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3 April 2020updated 11 Apr 2020 9:28am

Could social care become the new front line in the coronavirus pandemic?

"With all the rightful focus on the NHS, social care hasn't had the attention it desperately needs. We've got to stop seeing the NHS and social care separately."

By George Grylls

Last week, the Spanish government ordered soldiers to go out and disinfect the country’s care homes. Upon arrival, the soldiers made a horrific discovery.

“The army, during certain visits, found some older people completely abandoned, sometimes even dead in their beds,” said Spanish Defence Minister Margarita Robles. 

As the coronavirus overwhelmed Spain’s public services, carers had seemingly took matters into their own hands when residents began displaying symptoms of the disease: they had simply walked out. Indeed across Europe, the coronavirus pandemic – which disproportionately endangers the lives of the elderly – has fallen hard on social care.

“With all the rightful focus on the NHS, social care hasn’t had the attention it desperately needs,” says Liz Kendall, the Labour MP for Leicester West, who previously served as shadow minister for care and older people. “We’ve got to stop seeing the NHS and social care separately. The chancellor was right to say we’ll do whatever it takes and give whatever resources the NHS needs. But unless you have a properly functioning social care system the NHS is not going to be able to work properly.”

Many countries have excluded deaths registered in care homes from their official counts either because they struggle to test cases and report them, or because they actively choose not to do so. France does not count deaths that occur outside of hospitals; neither does the UK, where the ONS has begun making a separate tally to make up the shortfall. As a result, the scale of coronavirus’s impact on social care has had to rely on anecdotal evidence – the steady stream of hearses dropping off coffins across Paris, the 17 people who died in one care home in Wolfsburg, the grisly discoveries of the Spanish army. 

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Now, similar stories are appearing in the UK. Oak Springs care home in Liverpool reported six deaths and 54 staff displaying symptoms earlier this week. Oaklands care home in Hove reported 15 out of 20 residents suffering symptoms, with one man losing his life. In response, the local Labour MP, Peter Kyle wrote to Boris Johnson saying that “testing social care workers must become a priority for the government without delay”.

“None of us have had any testing,” says Sarah O’Connor, who works at a care home in West Yorkshire. “We’ve had two residents who have potentially had it. But no testing. No admission to hospital. We were just told to isolate them in their rooms.”

While a delivery of surgical masks was welcomed by the staff at the care home where O’Connor works, they have not yet received the full personal protective equipment (PPE) they have been clamouring for – no gowns, goggles or visors. With no time to formally collect data, the union Unison has contacted its members in the social care sector and found that 77 per cent of those who complained of lack of PPE last week were yet to see any improvement this week.

“We’re putting ourselves as much in the firing line as the NHS are,” says O’Connor. “These homes are going to end up at some point more like hospital wards caring for very sick people who will end up dying there. We’ve already had directions – I haven’t seen it written down – but basically none of our residents will be admitted to hospital no matter how ill they get.”

As a former NHS worker herself, O’Connor is also angered that the employment protection she used to receive in her public sector job is not matched in the social care sector. Previously, if she had fallen ill, she would have received full pay for up to six months, and yet now she is only entitled to statutory sick pay (SSP) of £94.25 a week, which she says is not enough to live on.

“The government needs to take steps to make sure people in social care are not feeling financially pressurised to go into work,” says Gavin Edwards, a social care officer at UNISON. “Obviously they are providing care for people who are predominantly in the ‘high risk’ groups.”

“There’s also two million people in the country who earn so little that they don’t even qualify for SSP,” adds Kendall. “A quarter of all care workers are on zero-hours contracts and that rises to 48 per cent of home care workers.”

(See also: Covid-19 will expose a gaping hole in Rishi Sunak’s budget)

As in continental Europe, a parallel front line could well develop where, under-counted and under-reported, care homes share the coronavirus burden with the NHS, but, because employees lack many of the same employment rights as their colleagues in the public sector, sick staff could continue coming into work with little or no protection.

“We see our hospitals, we see our GP surgeries – they’re very visible and they rightly have very organised, effective people representing the NHS and the professionals who work in it,” says Liz Kendall. “A lot of people working in social care are very very low-paid women looking after our elderly mums and dads. It’s typical that society doesn’t value care – it’s seen as women’s work.”