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NCF’s response to Care Quality Commission’s report on the state of health care and adult social care in England 

The National Care Forum (NCF) – the leading association for not-for-profit social care has responded to the publication of the Care Quality Commission’s report on the state of health care and adult social care in England. 

Vic Rayner, NCF CEO commented: “The CQC report lays bare the reality that the notion of a ‘care market’ was flawed from the outset. The outcome of systematically underfunding local authorities, who in turn have not paid the actual cost of delivering care, has brought us to a place where profound health inequalities for individuals and communities are now compounded by profound care inequalities. The CQC’s unhelpful adoption of market terminology around services means that we are faced with a government regulator explaining that inequities are fuelled by providers not delivering publicly funded care because it is ‘less profitable’. The reality is that providers are not able to provide care at the rates that local authorities can pay, nor can they provide quality services at these unsustainable rates. They cannot staff services where they do not have enough funding to pay staff, nor can they innovate and invest in buildings and technology to ensure that we have care services we are proud of and are fit for the future, as well as for the present. They are also unable to deliver the services those who draw on their services want.

“The language of profit, and the extraction of profit have no place in the delivery of public services. Yet, the persistence of a market ideology enables politicians at a national and local level to stand back and watch. The report makes absolutely clear that the market cannot regulate itself, and that Local Authorities have a sustained inability to fund services for the actual care that they deliver. This has embedded a level of disadvantage and exclusion that is unfair. Furthermore, the CQC report highlights the systemic failure of market forces and suggests that ongoing efforts to address the ways in which systems work will never succeed until we move away from allowing the notion of profit making in care to hold sway as an acceptable response to meeting a statutory, and moral, right for the most vulnerable members of our communities to receive care.  

“Over the last 10 years, since the vital review by Sir Michael Marmot, we have got better at understanding the long-term impact on people who are experiencing health inequalities. This report begins to unpeel the realities of living with care inequality, and the long-term prospects for people and communities who are already excluded from receiving the quality care that they need.  These inequalities and the absence of rights, fairness and choice for people and their families have to change which is why we have included calls for a national care covenant as part of our social care must haves for the next government. 

Professor Rayner concluded: “The report also demonstrates the failure of local systems to nurture strategic partnerships with care providers, something the Nuffield Trust pointed out as a priority in the summer following our joint roundtable event. Now as we feel winter’s bite, sadly we’re no further forward in addressing the pressures the coming season will bring for the people giving care, those receiving it and those trying to access it.” 

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