We think of our NHS, and Social Care, as a philanthropic safety net, for those, who need protection or help; the old, young, sick, vulnerable and poor.
We do not think of the profit, that this unaccountable, monopolised service of captive consumers represents.
But successive governments have.
Over the past 20 years, they have commoditised ‘need’ by pernicious ‘modernisation’.
The ‘modernisation’ of ‘Charity’, began with the Charities Act 2006 which created a politically controlled, all powerful, Charity Commission enabling the restructuring of independent philanthropy, into ever larger, corporately run, political bodies.
The ‘modernisation’ of the NHS, by asset stripping, marketization costs under the Health and Social Care Act,private/public partnerships, healthcare consortiums, destructive targets and ever tighter budgetary control.
The ‘modernisation’ of local authorities, by public/private partnerships, the amalgamation of health and welfare into local health and social care trusts that mixed budgets and roles.
Our government is now fulfilling its ultimate goal; health and social care services are to be made part of a private equity portfolio, available for global investment, boosting private wealth, and economic growth.
Enabled, by LA budget cuts, and targeted ‘safeguarding’, and protection, to produce an ever increasing ‘client’ base, via social services, local courts and MASH- Multiagency Safeguarding Hubs that act now in all areas, coordinating all care and information to harvest captive social consumers.
Our most needy, at the mercy of our most greedy.
Social workers and courts act as assessors and enforcers, herding the needy, into adoption, foster care, mental hospitals, care homes, and supported/community living.
More and more, are harvested, to fill the institutional ‘homes’ being built by venture capital, diverting huge sums of public money into private investment houses, increasing, not decreasing the nation’s deficit.
Why is venture capital/equity being used?
As its name suggests, venture capital, is funding of last resort, to enable small, risky companies to grow, where the risk is too high for conventional backers, but, if successful, likely to reap huge profits for investors ie IT innovations.
It is not used, to build up services, for an existing, publically funded, and ever increasing client base– the ‘needy’- with no future risk.
As David Porter, managing partner at Apposite Capital, a specialist healthcare investment firm, said
‘The UK has emerged as a favoured market thanks to its peculiarities’.
“The reason we focus on healthcare services in the UK is that there is a huge opportunity if you can navigate your way around it successfully. You have this globally unique system where 90% of healthcare is paid for by the government, and the NHS has a zero-growth budget despite demand growing’
Simon Stevens, a senior executive and board member of UnitedHealth Group for ten years from 2004 until 2014, and President of Global Health in 2009 was made the director of NHS England in 2014
So, our hard fought for NHS, the envy of the world, is used to obtain a guaranteed, continuing investment profit, with rich pickings of its most profitable services.
And, unlike America is not based on insurance, so effectively unaccountable for its services.
We are left, with the perfect business model, services, provided by a few monopoly companies, made too big to fail, receiving guaranteed, and increasing, government controlled consumers and funding.
No competition, no possibility of complaints, and effectively self- regulated.
80% of the residential care sector is privately own, and these companies are being taken over by venture capital and the remaining 20% NHS public is being privatised.
In the first six months of 2012 alone, Terra Firma Equity, bought nursing home operator Four Seasons Health Care for £825million; Omers bought Lifeways care of 1500 learning disabled adults including Thomas Rawnsley, for £207 million, Castlebeck ( who owned Winterbourne View ) providing ‘specialist care’ for autistic/LD was asset stripped and Bowmark Capital, bought Hesley North, a provider of autistic residential care and education for £75 million.
Several Care UK homes were being investigated by CQC after being taken over by venture capital see http://www.ft.com/cms/s/0/243543e4-586d-11e4-a31b-00144feab7de.html#axzz47mj5lM45
And what huge profits can be had, from public services, particularly mental health https://finolamoss.wordpress.com/2015/08/01/st-andrews-healthcares-recycled-income/
And, millions lump sum payments, to managers on venture capital purchases.
http://www.thesundaytimes.co.uk/sto/business/Companies/article705103.ece
Special Needs Education, Adoption, Fostering, and Care Homes
And, look at how the remaining independent parts of the care sector, were analysed as rich pickings, in an investment advice report;
‘All independent sector providers of special education, and children’s social care, together generated annual revenues estimated at £2.0 billion in 2011, representing 23% of the estimated total market size (independent and public sector providers combined) of £8.5 billion a year
Within the fostering sub-segment National Fostering Agency (NFA), now backed by Graphite Capital and formerly by Sovereign Capital Partners, is the largest private equity owned provider with revenues of £54 million in the year to March 2011/12 within a £1.5 billion market, which was 43% outsourced to the independent sector in 2010/11.
