What a £20 Note Tells You about Your Freedom to Choose Your Home Care Provider

At Caremark Thanet, we are acutely aware that our customers have a choice. Every domiciliary care provider should be as equally aware of this fact as we are.  If our customers are unhappy with the care that we provide, they can exercise their choice and go to an alternative provider. Customers of other private providers can make the same choices to go elsewhere if they so wish. However, customers who receive home care from social services in Kent have recently seen their freedom to choose who delivers their domiciliary care reduced significantly. We believe this is fundamentally wrong. 

Charles Dickens and Adam Smith

Before we explain why this is so wrong, let’s take a little diversion. Those of you who reside in South East Kent – and even further afield - will know that each year Broadstairs hosts a Dickens’ Festival -   the organisers of which are to be highly commended and congratulated for their work. Here’s a question for you. Take a look at the back of a £20 note. The image on that side of the note is that of Adam Smith, economist, moral philosopher and a leading figure in the Scottish Enlightenment. The question for you is this: what is the link between Adam Smith and one of Charles Dickens’s most famous characters?   

The answer is that Smith’s great nephew was the inspiration for Ebenezer Scrooge or at any rate Smith’s great nephew’s gravestone was. It seems that on a visit to Canongate Churchyard in Edinburgh Dickens came across the grave of one Ebenezer Lennox Scroggie and misread the inscription “meal man” – Scroggie was a corn merchant – as “mean man”. You can read more about this on the website of the Adam Smith Institute.  

Why Choice Is Good

Smith was a brilliant man. In a work regarded by many as his most important, An Inquiry into the Nature and Causes of the Wealth of Nations, he wrote: 

“In almost every other race of animals, each individual, when it is grown up to maturity, is entirely independent, and in its natural state has occasion for the assistance of no other living creature. But man has almost constant occasion for the help of his brethren…” 

He then answers how best we can motivate others to provide us with all the many goods and services that we need:  

“It is not from the benevolence of the butcher the brewer, or the baker that we expect our dinner, but from their regard to their own interest.” 

If the butcher, the brewer or the baker do not produce something that their prospective customers value, they’ll pretty soon go out of business. It is in the interests of these merchants to satisfy the needs of their customers. Their interests and their customers’ interests coincide. These merchants are compelled to provide a quality product because they know their customers have a choice. Their customers can go to the butcher, the brewer or the baker who provides them with a product that best meets their needs. However – and this is the key point – it is only because customers have a choice that their interests and the interests of the merchants coincide. And this is why we believe that reducing the choice that customers have to choose their domiciliary care provider is wrong. 

Direct Payments

From the 2 June 2014, there are just three domiciliary care providers providing social services home care to the people of Thanet. Previously there had been well over twenty. In Kent as a whole, the number of providers has been reduced from 120 to just 23. This drastically reduces the freedom to choose who people want to deliver their domiciliary care. At Caremark Thanet, we believe, firmly, that customer choice and provider competition are good things. 

There is, however, something that social services customers can do if they wish to increase the number of home care providers available from which they can choose. The remedy is simple: they should ask Kent County Council for a direct payment. In most situations, a person will have a right to receive direct payments. Direct payments put people in control of their care. It returns to them their freedom of choice: and that has to be a good thing. Adam Smith would certainly have agreed with this and maybe Dickens would have agreed too.

 
If you need advice about direct payments or anything to do with domiciliary care contact Caremark Thanet on 01843 235910 or visit: www.caremark.co.uk/thanet

Garry Costain is the Managing Director of Caremark Thanet, a domiciliary care provider with offices in Margate, Kent. Caremark Thanet provides home care services throughout the Isle of Thanet. Garry can be contacted on 01843 235910 or email garry.costain@caremark.co.uk. You can also visit Caremark Thanet's website at www.caremark.co.uk/thanet.