Arguably, the free market is anything but free when we consider the excessive loss of lives in our care homes during the pandemic …….
Three years ago a report published by Lancaster University entitled ‘A Trade in People‘ expressed the failure of the free market in providing services to those most vulnerable in society writing
‘it is clear to us that the way in which the healthcare economy has been encouraged to develop by recent governments turns people into commodities and liabilities. For local authorities and CCGs they are liabilities that they have often sought to export to other areas and for independent hospitals they are a commodity and source of millions of pounds of income and profit.’
In the intervening years nothing has changed, Covid19 has exposed yet again the nature and limits of the State, with its’ continued adherence to the free market in health and social care to develop a fragmented, unmanageable and insecure matrix of social care. The consequences of which has cost lives. Across the country, more than 20,000 residents and care workers have died with Covid-19. Yet Government boldly absolves itself of any responsibility, it’s the providers fault they claim, it was someone elses responsibility to save their lives not the Governments.
The truth is each life lost was seen by Government as a commodity, traded, faceless, of no economic value to society, abandoned by Government, living on the ‘Forgotten Frontline’. What makes it worse is this situation was predictable.
Over 5 years ago the King’s Fund highlighted what many in the sector already knew, stating
‘Social Care is now a complex and sprawling sector of more than 12,000 independent organisations, ranging from big corporate chains to small family-run businesses, charities and social enterprises, which makes the NHS provider landscape look like a sea of organisational tranquillity. Less than 10 per cent of social care is actually provided by councils or the NHS their retreat from long term care provision is virtually complete. But unlike the NHS, when a social care provider hits the financial rocks, bankruptcy not bail-out is the more likely scenario. But a deeper problem is the failure to think through the consequences of shifting the bulk of our care provision to a private business model’.
2 years later this was supported by Andrew Dilnot , former drector of the Institute of Fiscal Studies, who suggested social care is is a classic example of a market failure where the private sector cannot do what’s needed.
In 2019 the Kings Fund again highlighted the fragility of a free market approach which continues to threaten the sustainability of social care.
One need not dig too deep to see the flaws within the current system. Care home deaths during the pandemic, along with previous research by Lancaster University adds to a plethora of reports, all stating the same thing. This system is broken, and at it dark heart is the ideological nemesis of health and social care, neoliberalism. Derided by Nobel prize winning economist Joseph Stiglitz, who described free market neo-liberalism as a stifling economic ideology which has run it course, and economist Mariana Mazzucato who when discussing the neoliberal agenda suggests “there has been kind of a strange symbiosis between mainstream economic thinking and stupid policies.
Neoliberalism has an insidious presence in our lives, much like the air that we breathe, everywhere, yet made invisible by the taken for grantedness of its’ core premise ‘public sector bad, private sector good. Supporters of neoliberalism maintain the market delivers benefits that could never be achieved by government, and that the more unregulated the market, the better the efficiency.
Within such an ideological framework everything we do, and every person is a potential commodity that can bought, sold and traded for profit.
However, the effect of the failure of the free market and neoliberal ideology extends beyond money, the real effect of failing markets rests upon the poorest and most marginalised in society, like those older people who have lost their lives, abandoned by government in private care homes.
The problem in government today is that many of those who govern this country are woefully out of touch and too quick to blame individuals rather than look at their own role in creating and maintaining a broken system.
Michael Sandel argues the free market is not just a mere mechanism designed to deliver goods, it also embodies certain values, and the problem is these values crowd out non market values which are really worth caring about and preserving, such as compassion.
Where values and ethics are weak in any system which seeks to support those in need, we need a strong and active State to intervene, where both are weak those most vulnerable in society will be abandoned.