprofitable. Moreover, they have no interest in providing care as a public good.
The private sector, in the market as it is currently structured, will always follow the money (that is, affluent old people who can pay for care out of their own pockets, and who are then placed in the position of cross-subsidising those who are paid for by cash-strapped councils, themselves unable to pay the full going rate as set by the providers).
Depressingly, this does not even address the issues around quality that are shown to arise time and time again in services that have been outsourced (which is essentially what the private provision of social care is really all about) – just look at the parlous state of many of our privately provided (but publicly funded) prisons, immigration centres, probation services and primary healthcare services.
The only difference is that social care is a hybrid form of outsourcing – private payers and publicly supported clients coexisting side-by-side within the same privately provided service.