Why Not Trade In The Care Of The Demented?

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At one level – and this is the level the politicians will use – this is ludicrous. The elderly and demented sent 10,000 miles away to be cared for? Brits in care homes in Thailand?

In the manner we really should be thinking about this well, why the hell not?

British families are sending elderly relatives with dementia overseas to Thailand in a small but growing trend.

Researchers visiting private care homes in Chiang Mai have found eight homes where guests from the UK are living thousands of miles away from their families, because suitable care in their home country was impossible to find or afford.

“Thailand already has a long history of medical tourism and it’s now setting itself up as an international hub for dementia care,” said Dr Caleb Johnston, a senior lecturer in human geography at Newcastle University.

The necessary thing for this care is human labour. In the UK this costs £8 an hour at minimum. And it is just minimum work too. No, not to say that it’s not proper work and thus difficult in that sense. But it’s far more about simply being there with a damp cloth and a cup of tea than it is about anything else. We are talking about the demented after all.

So, how should we organise this? We could – sure we could, at a cost – throw enough of our own expensive labour at the problem. We could, as we do, throw not enough labour at it because of the cost. For two allied reasons, One, we’ve got to give up other things we value in order to pay for that labour, secondly we’ve got to give up those other things that labour could be producing for us in order to gain the care.

We could import the labour. Plenty of people out there among the 7 billion who would trade the better lifestyle of £8 an hour in the UK for what they’ve got. But that might solve the labour supply issue but it doesn’t solve the cost to us one.

Or, of course, we can send those needing the care to where the labour is cheap.

There are an estimated 850,000 people living with dementia in the UK. Local authority residential care costs up to £700 a week, with private care around £1,000. There are no prescribed staff-to-guest ratios in the UK but, with annual staff turnover exceeding 30% and 122,000 job vacancies, levels in state and private facilities tend to be around 1:6.

In Thailand, in contrast, 1:1 around-the-clock residential care with fully-qualified staff – in award-winning facilities that look like four-star hotels – costs around £750 a week.

Sure, we can itch a bit at the idea that Granny gets sent those thousands of miles because we’re not willing to give up our lives – or the portion of them to pay for the institutional care – to care for her. But it’s a lovely example of the way that voluntary interaction, what we call trade when it crosses international borders, benefits everyone involved.

Grandad gets vastly better care, we have to sacrifice less to get it, the workers get higher than local wages (exporters, even of services, do near always pay substantially better wages than the domestic economy) and so why not?

This being that lesson of trade. It benefits everyone involved. We can argue against it for other reasons – Granny wiped your Mum’s bum so it’s your turn now has a certain resonance to it – but we do have to at least understand what we’re giving up by not having it.

We’re giving up those gains from trade.

It’s also possible to mutter that perhaps Thailand isn’t entirely necessary. The same could be done just outside Chisinau no doubt…..

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Ben S
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Ben S

Added to that, it may well be that they will be better cared for in a society that ‘venerates’ age (rather than ours which venerates youth).

I read somewhere that even putting OAPs on year-round cruises would cost less than being in a home.

Mr Yan
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Mr Yan

Is there equivalence between the Local Authority care at £700/week and the private at £1000 I wonder? Some would say that is the private sector gouging the state, but bearing in mind “guests” in private subsidise the local authority I’d suggest otherwise.

Just looked at P&O and you can get a 52 night cruise for £5.5k – which is close to the Local Authority costs of £100 per day.

Quentin Vole
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Quentin Vole

Is that an ‘all inclusive’ deal? Many cruises advertise an attractive headline cost, but then you have to buy food, drink and other services from a monopoly provider.

Mr Yan
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Mr Yan

Seems to include full board. Also flights, but I guess you’d want to cruise back anyway. https://www.pocruises.com/find-a-cruise/JMH/JMH

Pcar
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Pcar

@Ben S

Cruise, yes. Many oldies have negotiated a 52 week residency

Hotels – same

iirc there was an article a while ago about a retired couple who moved into a Travelodge as cheaper

Thailand: downside is can’t visit, but if they’re bonkers and don’t know you any more it’s emotion vs reality