Who Cares?

Here's a piece that appeared in the national Green Party magazine Green World:


There have been huge changes in both the funding and approach to care since the 2010 general election. Philip Booth and Bob Rhodes look at the underlying issues and how they might be addressed from a Green perspective

The Regulator tells us that elderly people are far from safe in too many NHS hospitals. Front page scandals regularly remind us about neglect and abuse in Care Homes, Castlebeck being the latest of a long list over the last 5 decades proving the ineffectiveness of administrative ‘safeguarding’. Most of us fear getting old or becoming disabled and put it to the back of our mind. When, in the course of LivesthroughFriends workshops, participants visualise their 85th birthday celebration, very few folk see themselves in ‘care’. Their happy event is in the bosom of their families, associations and communities. So, how is it that we permit a social care system to persist that so clearly fails to support such aspirations? 


This is all the more inexplicable when we consider the unsustainable economics of our present rationed arrangements and immediate future challenges; if social care costs increase as expected then public spending would need to double by 2026. We need to evolve a sustainable and community-strengthening alternative. 


Margaret Thatcher radically changed the nature of government. She decreed that the ‘rules’ of the market should apply to just about everything including care. The consumerist consequences have led to insidious state occupation of territories previously deemed those of civil society. Ever since, managing the market is of greater importance than getting to grips with the real challenges of caring for one another. Care is bizarrely redefined as a commodity. 


Few gave credence to the objectors who pointed out that social care is a complex art, nurturing self-reliance and communal reciprocity alongside the selective and creative use of service options. The messiness and irrationality of real life was denied through the adoption of business disciplines to remedy the perceived shortcomings of the public sector. As services were increasingly deemed the only answer, costs grew exponentially. Care was deconstructed into tasks and the human condition into serviceable needs, discarding that which could not be so specified. Concurrently the virtues of self-reliance, reciprocity and true community care were devalued while the self interests of the professions and service providing businesses (including charities) claimed precedence over those of the served.


The consequent neglect of ‘community’ and interdependence (‘no money to be made here’) and failure to address key human necessities too often contributed to the loneliness, isolation, vulnerability and disempowerment of people in need of help: outcomes accorded no or low tariffs on the system’s performance scales. 


After nearly 3 decades of ‘the market’ the challenge is to get back to helping people to address their own situations, developing and pursuing their preferred solutions. Life is a journey replete with relationships, not a series of episodes with difficulties to be resolved from time to time with a dollop of jollop or the prescription of a comprehensive service. Helping involves knowing people and their gifts and associations (past and present). 


Politicians could start by attending to what really matters to us all: belonging, intimacy, reciprocal relationships, financial security, citizenship, opportunities to contribute, self-realisation and personal autonomy, a place of one’s own, and the safety and security that derive from all of these. Priority is needed for proven approaches that address these essentials, such as:
• Personal Network Building: ensuring that no-one is alone and vulnerable
• Local Area Coordination: putting people who are skilled in helping others help themselves at the ‘front-end’ of the social care machinery
• Personal/Individual Budgets and Self-Direction: giving citizens real control over how their social care financial entitlement is applied in accordance with their priorities with help from professionals, if requested, who really understand that ‘care’ cannot be purchased
• Asset-Based Community Development (ABCD): restoring power, confidence and competence to citizens who organise and act together
• Promoting the philosophy and competences of self-reliance, reciprocity and interdependence throughout our educational and institutional ‘bone-marrow’. 


In summary, we need politicians and professionals who fully grasp the fact that institutions and services are not suited to satisfying our most essential needs and who see services as complementary, supplementary and supportive of the familial and associational relationships and reciprocities that do.

As Greens we should not be seeking to assume ‘Old Labour’s’ clothes as the guardians of public services without first establishing, by learning from our experience of the last 3 decades, that the services and jobs we are so keen on protecting actually serve the public. A final word: we must not impose institutional culture and language on citizens and their associations (the community), as anyone in business will tell you: contracts and relationships don’t mix! 

ABOUT
Bob Rhodes is co-founder of LivesthroughFriends, livesthroughfriends.org.

Philip Booth is a Stroud District councilor, has a background of working in social services and currently works for a national charity. His blog, Ruscombe Green, is in the top 10 councillor and green blogs: ruscombegreen.blogspot.com