Slow, inconsistent, sometimes reckless and even negligent.
That’s the damning assessment of the government’s approach to social care during the COVID-19 crisis, published today by the House of Commons’ own spending watchdog, the Public Accounts Committee (PAC).
Their report says the pandemic has exposed the tragic impact of years of inattention, funding cuts and delayed reforms.
All of which, it says, have left the social care sector as a poor relation to the NHS.
Meg Hillier MP, chair of the committee, said: “The deaths of people in care homes devastated many, many families.
“They and we don’t have time for promises and slogans, or exercises in blame. We weren’t prepared for the first wave.
“Putting all else aside, government must use the narrow window we have now to plan for a second coronavirus wave. Lives depend upon getting our response right.”
The report says the Department of Health and Social Care (DHSC) decision to discharge 25,000 hospital patients into care homes without ensuring they’d been tested for the virus was an example of the government’s “slow, inconsistent and at times negligent” approach to social care.
The committee also described the move as being an “appalling error”.
Culture Secretary Oliver Dowden told Sky News: “I don’t accept that characterisation. First of all, this idea that we were mass discharging people from hospitals into care homes is not the case – actually there were fewer people discharged from hospitals into care homes between February and April.”
He added: “I accept that we need to look back and we need to learn lessons, of course with hindsight there are things we could have done differently.
“What I don’t accept is the kind of characterisation that is made in that report – because for example, we discharged fewer people than the year before, because we put the testing in place subsequently, because the NHS providers have made clear that they would not have discharged people systematically on that basis.
“I think a more nuanced judgement is required.”
The committee has made a number of recommendations which it wants the DHSC, NHS England and NHS Improvements to respond to, including:
- A review into which care homes received discharged patients and how many subsequently had outbreaks
- The identification of national leads for all critical elements of the pandemic response
- Details of what will be done to ensure the needs of social care are given as much weight as those of the NHS
It is also asking for more information about the cost and function of private hospital contracts and the Nightingale hospitals. There are concerns, it says, that there has been “a lack of transparency about costs and value for money”.
The report also identifies a further lack of transparency around the availability of personal protective equipment (PPE), citing a tendency for the government to “over promise and under deliver”.
Meg Hillier said: “The failure to provide adequate PPE or testing to the millions of staff and volunteers who risked their lives to help us through the first peak of the crisis is a sad, low moment in our national response.
“Our care homes were effectively thrown to the wolves, and the virus has ravaged some of them.”
The Local Government Association represents over 300 councils across England.
Councillor Paulette Hamilton, vice chair of its community wellbeing board, said: “Social care has been on the frontline throughout this crisis but this report’s conclusions show that those who use, work and volunteer in these vital services were not given as much priority as the NHS from the outset.
“We cannot and must not allow any of these mistakes to be repeated again, if the country is to experience a second wave of coronavirus. Social care deserves parity of esteem with the NHS.”
A DHSC spokesperson said: “Throughout this unprecedented global pandemic we have been working closely with the sector and public health experts to put in place guidance and support for adult social care.
“Alongside an extra £1.3 billion to support the hospital discharge process, we have provided 172 million items of PPE to the social care sector since the start of the pandemic and are testing all residents and staff, including repeat testing for staff and residents in care homes for over-65 or those with dementia.
“We know there is a need for a long-term solution for social care and we will bring forward a plan that puts social care on a sustainable footing to ensure the reforms will last long into the future.”
The PAC said nobody would expect the government to get everything right in its initial response, but that it “urgently needs to reflect, acknowledge its mistakes and learn from them”.