Will a National Care Service save the NHS from collapsing? - Daxa Patel

Will a National Care Service save the NHS from collapsing, and will it reassure us that, in our time of need, we will be cared for? These are the most basic questions we all need answered. Otherwise, all that Andy Burnham set out in his first Labour Party conference speech as Prime Minister is nothing more than rhetoric.

I genuinely want him to succeed because he is the first Prime Minister to grasp the nettle on a problem that recent prime ministers, including Tony Blair, have failed to address.

In the Prime Minister's interview with Laura Kuenssberg on the BBC, I was struck by how much this issue means to him personally, having recently lost his father, who spent time in the care system. If anybody understands the brutal reality of how care workers go unnoticed, and how appalling our current system can be, then surely it is him. We can therefore be forgiven for desperately wanting to believe in his vision for a National Care Service.

When we talk about being a nation with a growing elderly population, it is often framed as though it is somehow a bad thing, as though we become a burden once we pass society's arbitrary best-before date. At present, anyone over the age of 60 is often described as elderly which, frankly, is ridiculous.

Baroness Casey will undoubtedly guide the Prime Minister and his team on how to create a joined-up National Care Service that works alongside the NHS, but there are other issues that also need to be addressed. These include our attitudes towards ageing and the way we view those working in social care. For far too long, care homes and nursing homes have represented a money-making opportunity for large corporate organisations that profit from providing substandard, and often threadbare, services to those most in need.

Those people are vulnerable, frail, and wholly dependent on those who wash them, care for their personal hygiene, and feed them. The stakes could not be higher. The true stakeholders should be the person requiring care and those providing it, not organisations making enormous profits by charging an average of £1,400 a week for a basic room for a person living with dementia. Too often, the quality of compassion provided is dependent on whether an angelic care worker is on duty or someone who is simply there because they need a job.

As for those working in the care and nursing sector, we need to address the imbalance in their pay. This is not work that should attract little more than the minimum wage. Those of us who have cared for a loved one know that no financial reward can equal the love, patience and gentleness required to care for a vulnerable person. Yet this country has saved billions through unpaid and largely unrecognised carers who receive little more than a token payment in carers' allowance.

Very few family-run care and nursing homes survive, but those that do, and I speak from personal knowledge as there is one such home in our area, develop reputations so strong that they have waiting lists. Anyone who has had to make care arrangements knows that these decisions are often made in the midst of a crisis rather than through careful planning. Yet if we cannot care for ourselves, we will need care. None of us can honestly claim that we will never require such support.

During the years when I found myself as my father's primary carer, I learned about NHS Continuing Healthcare funding. For obvious reasons, it is not something widely discussed. It is not means-tested and is available where a person has a primary healthcare need. The decision support tool used to assess eligibility is often applied subjectively by those carrying out the assessment. It is rather like saying that the outcome of a court case depends on the judge you happen to appear before.

My father qualified for this funding two days before his death, and I chose to reject it. However, for many families, that non-means-tested funding could be the difference between keeping a treasured family home or being forced to sell it. It could mean the difference between dignity and unmet need for a frail person. How we have become so desensitised to this injustice as a society is astonishing, and not in a good way. The Prime Minister is right when he says that Accident and Emergency departments are inundated with people whose real need is social care. Hospital beds are occupied by people who could be cared for in the comfort of their own homes if only social care services had the resources to meet demand.

I have not given up hope that one day we will have a joined-up and genuinely integrated NHS and National Care Service. Achieving that will require political courage, a shared national voice, and a willingness to make personal sacrifices. We cannot say no to a right to assisted dying and not fix this.

Daxa Manhar Patel is a leadership coach, author and solicitor.