Being ‘asset light’ this sub-segment has relatively low capital requirements.
Private equity backed companies, have nevertheless been active in recent years in building the key component of capacity, which is the number of available foster carers.
It is widely recognised within the sector that the number of foster carers is the principal constraint ( note not the number of children in need of protection) on the further expansion of fostering as a lower cost and arguably higher quality substitute for residential care for looked after children’.
https://www.laingbuisson.co.uk/Portals/1/Media_Packs/Fact_Sheets/LB_PrivateEquity_2012.pdf
A fixed fee of an increasing minimum £30,000 per adoption is paid per adoption, maximum is discretionary see the figures for fostering in this article
And here the massive scale of the money being given to grow the fostering industry is exposed by corporatewatch here
. https://corporatewatch.org/news/2015/dec/15/foster-care-business
‘We have found millions of pounds that could be reinvested in the care of children are instead leaving the system as bumper payouts to shareholders. Directors enjoy very generous pay packets, while some companies are siphoning profits out through tax havens in the Channel Islands and the Caribbean’.
If foster carers are the only restriction on industry growth, then Care Homes can be built.
An average placement in a home, costs over £150,000 per year.
Independent sector providers of care homes for younger adults annual revenues, were estimated at £3.9 billion in 2011, dominating the segment with 82%
Self Regulation and Quality Control
‘Each of August Equity’s portfolio companies, Active Assistance, Enara and Lifeways, has an independent Quality Board which takes independent decisions on quality related issues, such as health and safety and staffing levels for specific purposes.
The Quality Boards are independent and are made up of service users and professional leaders. This effectively means that August Equity and its portfolio company managements have ceded control of spending on quality to quality ‘champions’.
Most care home/supported living owners, now have a representative on the local Safeguarding Authority Board.
UK is European leader in Venture Capital Growth deals.
‘Most of the other noteworthy add-ons in the period occurred in the UK. These included OMERS Private Equity-backed Lifeways Group acquiring the learning disability division of Care UK for an estimated £66 million.’
Tax Incentives for venture capital
UK early stage investment is heavily driven by the substantial UK governmental support, provided through the SEIS (Seed Enterprise Investment Scheme), and EIS (Enterprise Investment Scheme) tax incentives (Venture Capital Trusts also play a role).
http://www.notioncapital.com/blog/the-differences-between-uk-and-us-early-stage-venture-deals/
When Omers, Cambian, bought Lifeways for 403 million, Mark Redman, the senior managing director and country head for OMERS PE Europe said.
‘’The Supported Living market offers considerable long term growth potential and increasing barriers to entry ( no competition) as the social care and independence benefits of this approach become ever clearer ( only government policy for disabled adults) .
Lifeways perfectly fits our investment criteria: it is a market leader in every respect with a proven track record of top quality service (where and by what criteria), and profitable growth both organic and via acquisitions, in a market with sound long term growth fundamentals,”
So, from the care of 1500 learning disabled, in enforced supported living, including the deceased Thomas Rawnsley, the investors, in these ‘commodities’, got substantial tax breaks, a minimum £4,000 per week, six figure management salaries, and millions in buy out payments- all public money, in a time of deep welfare cuts, and austerity.
And what do the learning disabled get?
A service, neither they, nor their family can complain about, or choose, minimum cover, itinerant, zero hour workers, who are transferred with decreasing wages
team leaders, and managers, food , cage and medication, resulting in, even more profit, for the pharma industry.
And, let us not forget, our governments personal connections with the profit made by the healthcare sector
.http://socialinvestigations.blogspot.co.uk/2012_05_01_archive.html
Cambian have also bought the Hesley Group which provided residential education for LD/ASD and services.
http://www.cambiangroup.com/cambiangroup/investor/history.aspx
finolamoss 
‘Our most needy at the mercy of our most greedy’. That short sentence says it all really.
