How privatisation has led to a private hell

Britain on the Couch

Why is this system cheaper and, above all, how is it a better way to meet the needs of the disabled?

IT MAKES a kind of sense to me that most manufacturing industries and some services, such as airlines, deliver a better product if they are done for profit and with accountability to shareholders. But I have never been able to accept that there is any intrinsic reason why vital services will be more efficient if they are privatised - railways, water, electricity and so on.

What stopped the Civil Service from simply rationalising these industries themselves, if they were overmanned? Why does it make sense to pay the same managers three or four times more to do the same job? As a senior water industry executive told me recently, his job is the same; all that has changed is his pay packet and capital assets (through share options).

The true cost of the Tory privatisation would include the bungs (otherwise known as sweeteners) given to investors to encourage them to buy the family silver. Only by massive, hidden public subsidies was this possible: under-priced shares and assets, huge fees to NM Rothschild and other merchant bankers and the liberty to sack large swaths of the workforce, making them equally dependent on the taxpayer through the dole.

We footed the bill for thousands of already powerful and often rich people to become more so in the name of better services and the end of monopolies. In most cases nothing of the kind happened and, as is becoming increasingly public knowledge, dividends to shareholders and directors of the likes of the water and train industries have been huge: a survey of six water companies, for example, showed that an average of 21 per cent of the bill that you paid was given away as dividends.

On top of this, but rarely considered, is the social audit of privatisation, the less tangible costs, the human ones. The farming out of much community care for the elderly and disabled to private agencies is a fine example.

Celia is 45 and rendered wheelchair-bound by multiple sclerosis. She cannot stand or move her legs, she is without bladder control and her numb hands allow minimal dexterity. Although she can think, talk and feed herself, she needs help for basic tasks including showering, dressing, toileting and moving in or out of bed and car.

Privatising her care has resulted in her carers changing with depressing frequency. It has made the ex-nurse who won the tender from her local authority a millionaire, but that manager's individual wealth is at the expense of Celia's well-being and subsidised by the low pay (around pounds 3.50 an hour) and precarious conditions of work of her carers.

She described her plight to me in a letter. "Despite the valiant efforts of my loyal husband and four children, I require daily visits from the agency carers to help shower and dress me in the morning. When this started three-and-a-half years ago, I found the intrusion of strangers into my life very difficult to cope with.

"It requires trust to be lifted from my wheelchair to the shower chair or bed, to be undressed and to reveal where I keep my underwear or clothes: trust that I will not be dropped... trust that I will be treated with dignity and that in my dependent state where I cannot fend for myself, I will not be abused. The dependence on others is frightening.'

Celia draws an analogy with child care. "A baby is completely at the mercy of its carers. It yearns for familiar carers who understand its unique needs, and the same applies to me. The more I know the carer, the better it is.

"A shower involves lifting me from loo or wheelchair on to and off the shower chair. As my legs do not work this involves a very close embrace to ensure safety. To go through this experience stark naked with four strangers in a week is horrendous.

"I have had so many different carers over the last three-and-a-half years that I can remember only a few of their names. Since I complained about this the rota manager has occasionally got it down to two carers a week. Considering that the manager was once my carer you would think she would understand how distressing this is, but she has a constantly changing, low-paid workforce. This week I had five, all but one of them strangers. I was so angry - I felt like a thing, not a person to be respected.

"By contrast, familiar carers understand my idiosyncrasies and desire to have an illusion of independence. They know where I keep my clothes and my favourite outfits, what to do if my legs spasm and the routines which ease the pain and tedium. .

"I am beginning to detect in myself the depressed, resigned feeling that I have observed in babies who have had constantly changing carers. I can hardly be bothered to try and relate properly to my present ones. I worry also for the lone elderly people who make up most of the agency's clients, for whom the carer is often their only visitor of the day."

Before privatisation there were perfectly adequate public servants managing community care who were paid perhaps pounds 30,000-pounds 40,000 a year. What has been the point of creating millionaires to do the same job? The extra pounds 960,000-pounds 970,000 incurred can only have been put in their pockets by allowing them to cream off profits through exploitation of carers and taking money from the public purse. Why is this system cheaper and, above all, how is it a better way to meet the needs of millions of dependent people like Celia?

Let us hope the Government will put right the dehumanising consequences of care done for profit rather than as a service.