Edinburgh care worker sends open letter urging halt to further transfer of long-term care to private sector

A care worker has sent an open letter to members of the body in charge of the Capital’s health and social care, urging them to stop the further transfer of long-term care to the private sector.

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As the Edinburgh Integration Joint Board (EIJB) meets today to discuss plans to close five council-run care homes, Ross McKenzie claimed the evidence for cutting the number of council-provided long-term care beds by over 200 was “flimsy at best”.

And he said provision would instead move to private-sector homes, most of whom operate in a way that is “bad for staff and bad for residents”.

Drumbrae care home is proposed to close as a care home and switch to medical care

In his letter Mr McKenzie said he wrote as “a concerned Edinburgh citizen and long-standing employee of NHS Lothian” who had carefully read the Bed Based Care: Phase 1 Strategy Report, on which the closure plan is based.

The report proposes an increase in “intermediate” care beds – mainly for people who have completed hospital treatment but need further care before going home – but turning the council’s remaining residential care homes into nursing homes, claiming there is no longer such demand for residential care and arguing more people should receive care at home.

Mr McKenzie continued: "When I started as a care assistant in Liberton Hospital in 2005 there were over 180 beds there, with Astley Ainslie providing a similar number. As these two hospitals have seen their capacity reduced steadily over the past decade, it is no surprise to learn that Edinburgh now has a shortage of intermediate care beds with consequential delayed discharges from acute wards.

“Part of the solution offered by the EIJB involves a huge reduction in the public provision of long-term care in Edinburgh. The evidence offered in support of this decision is flimsy at best – low care home occupancy rates which are clearly influenced by the pandemic, anecdotal evidence of ‘recent thinking that care homes are no longer seen as long term accommodation choices’, and an expectation that buildings will not meet Care Inspectorate standards in the future. Surely a more serious analysis is required before the removal of over 200 long-term care beds?

“Where is the vision for the future of long-term care in the face of demographic changes that we know will create an increase in demand in the coming years? Surely an integrated health and social care body is able to respond to these challenges by proposing a new care home model for the city which sees registered nurses compliment the current council workforce?

"Instead, it is clear that the buck is being passed to the private sector, perhaps to Four Seasons which is already established as an EIJB partner.”

He said he had looked for care assistant jobs at Four Seasons in Edinburgh.

"The only jobs available are 'Bank Care Assistants' on zero-hour contracts who will need to travel within a 30-hour radius of the city to pick up shifts with no reimbursement of travel expenses. They do, however, receive a free uniform and free training, something that many of agencies used by private care providers do not offer.

" This is the staffing model that dominates in private provision of long-term care – it's bad for staff and it's bad for residents who often receive personal care from different people each day, with few opportunities to establish the relationships with staff that are integral to any of model of person centred care.”

And Mr McKenzie concluded with a plea to the EIJB members: “I urge you to do whatever you can to stop the further transfer of long-term care to the private sector, beginning at this Tuesday's EIJB, by rejecting the proposals to close Liberton Hospital, withdraw from the Ferryfield PFI, and approve the change of purpose for Drum Brae Care Home. Regardless of the individual merits of those proposals, they are founded on an strategy does not put the needs of care home residents and health care workers first.

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