What a wonderful eye opening exposure you have achieved Finola when you write about what is rotten and ugly in our government today. A government that rubber stamps private gain at the expense of vulnerable people. Their avarice knows no bounds. How low can they go? What an awful future our learning disabled loved ones have to look forward to.
Thank you Pauline, this is very much appreciated.
It is beyond obscene, and belief, that our most vulnerable, are treated as the ultimate commodity , no one caring for them, and, yet making so much money out of purporting to.
And, parents, nor children at 18, have any rights.
You will not find, another country in the world, where this happens, as no one else as far as I am aware has the MCA, so worse still, it has been deliberately created, by successive political governments of all persuasions, for profit.
And,,,,,,, uses the excuse of cutting budgets, for the disabled!
It is total dishonesty.
An autistic living with his parents gets £103 DLA, and his carer get £63 a week, this is the figure now, and has decreased 20%.
The carer, gets no support ,respite, as Carers Assessments do not lead to support ,unless caring has a severe effect on welllbeing,
if this were the case, there is then evidence to remove the cared for, which is the HSC/LA only policied support.
Once in private provision, on average £4000 per week and drugs bill, to allow most efficient, factory care, and the’ cared’ for, becomes an audit statistic, with no accountability for services, even death.
So, costs less than £200 a week at home, £4,000 + a week in private venture capital cages………………….
Best Wishes,
And thank you once again
Finola
the latest from the care provider £2,400 a week. Yesterday Martin texted me to say he had shingles he was not very well, had medication to help, had it since last weekend. For over a year I have been trying to engage the Home’s complaints process, so I send them yet another fax “please put your formal complaints procedure in place immediately. Martin has been ill since last Friday and no-one has told me” Phone call from Responsible Individual this morning, I say Martin has shingles he says he knows Isay since when he says since yesterday I say how long has he had it he says he doesn’t know I say what medication is Martin on he says that is private, I say no it isn,t, he says I am not going to tell you that – I am going to terminate this conversation and HE HANGS UP ON ME. he hangs up on me the **********. I can trace every pound of the million that has been spent on Martin’s non care. Martin was declared not to have capacity by the Court of Protection, yet he can text as above.
This is exactly, why the Mental Capacity Act was passed, as well as, making billions for lawyers, and sequestrating billions of private assets, and, income for the Public Guardianship, etc, to render people ‘incapable’, so that any service, medication, housing, can be imposed upon them, without any possibility of a complaint.
Not only, is it a huge, unaccountable money spinner, and property acquirer, but its services, are the perfect business model, as rip off services are possible, for maximum government funding ie a huge profit margin.
Its an ingenious way of making a guaranteed gravy train, doing little but rubber stamp for so many, and a permanent income, and huge profits for investors.
But to use the law, and people in this way ??? There is not a word for it.
And, to live, as you and Martin have to, as do now millions, and increasing, is unbearable.
My thoughts are with you, and the horror you and Martin, are forced to endure..
Best Wishes as always,
Finola
Sorry, Shirley, I got so enraged, by the state’s treatment, of an elderly mother, trying to ensure her son was being adequately cared for, on the excuse of Martin’s ‘privacy’, when that same state, affords him no choice, autonomy, or freedom, and, have, effectively declared him a vegetable, and removed all his legal rights and status.
What utter hypocrisy, and utter nonsense, then, to worry about his ‘privacy’.
We also have s4 MCA, which states, they should give effect to an incapricious person’s wishes, and, I am sure if Martin, were to be asked, he would tell this Responsible whatever, that he wants you, to know what his medication is.
That, I forgot to say, I hope it clears soon, as it is very painful, and nasty, and caused by nerves, probably as a result of the way, Martin is, so expensively, forced to live.
Best Wishes,
Finola
Thanks Finola for being so enraged – its the best reaction. I’m very worried because the shingles virus affects his epilepsy. Martin already has an impaired immune system anyway, and the virus puts him even more at risk. I sent the home message after message to say he wasn’t ok. all ignored. Its 10 years now this has been going on God help us and our sons and daughters
I didn’t think of the effect on Martin’s epilepsy..
