The women each had a story to tell about their working lives and the people they care for. When I met them a week ago, two broke down in tears, less for themselves than for the shocking care they felt they offered fragile people at the end of their lives. Each has worked for years in different private care homes in the West Midlands, too afraid of their employers to let me name them or their places of work. When you listen to the budget on Wednesday, think of them and their residents as the real meaning of the government’s “long-term economic plan”.
“There’s no care, no time to talk to someone lonely, though we’re often their only family. We’re told not to waste time on that.” Another said: “You have to do things every day you know are wrong.”
Though their residents, all with dementia, need lifting and difficult care, “the training is one shift observing, and you’re on your own. You get very skilled – then they call us unskilled.” Petty meanness gets them down – they all said kitchens in their care homes are locked after tea, but residents are often hungry at night. “The companies say we’d steal food if it wasn’t locked away, so we use our own money to go out and buy them food or soap.” That comes out of their minimum-wage pay, or 10p above. “Some people we care for had their homes sold to pay £900 a week to be treated like this, and you can’t even make them a sandwich,” says one. “It’s disgusting,” she says, and she weeps.
Several had complained to the Care Quality Commission. “But they took two months to respond and managers jump ship to avoid trouble. We’re warned not to talk to the CQC and they use our rotas as revenge if we complain.” The others tell the same story. Their care homes often change owners. “In 10 years my home has had multiple owners and several managers. When company letterheads change they send us glossy brochures with pictures of new directors. Those go straight in the shredder.”
Each owner tries to make money by cutting costs. “First thing, they come round and cut staff, cut hours for anyone on zero hours and leave posts vacant.”
They say four staff for 22 residents is standard, but often it becomes three or two to care for 38 or 40 incapacitated demented people. “But they soon find they can’t make much profit and they sell us on again.” The GMB union says care homes in this area are pre-empting the rise in the minimum wage by extra cuts to staff, shifts and hours.
Worse, there is less outside help to call on as they are given sicker people to care for. “Residents can turn violent. If they get urinary infections it can make them suddenly deranged, lashing out.” Care workers are not allowed to restrain them. All said they’d been assaulted. “You call the number you’re given for emergency help and you just get ‘Please call later’. You call the social workers’ duty desk to get someone moved to a secure mental unit and all you hear is ‘All our operators are busy’.”
Often social workers can’t come for weeks as they have worse risks on their growing case loads. One worker spoke of what happens when they call the police: “They just tell us we’re more trained for this than they are.”
Why do they stay, I asked them. “You get locked in, when you’ve worked in a home for a few years you stick with your friends, you survive together.” Mothers can’t travel far from home, there’s no time to look for a new job and they fear losing even one week’s pay between jobs. “And somewhere else might be worse.” The syndrome is familiar to the million low-paid carers stuck with bad conditions. “They trap you because you care about the residents. We’re slaves, really.” A solidarity of endurance binds them together.
That’s what awaits any of us needing care at the end of our lives. It will get worse, not better, reversing our lifetime expectations of everything steadily improving. This is an example of what it feels like to shrink the state permanently to 35% of GDP. It’s back to 1948, says the Institute for Fiscal Studies, far from the western European norm of about 44%. Austerity will never end, the screw tightening at every budget.
On Wednesday the chancellor may delay much pain for fear of inciting revenge votes in the EU referendum, but some of the vulnerable will take another kicking, saving £1.2bn by cutting the incomes of 600,000 people with disabilities. Some bogus offers will be made to low-paid workers like those carers: raising the tax threshold again is a quintessential Osbornism. It does nothing for the six million earning less than the threshold, and is deducted from the tax credits of many others, while most money flows to earners in the top half, mainly Conservative voters. His beneficent “new” savings incentive for low earners is exactly the same as Labour’s savings gateway, which Osborne abolished. It will cost him little because most low earners have nothing to save.
We are aboard this government’s starship to their “low tax, low welfare, high pay” planet. Low tax? Helpfully the Taxpayers’ Alliance calculates the top tenth pay a lower proportion of their income in tax at 35% than the bottom tenth who pay 47%. Low welfare? Osborne cuts more at every budget. As for high pay, FTSE chief executives have seen theirs rise by 40% on his watch. His state is shrinking all around us, with assets in the government estate sold off, their footprint bigger than the state of Monaco. The royal parks are next for auction; a million public jobs have gone.
To raise more money for the NHS or social care, there is no shortage of measures for a brave chancellor, for a cornucopia of state money still flows to those who don’t need it. The £35bn pension tax relief flows to mainly to the top 8% of savers. Home owners’ capital bonanza will never be at risk under Osborne; nor will the 1,128 tax reliefs, mostly used as business loopholes. The marriage bonus mostly paid to well-off pensioners, and the £1m inheritance tax bonus for the wealthiest 6% of families will stay safe. The “long-term plan” doesn’t need more tax to come in, just more cuts from spending. All tax is theft, always a burden in the Conservative realm.
The question is, when does the balance tip, when do enough voters start to regret what they are losing. Ipsos Mori finds that 59% now think that no more cuts are needed (with no hint of a glimmer that translates into trusting Labour). But when people see the growing effect of Osborne’s cuts, they may remember that tax is the price we pay for civilisation. Does it start with the collapse of social care?
