Shut your mouth, Betteridge. Also: the campaign to stop water from ruining our countryside, how a leading AI accidentally emulated a broken bureaucracy, and the colossal costs of complex care cases.
Building a reservoir may seem a no-brainer perhaps, but I think you shouldn’t dismiss objectors in this manner. If it weren’t for the building of a reservoir there would very likely have been no devolution for Wales and no Senedd in Cardiff, after all. Look up Capel Celyn and the impact of its drowning if you’re not familiar with the history.
I’m not familiar with the details of the Abingdon reservoir. Perhaps the community in this area near Abingdon is not culturally significant (I’m not the judge of that and it may not be a right question in any case) but there is something visceral about drowning that, for an area’s inhabitants, is fundamentally different from (say) the building of a housing estate or windfarm. Coming from the area, I can feel shame and pain at the loss of Capel Celyn 60+ year ago whilst accepting that Liverpool did need water from somewhere.
I suspect it’s staffing 24hours a day seven days a week 52 weeks a year. I would suggest at that cost it’s probably more like 3:1. - with housing costs and other factors such as heating food etc etc. not saying institutional care is better (it was not) but at that staffing you would have had ward sizes of 30beds. And appalling care - not that what is being offered would equate in a lot of cases to good care as the staffing would be agencies and high cost temporary staff as that type of package is almost impossible to staff with consistent people in a lot of cases.
I suspect neither of us actually know the answer, but that still doesn't add up. Even being generous with estimates I get:
1) 4 staff (2 on, 2 off) working 24/7, 365 days a year - maybe £1000 a week each, so £4k - add further auxiliary support for another £500
2) Housing costs - what costs? Is the LA renting a house or does it own it? If it owns it, what are the ongoing costs? Maybe £500 a month maintenance fee? Presumably offset by housing benefit etc.
3) Energy? Maybe if the house is huge and leaky you get £250 a month
4) Food. Why is the LA buying food? Won't the recipient quality for benefits?
5) Medicine and healthcare? Covered by the NHS and so general taxation (not LA).
Yeah, it’s a head scratcher, even at £6k per week - live in carers are about £50k per year. I would assume they’re supplied by a company that has some level of overhead, so maybe double the staffing costs to account for that, but even that barely comes close.
Interesting take on how to manage people who need care and shelter. Society chose to close the other options that previously existed. First the workhouses (finally) in 1948 and then the mental hospitals, interestingly a programme that accelerated after on E Powell’s “water tower” or otherwise called “doomed institution” speech in the 1960’s. We moved care into the community and it was supported by the developing welfare state. Something that we can see as a public good. But as with “off grid” living being only sustainable within the reality of a society of plenty so are the extreme cases where institutions no longer exist that will cost a fortune. If we want cheap institutional care we have to build at scale. There were more NHS mental hospital beds in the 1950’s than all types of NHS beds today. Oh and let’s not forget the growth in prison beds…. Since the 1950’s. These things are not mutually exclusive. We are a compassionate society (I hope) and for the vast majority of people who were previously institutionalised the options for people in need now are far better… than a life locked behind the guarded door of an asylum or workhouse. But let’s not ignore the costs of this for those that cannot fit into the post institutional world. The shame is all governments have denial of this cost and the harm lack of funding across the public realm causes all of us.
Yeah, I can’t comment on the needs of particular cases but I think the point about the lack of institutional care at scale is a key point - everything has been devolved to councils trying to find small scale stop gaps with whatever homes are available to them, and that’s both staggeringly inefficient and liable to mean wildly different standards of care if it’s even available in that area at all.
Can someone unpick this for me, "Our highest-cost residential care placement is currently £15,000 a week because the individual requires two people with them and specialist individual accommodation."
Presumably the accommodation is a sunk cost, and I presume that the carers are not on £5k a week each, so where does the figure of £15k a week come from on an ongoing basis? What exactly is being 'purchased' in cases like these?
Hypothesising but if that’s 2 carers 24/7 it’s more than 2 people employed. The accommodation may be rented or a placement in an institution (maybe not, depends what ‘individual’ means here) not a purchased property, so not sunk. Assuming medical need there may be high energy & water using equipment - long term ventilation or dialysis type costs. Possibly physical therapy input, plus clinical supplies costs, and food / nutrition presumably if it’s long term care. £15k is still a lot though.
There was mention of children’s social care as well as adult social care. While it’s wonderful that we are able to save more babies either born very early or with conditions that would have meant they didn’t survive early infant hood, there’s an increasing number of young people with very complex ongoing needs as a result. Ie they aren’t all surviving to have a normal healthy life (even if many are). The costs for the state are substantial but much as increasing life expectancy but without increasing healthy life expectancy in old age, we aren’t comfortable with discussing whether all treatments are worth it nor the corollary which is how to pay for the care if we say all life extending interventions are worth it… better put our heads in the sand than have an honest debate
Grrr... the "off grid"/no money people might genuinely be my bete noire. They never actually have the courage of their convictions. I bet they would see a doctor when they're ill or have their child vaccinated. Which are only options because as some point we decided self-sufficiency was rubbish....
That's a nicely grumpy way to start the day, at least
Building a reservoir may seem a no-brainer perhaps, but I think you shouldn’t dismiss objectors in this manner. If it weren’t for the building of a reservoir there would very likely have been no devolution for Wales and no Senedd in Cardiff, after all. Look up Capel Celyn and the impact of its drowning if you’re not familiar with the history.
