Selling England by the Pound

[Brian Peacock]

[Scot Dutchy]

I like her car crashed. It suits her...

[L'Emmerdeur]

In other news, chemical compound H20 is determined to be likely contributor to states of dampness.

'Outsourcing adult social care has contributed to England’s care crisis, argue experts'

Outsourcing adult social care services in England to the private sector since the 1980s has led to worse care and should be rolled back, argue experts in The BMJ today.

Benjamin Goodair at the Blavatnik School of Government, University of Oxford and colleagues suggest that removing the profit motive would help improve quality and reduce inequities.

Social care, sometimes referred to as community, residential, or personalised care, for older people and people with physical and mental disabilities is facing record demand but performing worse than any time in recent history, they explain.

One contributor to this, they say, is the outsourcing of care provision from the public to the private sector. Figures suggest that the share of publicly provided adult social care has fallen by 56% since 2001.

Although competition from private sector provision was championed as a solution to achieve cheaper and better quality care, the authors point to evidence from the past few decades in the UK and elsewhere that challenges this view.

For example, international evidence shows quality differences are seen when private companies take over public services, suggesting that the same locations run by for-profit companies do worse.

These quality differences are found in many countries and in many different measures of quality, such as lower staffing rates or forced closures of care homes (an action of last resort when residents’ safety is at risk) suggesting that the for-profit gap is robust to different measures of quality.

[Brian Peacock]

Its a mess. Creating middle-markets between the commissioning of public services and their delivery was supposed to generate competition but it's simply led to more routes for the syphoning off of public funds to the private sector, and nobody seemed to have considered that creating and outsourcing those roles would end up in the hands of a few major players operating across every their - and therefore functionally capable of setting the prices they effectively charge themselves.