The Public Sector Executive website reports that, according to the Centre for Health and the Public Interest (CHPI), increased privatisation has caused the quality and staff conditions of adult social care to decline significantly over the last twenty years.
It found that private social care staff receive a ‘considerably lower’ rate of pay compared to the public sector, resulting in higher staff turnover.
Since 2104, 41% of community-based and residential social care services were found to be inadequate or requiring improvement by the Care Quality Commission (CQC).
The report said: “While recognising the difficulties involved in replacing private by state provision, it would be possible to introduce a ‘preferred provider’ policy. Local authorities would give preference to their own provision, voluntary sector or user-led organisations.
“Local authorities could require the return on capital achieved by private providers to be capped to a maximum of 5%. This would help re-balance the market.”
The CHPI found that state-funded community services were slashed by almost 40% over the last decade. Due to budget cuts, councils have been reduced to the role of ‘commissioning authorities’, leaving them unable to direct the strategic outsourcing of care services and making the market unstable.
Despite these concerns, the report also acknowledged that returning responsibility to the public sector would not be a cure-all to adult social care problems.
“However it does offer the prospect of returning to the public sector a policy domain that has been shown to be ill-suited to marketisation,” it concluded.
The new measures recommended by the CHPI include a transparency test, where contractual arrangements with a provider are fully open, and allowing the local electorate to demand that a contract be terminated if there are concerns about performance.
The CHPI also proposed forcing private providers to guarantee terms and conditions and workforce bargaining rights, and a requirement for companies to prove that they are subject to UK tax.