I’m not familiar with the details of the Abingdon reservoir. Perhaps the community in this area near Abingdon is not culturally significant (I’m not the judge of that and it may not be a right question in any case) but there is something visceral about drowning that, for an area’s inhabitants, is fundamentally different from (say) the building of a housing estate or windfarm. Coming from the area, I can feel shame and pain at the loss of Capel Celyn 60+ year ago whilst accepting that Liverpool did need water from somewhere.
I suspect it’s staffing 24hours a day seven days a week 52 weeks a year. I would suggest at that cost it’s probably more like 3:1. - with housing costs and other factors such as heating food etc etc. not saying institutional care is better (it was not) but at that staffing you would have had ward sizes of 30beds. And appalling care - not that what is being offered would equate in a lot of cases to good care as the staffing would be agencies and high cost temporary staff as that type of package is almost impossible to staff with consistent people in a lot of cases.
But that’s not really the point - the point being that this type of care is unaffordable yet what else are councils to do
It’s more like 10 staff as they are working a rota with annual leave and days off. Agency is very expensive.
I suspect neither of us actually know the answer, but that still doesn't add up. Even being generous with estimates I get:
1) 4 staff (2 on, 2 off) working 24/7, 365 days a year - maybe £1000 a week each, so £4k - add further auxiliary support for another £500
2) Housing costs - what costs? Is the LA renting a house or does it own it? If it owns it, what are the ongoing costs? Maybe £500 a month maintenance fee? Presumably offset by housing benefit etc.
3) Energy? Maybe if the house is huge and leaky you get £250 a month
4) Food. Why is the LA buying food? Won't the recipient quality for benefits?
5) Medicine and healthcare? Covered by the NHS and so general taxation (not LA).
Tv licence, broadband etc?
We are still a long way off £15k
Yeah, it’s a head scratcher, even at £6k per week - live in carers are about £50k per year. I would assume they’re supplied by a company that has some level of overhead, so maybe double the staffing costs to account for that, but even that barely comes close.
Interesting take on how to manage people who need care and shelter. Society chose to close the other options that previously existed. First the workhouses (finally) in 1948 and then the mental hospitals, interestingly a programme that accelerated after on E Powell’s “water tower” or otherwise called “doomed institution” speech in the 1960’s. We moved care into the community and it was supported by the developing welfare state. Something that we can see as a public good. But as with “off grid” living being only sustainable within the reality of a society of plenty so are the extreme cases where institutions no longer exist that will cost a fortune. If we want cheap institutional care we have to build at scale. There were more NHS mental hospital beds in the 1950’s than all types of NHS beds today. Oh and let’s not forget the growth in prison beds…. Since the 1950’s. These things are not mutually exclusive. We are a compassionate society (I hope) and for the vast majority of people who were previously institutionalised the options for people in need now are far better… than a life locked behind the guarded door of an asylum or workhouse. But let’s not ignore the costs of this for those that cannot fit into the post institutional world. The shame is all governments have denial of this cost and the harm lack of funding across the public realm causes all of us.
Yeah, I can’t comment on the needs of particular cases but I think the point about the lack of institutional care at scale is a key point - everything has been devolved to councils trying to find small scale stop gaps with whatever homes are available to them, and that’s both staggeringly inefficient and liable to mean wildly different standards of care if it’s even available in that area at all.
Can someone unpick this for me, "Our highest-cost residential care placement is currently £15,000 a week because the individual requires two people with them and specialist individual accommodation."
Presumably the accommodation is a sunk cost, and I presume that the carers are not on £5k a week each, so where does the figure of £15k a week come from on an ongoing basis? What exactly is being 'purchased' in cases like these?
Hypothesising but if that’s 2 carers 24/7 it’s more than 2 people employed. The accommodation may be rented or a placement in an institution (maybe not, depends what ‘individual’ means here) not a purchased property, so not sunk. Assuming medical need there may be high energy & water using equipment - long term ventilation or dialysis type costs. Possibly physical therapy input, plus clinical supplies costs, and food / nutrition presumably if it’s long term care. £15k is still a lot though.
There was mention of children’s social care as well as adult social care. While it’s wonderful that we are able to save more babies either born very early or with conditions that would have meant they didn’t survive early infant hood, there’s an increasing number of young people with very complex ongoing needs as a result. Ie they aren’t all surviving to have a normal healthy life (even if many are). The costs for the state are substantial but much as increasing life expectancy but without increasing healthy life expectancy in old age, we aren’t comfortable with discussing whether all treatments are worth it nor the corollary which is how to pay for the care if we say all life extending interventions are worth it… better put our heads in the sand than have an honest debate
Grrr... the "off grid"/no money people might genuinely be my bete noire. They never actually have the courage of their convictions. I bet they would see a doctor when they're ill or have their child vaccinated. Which are only options because as some point we decided self-sufficiency was rubbish....
That's a nicely grumpy way to start the day, at least
Yeah, it seems to end up with other ‘oh I need a doctor now, please donate to my crowdfunder’ or ‘I can cure cancer with kale juice’.
Are the off grid people just ultimate-NIMBYs? They want the good thing but don't want the good thing to happen.
I really am grumpy now