INNOVATIONS LIKE 'CAREBNB' ARE GOOD FOR THE NHS

November 02, 2017 4:39 PM

The gravest domestic health crisis facing our country today is the thousands of people dying from bedblocking.  This is where medically sound patients who should be able to be discharged from hospitals aren’t, often due to a lack of social care. This could mean someone recovering from a broken leg who needs no further treatment, but who is not able to get dressed by themselves and needs a carer to help them. This potentially has an effect on those who need urgent surgery. According to data from the Nuffield Trust, the daily average number of “Delayed Transfers of Care” (the official NHS term for bedblocking) since 2010 due to the lack of social care or a nursing home has gone up by 172% and 110%, respectively. Looking at data over a six year period up to 2016, one study found that for every person’s delayed transfer of care, another 7.32 people die.

Considering this, it may come as a surprise that the NHS’s latest plan to deal with bedblocking was shouted down.  The start-up CareRooms had partnered with the NHS, through its Clinical Entrepreneur programme, in an effort to pair patients in need of social care with people willing to help in the community. Sadly, a series of online protests and uproar by scared off the Southend University Hospital in Essex, which has since announced that it has “no intention…to support this pilot at this time.”  It is now unclear whether or not a trial with NHS anywhere will take place. Health minister Philip Dunne offered tentative support to the scheme, saying that he would not reject it outright and open to similar ideas. This is welcome news, and the plans for the trial are advanced enough that they can be implemented on a month’s notice when given the green light.  We should all hope they go through.

Critics of the solution say that rather than give money to strangers to care for those in need, the NHS should give more money to the community care facilities.  However, this would not solve the problem but only alleviate it in the short run.  “In the long run,” Keynes said, “we are all dead,” and, in our case, aging rapidly. The baby boomer generation needs ever more care as they age and there is no spending solution that can readily address this. The care system needs a qualitative fix, and opening it up to the gig economy is brilliant.  Especially framed with TfL’s recent abandonment of Uber in the nation’s capital, condemnation of this plan often appears more like Luddite fear of progress. 

Another criticism of the private room-rental is that people who depend on others for care should not be reliant on a stranger looking to make a few quid.  Necessarily, everyone in the hospital is a stranger to the patient at first as well, so the real criticism is that these people are not trained employees of the NHS.  But as in many other areas of the economy, there would of course be background checks and possibilities for countless other means of ensuring accountability and safety.  Indeed, these assurances actually go hand-in-hand with supporting the renting plan, and are not mutually exclusive, as insinuated by its critics.  Arguing against the plan in its entirety just because its security safeguards are not set in stone is not sensible at all.

Further, many take issue with the very idea of others making money by being temporary carers. But what’s wrong with compensating people for their work?  This is reminiscent of the argument against paying teachers more:  we shouldn’t pay teachers more because then people will teach for money as opposed to teaching because they want to teach, which will result in worse teaching.  This is an incoherent argument. Better pay, or more widely available pay, would mean better teachers, and the same applies to those offering care: if the potential carers want to make money, they have to provide good care.  

All of these criticisms, however, take away from the main point:  people are dying because of bedblocking. Nobody wants to be stuck in whitewashed sterile hospital in a motorized bed that could be used to save someone’s life, and yet our current care system forces them to stay. We have a system that creates victims of everyone and we must break free of it.  What other options do we have?  We must innovate, and to fight against the mere idea of a trial of a plan to address this problem is dangerous.  No criticism can be valid until a trial is done. In spite of its sclerotic approach to many areas of spending, the NHS has adapted to changing times since its inception and to hold it back now would be disrespectful.  As economists Uri Gneezy and John A. List say in their book The Why Axis, “imagine what would happen if... governments around the world could make broad policy changes based on solid empirical tests.”  Finding out what works and what doesn’t, casting off what doesn’t and embracing what does is integral not only to public policy, but to human reason. To stay ahead and save lives, we must not be afraid to experiment with new solutions, especially not ones with as much merit as the CareRooms plan.

 

- Luke Borman

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