Tim Worstall comments pithily on this subject today, but the "damning report" on state provision for the elderly cannot really have been a surprise to anyone likely to rely on such services. As someone who has visited family in state-run care homes and knows people who work in them, how could I (unless blinded by ideology) not be aware how bad they are? I blogged about it ages ago, commenting in the context of the horrors of the "Baby P" case;
Not only does the welfare state create perverse incentives to feckless breeding, it also divorces people from the need to care personally for the young, the sick and the elderly. Practical caring for others involves skills that need to be learned and maintained by practice. When every widowed grandparent incapable of looking after him or herself moved in with their family, the children of the house learned both to value them as humans and to help take care of them. They were family, after all. Nothing could be more natural. Now they are looked after in state nursing homes, where “carer” is just a job title; usually with as much relation to reality as most modern job titles. An old school-friend works in just such a home and routinely starts her shift by cleaning up residents who have been allowed to sit in their own filth by "carers" who couldn't be bothered because "they will only do it again." Tellingly, she reports that residents are only really cleaned up (other than by her) when relatives are due to visit - for fear that the families will "make trouble." The very families who would, if the welfare state did not exist, be looking after their old folk themselves.
With all due respect to those commentators who will worthily discuss how to reorganise the NHS, this problem is in the nature of the beast. It's not to do with how management or staff work in a socialised system of "care". It's to do with how such a system takes away responsibility from the people who care in the real sense of that word.
Of course good, kind people can be found to take care of you when you are sick, disabled or elderly. However, if you are not able to pay them and hold them accountable for their work yourself, someone who loves you needs to take on that role. If I am ever in a nursing home, I want my daughters to be paying the bills, checking up on the service and making it clear to the proprietors that they are ready to take our family's business elsewhere if they are dissatisfied. No bureaucrat, however kindly s/he may be, can replace that.
That the State could replace - or even do a better job than - a loving family is the most barbarous of the fallacies by which the 1946 generation has lived. They were so hung up on this fantasy that they systematically undermined the very concept of family at every opportunity. They actively encouraged people to depend on a burgeoning, state that would nurture them "from cradle to grave." Not only was that wrong, it was corrosively wrong. In fairness to the hapless wimp, that is what the boy David is trying to signal to the nation behind the backs of the Guardianisti with his "Big Society" schtick. The blank incredulity on the faces of the Polly Toynbees of this world is quite genuine. Their confusion between "society" and "state" is as total as their confusion between "the economy" and "the Treasury". But then Polly is wealthy enough never to sit in her own piss in her dotage as most of the nation's grannies - thanks to idiots like her - have good reason to fear.
Don't tell me that socialists "care" more than conservatives or libertarians. Ignore their fine words and look at what they actually do.