Caretelization revisited and the lessons of Southern Cross

‘Caretelization’ is a term coined to describe the process, in a substantially privatized care home sector, whereby large corporate providers have gained greater market share through the process of mergers, acquisitions and takeovers. It has been argued that this process has reduced choice and weakened accountability for older people as consumers and local authorities as commissioners. The care regulator has also had difficulty in keeping up with complex and changing ownership patterns. In an earlier article it was predicted that with market concentration likely to increase, such problems would intensify. Prompted by the market failure of Britain’s largest private care home provider, Southern Cross, in 2011, this commentary reflects on the perils of relying on a privatized and marketized system of care homes for vulnerable older people, particularly as the regulator appears powerless to take effective action in such circumstances.