The MCA encaged, NEED more medical attention, and get far, far less, if any just cursory perfunctory examinations by a practice nurse, and the inter action of their various medications, needs careful monitoring and, in the factory, all for more efficient care venture capital backed cages, they are increasing being herded into, with not even a check on their deaths,,,, this is not happening.
How can this possibility be in theirs or Martin’s best interests ????
The effect of encagement on their mental and physical health, isn’t even considered, let alone the effect of treatment.
And, for parents like you- you don’t need reminding I know, it is a living hell. In fact, its difficult to think of a worse one.
[…] via Venture Capital NHS, Care Services, our most needy, feed our most greedy. — finolamoss […]
Thank you
Reblogged this on Wessex Solidarity and commented:
What seems to be going on is that as technology makes actual production less profitable and progressively devalues wage labour, those individuals found unsuitable for the extraction of surplus-value in the conventional way are becoming commodities, in fact raw material to new ‘industries’. These don’t produce anything of course, and the advantage to the bourgeoisie is that the raw material remains unchanged by the process.
Profit-making providers of health and social care, rehab, training, unpaid work placements and penal facilities all have a vested interest in holding back the ‘client’ who is of course nothing of the kind.
Where the service is purely maintenance of the individual concerned, they seek to minimise the cost, whilst charging the maximum they can get from the taxpayer. Behind all this are people with company cars, plush offices, lunch accounts and all the bureaucrats, auditors and so on that goes with it. Charities are no exception to this, though some may be better than others.
Care is strictly an obligation on the social organism, not a commodity, nor are the carers or their carees, but capitalism has made it so.
Thank you for your comment and reblog.
This is worse than capitalism, I’d say it borders on extortion.
And governments of both persuasions, have conspired to produce this horrific use of both service users and workers, as investments for maximum profit, now from Canada and USA..
There is not even a proper list of deemed approved care providers, and it appears, they can charge a fortune, average £3,500 a week for their ‘care’, whilst families have no support at home, and are paid £103 DLA, and £62 carers allowance.
See my latest post,. It is only through disgusted workers, that we can find out what the service provision is like.
Best Wishes, and thanks once again,
Finola
Reblogged this on danutag57.
Thank you for the reblog.it is much appreciated people should be made aware that it is not ashortage of money for disabled but indeed making money from them via spending of huge amounts of public money but not for disabled with their family nor even on them per se.Thank you Finila
I really appreciate all your blogs Finola and agree with what you write having direct experience of what has gone on in my son’s life. The huge dysfunctional health/care and education support systems need going through with a fine tooth comb, especially the private sector businesses many of whom exploit the needy and vulnerable for their greed and profit as you correctly state in your blog and they are allowed to continue and expand their poor services, lies against families and unaccountability – cruelty and incarceration of the vulnerable behind closed doors continues. Inspections need to be more rigorous and families and staff genuinely consulted and involved.
Shambolic System. Stand up for Human Rights until our last breath!
Thank you, Finola.
I see huge cost for my son’s placement for years producing poor returns – neglect and permanent damage so far.
We family are damaged too by his ‘care’, need it to be better for him so we all get better.
We save money.
I do a lot of the work, give him 15 hours a week of real care (or 15 hours of life I should say), get the paperwork improved for the provider because they don’t even try, and staff are only capable of doing 10% perhaps?
They do the 10%, complete shifts, go on holidays, one accused me of moaning about everything, when in fact I pointed out things that were dangerous.
Even some relatives of disabled people themselves run businesses (as one of our ‘care providers’ was a relative of a person with autism), not caring for others’ children, so I think the care must be at least 50% under family control if family input is real.
I can get a personal budget I’m told, deputyship, etc., but need to compile a list of time taken to do paperwork, provide care, what that care is, etc., to evidence our input.
Facts are gold.
High fees are okay if care is okay, NOT if it isn’t. Your slogan is true for most services, and for every service we’ve had. It can’t go on.
I think the Chinese say you can’t fool all of the people all of the time.
The system is only going to get worse, as with adoption/fostering, it is a growth industry ,fueling our economic growth,
This means, deputyships will rarely if ever, as they are now, be given to a parent/family member ,unless a child is severely physically disabled, and therefore, not as profitable.
