The perils of privatising social care

This is a story in the Guardian about how children in care are treated as commodities in a market-system of placement.

The Guardian often does these kinds of stories quite well. However; they never draw the obvious conclusion. The system is not ever going to be fixed by a worried / outraged article in the press and some more regulation / money.

The problems described in this article are the inevitable result of bringing the profit system into the field of social care for looked after young people. Of course if you do this calculations are going to be made on the basis of profiteering and of course this will not result in the “best care” for young people.

There may be some fields where the profit-motive can produce results which socialised production cannot. An obvious example is the case of any field in which technological innovation can be stimulated by profit and competition. It is hard not to accept, for example, that the competition between Nikon and Canon – both chasing profits – has not been the driver for the exceptional technical developments in digital cameras in the last few years.

But some fields do not require innovation. Social care is one such field. Care is care and the basics of what is needed does not change or develop over time. What is needed is not technical innovation but long-term planning and the stability that comes from this. There is no need to make profits to invest in R&D. Private companies operating in these fields are simply creaming off the profits. If the service was delivered on a socialised basis any surplus could be re-invested.

These services have been privatised so that greedy business people (in many cases US investment capital) can make lots of profits and accumulate even more capital into private hands.

The system of social care for young people taken into care in this country is frightening. If the public knew what was going on there would be widespread horror. Since the ideology of privatisation of local authority services has taken over there has been a surge in small private providers running a small number of care homes – with just a few beds per home. In some cases (probably many – I don’t have figures) these private companies are run by people who used to work in social services departments. They use their contacts and training and domain knowledge (all provided for them by the public purse) to develop their profitable private businesses. Local authorities pay whatever they are asked. There are multiple reasons for this lack of cost-control which it is beyond the scope of this article to discuss. But we can note that local authorities operate in a risk-averse environment – penalties accrue for allowing a scandal to occur but there are no rewards for taking a small risk and saving some money.

The Guardian article gives some mouthwatering ideas about costs of placing a young person in a private care home.

The author of this site worked for one shift in one of these homes. A young boy aged 12 had just arrived – he had just been taken into care and the home had just accepted his (no doubt lucrative) placement. It emerged that one of the older youths had on his file the remark that due to his sexual behaviour no younger people should be placed in the same home as him. Fortunately, one of the staff remarked, this was just a comment and not a legal ruling so the home was able to ignore it when taking the placement of the younger boy. This is precisely the kind of decision making based on financial motives which occurs when you have a privatised market. And it is harmful to young people. In this case definitely so; during the night – I heard a scream from the bedrooms – I am 100% sure this was the 17 year old pedophile introducing himself into the bed of the new arrival (the 12 year old).

The arguments about ‘efficiency’ with which the public were sold large-scale privatisation in the 80s are massively overstated. The costs, especially in sectors, which should be embodying social values, were never considered.

There are similar problems in the system of local authority funded care for the elderly. As private care homes go bust their elderly victims are turfed out and dumped in hospital wards.

Money won the argument. Care lost. Articles like the one linked to above in the Guardian can highlight the problems – but it will take more than a little bit of regulation to fix. Some “services” can only be properly provided on a socialised basis. The left – what remains of it – should at least focus on bringing social care, prisons, probation and education back into the state sector.