I have to confess that the words “Return on Investment” often make me want to roll my eyes.
This is not to say that I don’t think service delivery or innovation shouldn’t have some form of financial attractiveness attached to it in terms of better value for money or more for less.
It’s more that my eye-rolling is an outward expression of a feeling it’s quite easy to hide behind ROI as something that is very hard to robustly prove, either as a way of saying “no” or just to put off for a bit doing something someone may not necessarily want to do.
(There’s also a point here that it shouldn’t just be financial measures we consider in terms of value, but that’s a post for another day.)
Shifting on slightly from ROI, figures published by the English Community Care Association (via Community Care) on the costs of residential and home care provision both by one particular council and by external providers operating in that council’s area make for fascinating comparisons.
In older people’s residential care:
- Gross total cost per week for external providers = £433.62
- Gross total cost per week for in-house services = £839.20
For domiciliary care:
- Gross hourly cost for external providers = £13.49
- Gross hourly cost for in-house services = £34.19
Obviously, we should treat these figures with some caution, and remember that they arise only from one local authority (which could have a particular history which skews these figures).
But the gap between in-house and external provider costs suggests that, even for adjustments because of the methodology used, there’s an argument that external providers (most likely private and voluntary sectors, don’t forget) are considerably cheaper than in-house.
If anyone knows if there is similar data across a wider set, I’d love to know about it. In particular, if there is anything out there regarding voluntary sector costs compare to public and private sector costs, please let me know.