Anyone autistic/LD/behavioural, is hugely profitable, just need to lock em up and drug them, that is why mental health, is being pursued everywhere- schools, prisons, police stations.
Deputyship, in any event, retains total control by state, as can be revoked at any time, and enables an increasing income via fees for the state.
Care workers, unless they are truly independent of state, how do you find these ? and there is competition between families needing them,do not need to care, all now are controlled by state, so are trained to find issues etc and naturally disrespect parents, as they know they have no power.
You ,and any parent, who is fighting to maintain decent care for their child/adult, are fighting a losing, soul destroying battle.
If they do set up their own company to care for their adult/child ,it can only be allowed, at the behest of the LA/HSC, and at their mercy, ie you would have to be well in, and, a player..
And by doing this, you are also feeding in to the existing to independent living remove, all decision control under MCA system,
And, for how long would your company exist, before it was bought up by the big boys ,and you, and your loved one lose all control/?
The modus of care, was small private companies, which grew bigger like Lifeways/ Cambian, and were then taken over by venture capital.
So all care is a fluid commodity, which becomes worse, as more profit is forced from it ,with no accountability
The future is factory care as large as possible same with mental health hospitals like St Andrews.
All powerful monopolies making as much profit as possible and unaccountable and forming a wonderful investment for international pensions etc. .
Beyond terrifying future for parents and the vulnerable.
I have just written a reply to your first comment when I saw this one so will paste it here and come back to this one.
The numbers, like you, me, and our children/adults, are increasing and unheard, and totally ignorant of what is really going on.
Here’s comment I’ve just written before I saw this one
It is sadly, and far too depressingly, more fundamental, than getting inspections of care homes, and more input from families.
Basic question is, why should the only transition, for any LD/Autistic now even behavioural problem 16 year old, be the misnamed removal from family ‘independent’ living route. ?
And, why should parents, and more crucially the ‘disabled’ ,have no rights.
The parents to their children, and their children, at 18 no rights to make even their most basic decisions ?
All now is efficient controlled Pathways.
Once you get a label, you are doomed to a controlled life at the mercy of the state, and care workers whims.
Unless, you are rich enough/canny enough to go to a private school.
All this has been planned since MCA 05.
We need to get rid of removal presumption, reinstate respite, proper education in schools again to 18, proper unspying services in the home via decent direct payments,
There must be parity between the £4000 per week to venture capital, and, the £170 per week to disabled and family care 24/7 at home.
But now 3 successive governments, have furthered this cash cow policy, and Carers Act continues it, the units have been built, the carers ‘training’ set up in universities etc
You are fighting a mutibillion pound industry, all those who feed in , the law, the courts, and the lawyers who get easy, reliable work under COP, accountants, experts, effectively everyone.
So where would you start ?
best wishes,
Finola.
Sorry if I still sound naive after all you’ve said so clearly, but in case bad providers are reading this, we should look at what Supported Living is meant to be about, even if it often not that..
We need to start by looking at research. Only 3 things help any human being; hope, opportunity and sense of agency.
All mental wellbeing checklists tell us all to stay close to family, so how can it be different only for our children?
Care is not supposed to be in factories, or separate from families, and care managers should not be able to avoid parents much as they might want. They can’t.
Parents can speak the same language as professionals, and throw a spanner in the works as needed to press reset buttons.
No parent I know would criticise good care, but people who can’t speak for themselves get by far the worst deal. Why?
I believe psychologists often sit on the sidelines and let psychiatrists be the focus, letting the medical model be the only tool, rather than do any work themselves looking at total communication as speech or symbols are often not used correctly by SLTs, and body language is 80% of our communication.
The whole idea in the last 20 years was to make ‘care settings’ be as normal as can be.
It’s NOT therefore normal for anyone (especially if unwell) to have family become estranged.
And it’s NOT right for a very complex person to have care met by shift workers.
So compromises should be whatever makes the person happier. That is all that should matter, as a lot of money will be paid anyway, whether it’s a good job or bad.
We only have to question staff to see how skilled they really are, as where Supported Living is done properly, parents employ their own workers anyway as they recruit.
I employed excellent workers for over 12 years with direct payments. They were students and did a much better job than anyone now does, and they complemented me with their fresh approach while still following my instructions. We were a perfect fit.
