“We don’t get paid for empty beds”

A snippet of research that I’ve just been expunged from a working paper on how care and accountability are imagined in the UK’s social care infrastructures.

An interview with Mike Padgham, managing director of the Saint Cecilia’s care home group in Scarborough reveals to the Financial Times the choice [care home operators like him] faced as [the issues of Covid-19] played out on the ground (Plimmer, 2020):

“Did he accept new Covid-19 positive patients from hospitals to replace the 19 residents who had recently died, helping to safeguard 160 jobs and prop up the 30-year old business; or did he reject them — and sacrifice their fees — in the hope of restricting the spread of the deadly disease?”

Mr Padgham responds:

“We don’t get paid for empty beds, […] we had to admit people with Covid-19 to stay afloat — but whether it’s right is a moral question.”

What’s interesting here is just how narrow the decision strucutre seems for Mike Padgham. Padgham acknowledges a moral delimma. What’s striking is that months later, in an interview with a global finance outlet, he trundles right by it. It’s there, but guess what, beds need to be filled.

All of this means that ‘beds need to be filled’ rationales can be used to explain why, in the case of this care home group, new residents were taken in, and nobody on the ground could effectively challenge the good sense or safety of the move.

The thing is, this is the care home sector working preceisely as it is supposed to under the guidance of the Quality Care Commission and the Competitions and Market Authority. And what’s missing here is an accountability structure that requires Mike Padgham to act differently enables the residents and carers under his care challenge him differently, or compels the sectors regulators to prioritise meaningful care over.

We will not innovate or technologise ourselves out of this mess. Changes to our care infrastructure in the UK have to be matched with significant attention given to accountability.