Local authorities placed nearly 800 children in unregistered settings last year, at a cost of £353 million. The same authorities, the same ministers, the same newspapers, spent the year attacking the registered private sector, the therapeutic providers working legally and above board to help children, for “profiteering”.
Both are true. The providers being attacked are not the sector causing the harm. And the thing that is actually broken sits underneath the argument everyone is having, where nobody is looking.
Here is the whole argument in nine lines. If you only read these, you have the position.
1. The duty is absolute; the delivery was outsourced. The law says every child who needs care must be cared for. No opt-out. From the late 1980s the state decided to buy that care rather than provide it. Everything else is the long story of pretending that gap doesn't exist. Goes deeper → Banning profit from care in Wales (and how we got here)
2. It was made a market, and it has none of the three things a market needs: a buyer who can walk away, a product that can move to where it's cheapest, quality you can see before you buy. Children's care has none of them. Markets for things you can't inspect in advance only work when someone builds the layer that lets you see quality. That layer was never built.
3. So you buy on price, and the specialist is the one who disappears. When the system can't see quality, it can't reward it. The squeeze doesn't fall on the cheapest. It falls on the careful specialist on thin margins, whose whole value is the thing nobody can see. They cut the clinical work, or they leave.
4. Ownership is not the variable. The operating model is. Private equity didn't break in; it's the operator that survives the way the state buys. You'll see studies where for-profit provision scores worse, but look at what they measure: Ofsted grades (who admit don’t measure outcomes), or US nursing homes (that aren't us). Whilst raw correlation is present; ownership as the cause is not. Long-term commitment builds care, extract-and-exit destroys it, and you find both under every owner. Regulate the behaviour. Banning ownership bans the good with the bad.
5. You cannot price what you cannot describe. This is the one underneath all the others. The sector has no accurate shared language for what a child needs or what a home offers. A referral is whatever a tired social worker types on a Friday. A specialism is whatever the website or generic SOP claims. Every reform of policy on the table takes that language as a non-issue. It doesn't exist…
6. Ofsted measures whether a home passed an inspection, not whether a child got better. So the rational provider refuses the child most likely to disrupt a snapshot on the day. The regulator manufactures the refusal it then condemns. Goes deeper → Run by Teachers, Engineered by Politicians
7. The child labelled "too complex" was made complex by the journey they were sent on. Three, four, five failed foster or residential placements, each one teaching them adults don't last. The cost of those moves gets booked against the service that finally catches them and gives them a safe space to recover.
8. Every reform on the table takes a fence down before building what replaces it. Wales is the proof: ban the profit with no funded transition, and the children go to England and to caravans. Right destination, dangerous route, no map. Goes deeper → Reset, Crack Down, Repeat?
9. Without names, there is no map. The fix is a sequence of things working from present day (pragmatically), not a slogan. Build the language first, then let commissioners choose on fit instead of price, then separate the price of care from the matching of a child to a home. In that order.
What this publication does
Analyses inspection, commissioning, provider economics and policy against the evidence, not the press framing. Shares the growing guide library (SCCIF preparation, Annex A, Regulation 44, statement of purpose, registration readiness) free to subscribers. Treats the sector as a professional community under pressure.
Who is writing this
Marcus Williamson. Builds technology sold into this market at elyndra.co.uk. The argument above defends the registered sector…it is also the argument commercially convenient for a vendor selling into it That is named here rather than buried!
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