I work in the system (as well as have my child receive services), and see the best care happen for those who can speak (best relatively speaking).
see the best care happen for those who can speak (best relatively speaking).
Whether they can speak, or not, there is a total inequality of power, as there is no accountability for care, within the present system, as we have seen by Thomas Rawnsley, Winterbourne.
And, there will not be, as ‘care’ provision is, at present, the perfect business model.
The HSCT/LA, commission the services, there is no choice, or ,competition.
Those commissioned, are the large, ever larger monopolies like Cambiam, Acorn Care etc, same with schools.
And, if that service is inadequate, even totally abusive, nothing can be done. Parents/ consumers cannot sue.
The commissioner HSC/LA, systemically via their management, cannot acknowledge even abusive , let alone inadequate service, as this would make them legally liable.
So, until some accountability, is placed into system, there is little point, in wondering how best to allow the disabled the best life possible.
As it is not going to happen. As all is about creating and sustaining a profitable industry.
At present ,the system, is merely determined to make as much money as possible, via large cages and zero hour staff.
We must also wonder why, we treat autistic, and learning disabled, as so ‘disabled’, and term them ‘complex needs’.
We, by doing so, are creating an industry, to feed into for profit, and deliberately making some people disabled, and labeling them for our own benefit.
That is graphically illustrated, if you were to see the same children, grow up in the private school system.
Would they then finish up in care cages, and far less would have been spent on them, than in special needs state/private/charitable schools.
See book ‘Bring in the Idiots’ about a private school for such ‘disabled’, who then went on to be IT specialists, writers and political speech writers.
And did not finish up having every decision made for them in 24/7 surveillance ‘care’
The challenges are huge.
Deliberately making people more disabled is definitely happening by design, and the term learning disability doesn’t help either, it’s insulting as it writes off people as though they have no ability or intelligence (even though there are many types of intelligence) and careworkers have no respect.
Careworkers themselves don’t have education to understand or skills to look after people with ‘complex care needs’. If they have, they should prove it, have outcome measures, ability tests, etc.
At the moment a tender is put out and businesses put in bids – it is vile.
This is the lie in the system: if there are ‘complex needs’, the carers should be expert. They aren’t. This must be challenged.
There are small services not all bought up (yet) by the big businesses, and we do have to create new models, our own small businesses, or otherwise what do we do? No one’s doing it for us.
But, we/parents, do not have any control over the funding of anyone cared for after 18.
All are being deemed illegally ‘incapable’ under the MCA, either formally or informally.
Once this happens, the Carers Act provides that only approved ‘care’ will be funded.
None, other than the state- via LA/HSCT, has any input into this ‘approved care provision
So how can any of this be achieved, the care model, is coming from the government ,in legislation like the Carers Act, to tick box training and care, so that it is managerialised from top down, and totally prescribed, and very much on paper, to maximise risk aversion, and self preservation, and maintain a structure, to allow for the most efficient, itinerant, profitable care.
Vulnerability, is being created, to serve as the excuse to claim billions for their care, which must sadly be as profitable and unaccountable as possible.
Why? Because, they/government are allowed to, and have been allowed to get away with it.
Reblogged this on | truthaholics and commented:
“Social workers, and courts act as assessors, and enforcers, herding the needy, into adoption, foster care, care homes, and, supported living.”
‘We have found millions of pounds that could be reinvested in the care of children are instead leaving the system as bumper payouts to shareholders. Directors enjoy very generous pay packets, while some companies are siphoning profits out through tax havens in the Channel Islands and the Caribbean’.
Thank you for your Reblog it is very much appreciated.
As you say the modus is to siphon off all public funds into a few monopoly corporations to provide ‘services’ which are enforced, prescribed for maximum profit and unaccountable.
It is merely about obtaining as much profit as possible by ripping these services off which is easy as there is no effective regulation.
And merely an accounting/auditing exercise of buyouts set offs and not only do they use our money for effectively abusive/non-existent services but they avoid tax on their profits.
So we are being mugged and ripped off and as these policies polically have been planned for years and are cross party who do we appeal to ?
Reblogged this on World4Justice : NOW! Lobby Forum..
Thank you for your reblog it is very much appreciated.