Beating up, humiliating and neglecting the old and vulnerable

The appalling revelations about care homes are shocking, but not new. I watched Question Time last night and was revolted at the attempts of Stephen Dorrell to claim that whether a care home was privately owned or part of the NHS was irrelevant. His attempts to lay it all at Labour’s door (Labour are not free from blame) were desperate, and pathetic.

The Tories, despite their protestations to the contrary, are always in favour of outsourcing vital services for private profit: it is an article of faith with them.

Here are some hard facts, the realpolitik of private profit. In private organisations run for profit where labour costs are not the major part of operating costs, it is possible to recruit employees by a selection process that properly assesses their fitness to carry out the tasks they will be assigned. Effective selection processes are not cheap - they require professional human resources staff and effective selection procedures, including where relevant, psychometric testing.

(As a human resource professional in industry for most of my working life, I used psychometric tests in a test battery designed to assess skills, aptitudes and personality factors relevant to recruiting employees who would interact with people. These tests were not cheap to licence or to apply. If they were relevant to, for example, sales people and customer service employees, they sure as hell are relevant to people carrying out the demanding and stressful work of dealing with the handicapped, the old, the senile the confused and the vulnerable.

How many private care companies use them? Indeed, how widely are they used for this type of employee in the NHS?)

Employees thus selected are therefore equipped physically, intellectually and emotionally to carry discharge their roles, and may also require formal qualifications. Having recruited them, it is almost always necessary to provide further training, including induction training and specialised skills training relevant to the organisation and the demands of the job. That training has to be constantly refreshed and updated.

To find the right employees, the organisation has to offer a remuneration and benefits package sufficient to attract and retain them.

In an organisation where labour costs are the major part of standard operating costs, all of the above costs have to be balanced against the profit objectives of the directors of that organisation.

To put it bluntly, where labour costs are the dominant costs, the goods or services the organisation delivers must be hugely profitable to justify all of the above procedures of recruitment, selection, training and remuneration and benefits. Examples are the law - legal firms, football clubs and high profile brands or hi-tech industries with large profit margins.

Health care - care of the elderly, the chronically sick and the mentally ill or senile - is a labour-intensive, high labour cost industry. When it is run by essentially amoral private companies, the only way to achieve the profit margins required is to either aim at the wealthy and charge high fees, or accept government subsidies and keep the payroll costs as low as possible. Even when government subsidies are adequate, a greedy company will still drive down labour costs.

This commercial cynicism might just be tolerable in an industry supplying a commercial non-essential product or service, but it is not acceptable in a civilised society when applied to the care of human beings.

That is why private health care is never - I repeat, never - an acceptable solution for those who cannot afford to pay inflated fees to private providers.