After the Winterbourne View Care Home scandal, exposed by Panorama earlier this year, questions were raised about the resources and funding of the Care Quality Commission (CQC).
Now, a series of emails and documents have revealed how the government forced the CQC to cut nearly £1 million.
Less than a week after George Osborne’s “emergency budget” in May 2010, the Department of Health made it clear to the CQC that they would not escape funding cuts.
An email to the CQC explained:
Although as a protected department DH will not see a reduction in its 2010-11 budget, we are not and should not be exempt from the need to make savings.
The CQC told the Department of Health they would need a capital budget of £17.5 million in 2010-11. But by July, they had been informed that they would be receiving nearly £1 million less – just £16.4 million. The CQC’s Director of Finance told staff: “This should be sufficient although there are some emerging issues”.
The previous year, the CQC had to write a desperate five-page letter to the Department of Health asking asking that they be considered for some additional funding. It boasts “we have delivered recurring savings of £44m”, but warned: “There are further ‘one off costs’ that will be necessary in 2010/11 in order for us to satisfy our obligations before CQC reaches ‘steady state’.
Savings in the CQC have been accompanied by a dramatic fall in the number of inspections that are undertaken. Figures released under the Freedom of Information Act show that there were only 5,331 inspections this year, compared to more than 48,000 inspections six years ago. In May, the CQC were criticised for failing to act on reports of abuse in Winterbourne View care home.
David Brindle had this to say in The Guardian:
On resources, critics have seized on the fact that the CQC’s annual budget of £164m is 30% less than the combined funding of the organisations it succeeded in 2009, even though it is being expected to do more. As well as NHS trusts, care homes, care agencies and dental practices, the body is due next year to start regulating GP practices.
According to Williams [Dame Jo Williams, CQC chair], each of the full quota of 900 inspectors – and until recently there have been up to 130 frozen vacancies – handles a mixed portfolio of some 50 different provider units and makes judgment calls, based on evidence of relative risk, about when and how often to visit (almost always unannounced, contrary to widespread belief).
Earlier this year, Pat Healy of the National Pensioners’ Convention said:
The quality of inspection of care homes is unsatisfactory, mainly because the regulator, the Care Quality Commission, is expected to do more for less money and does not have enough inspectors to do the job properly.
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The CQC doesn’t seem to keep an online FOI disclosure log, so here is a selection of the more interesting documents…
Email from DH
Email from John Lappin
Email from Cynthia Bower
Email from DH 2
CQC Budget Notification (Doc 11 20101222 ) (Excel)
Revised Budget for 2010 and 11
Letter from DoH re CQC 2011 and 12 Indicative Budget
DoH ALB Planning Guidance
DoH ALB Planning Guidance – supporting docs
Letter from DoH re CQC 2010 and 11 Final Budget
Letter from DoH re CQC 2011 and 12 Initial Budget