Paying people to house NHS patients is not a solution to our social care crisis

"The failure of the Conservatives to invest sufficient resources to meet the needs of patients has now become intolerable"
"The failure of the Conservatives to invest sufficient resources to meet the needs of patients has now become intolerable"

By Norman Lamb

Every day, thousands of people are stranded in hospital beds for no other reason than a lack of follow-up care in the community.  Many of those who are finally discharged return home to find themselves alone, in a cold house, with nobody to care for them or keep them company.  Research by Age UK shows that 1.2 million older people are left without the care that they need. This is one of the starkest examples of our crumbling health and care service, which the Care Quality Commission recently warned is "straining at the seams".

There is no question that we need to innovate and find new ways to make the system work more effectively. But there are serious doubts about whether controversial plans for 'Airbnb'-style accommodation in the NHS is the answer to this challenge.

Under a new pilot scheme that was reportedly considered at Southend Hospital in Essex, patients who are waiting to be discharged from hospital could end up staying in a spare room of a stranger's home if they are not well enough to look after themselves. Homeowners would be paid a handsome £1,000 a month for putting people up, despite not being required to have any previous experience of providing care. While the hospital now insists it has no plans to support the pilot "at this time", many people will be anxious that similar proposals could emerge at some point in the future.


As an MP and a former minister, I have argued for bold thinking and novel solutions to the great challenges society faces – and there are no challenges more pressing than the crisis that is crippling the health and care system.  However, the backlash to this pilot highlights some very serious and legitimate concerns about whether these plans would really be in the best interests of patients in their hour of need.

After being cooped up in hospital, it is difficult to imagine that many people would be attracted to the idea of staying in the home of someone they have never even met before.  Indeed, we can confidently assume that most people would be highly nervous or uncomfortable at the thought. Is it really fair to put this suggestion to them, when they know that the alternatives could mean being stuck in hospital or being left without the support they need?

But on top of that, there are far more pressing questions about the safety of individuals in these homes and the risk of vulnerable people being exploited. How would the safety and quality of care in these homes be regulated? What safeguards would be put in place to protect people from abuse? Unless NHS leaders and ministers can offer firm guarantees on these points, it is impossible to see how an experiment such as this could ever proceed without severely undermining patient care and the public's faith in the NHS.

When I was a minister, I was interested in exploring ideas about how we can step up and help people in need, particularly those living isolated and lonely lives.  On every street, there is an elderly or disabled person living on their own. Some of them might have family on the other side of the country.  Others may have no friends or family at all. As individuals and communities, we should think about how we can assist vulnerable people in our neighbourhoods – doing our bit to help them, out of the principles of kindness, compassion and companionship.

But the bottom line is there is not enough money in the NHS and social care. We spend far less of our national income on health than countries like Germany and France, and this scandalous failure to invest is not without consequences. Every week we are seeing new examples of serious failures of care, unacceptable delays for treatment, cancelled operations, and agonising waiting times for people suffering from mental health problems.

Ultimately, these are political decisions. As the fifth largest economy in the world, there is no reason why we should not be able to invest properly in a health and care system that can give everybody the compassionate and dignified care they deserve – including, wherever possible, care in their own home. 

The failure of the Conservatives to invest sufficient resources to meet the needs of patients has now become intolerable, and yet the Liberal Democrats remain the only party to have put forward bold and constructive solutions to tackle this crisis. It's time to face up to the fact that we might all need to pay a little bit more in tax to sustain our most treasured institution, which is why we have proposed an additional penny on income tax to raise an extra £6 billion for the NHS and care system. This will not be enough to tackle the challenges that are bringing the system to its knees, but it's a start.

For the last two years, I have also been trying to persuade the government to set up a cross-party NHS and Care Convention to look at how we deliver and fund health and social care services.  This would engage with people who rely on these services, as well as the hard-working staff who are battling to deliver them, with the aim of coming up with a long-term financial settlement. 

Southend Hospital might have shelved its controversial plans for the time being – but today's controversy is a warning that the government cannot afford to ignore this crisis any longer.

Norman Lamb is the Liberal Democrat MP for North Norfolk and a former health minister.

The opinions in Politics.co.uk's Comment and Analysis section are those of the author and are no reflection of the views of the website or its owners.

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