Over the next four posts I want to take a deeper look at the issue of social care. I'm hoping to include thoughts and views from others on Twitter, comments and email, so please feel free to add your own opinions, regardless of whether you agree or disagree with my views. I've been inspired to write in-depth on the topic because I believe that it is time to make social care personal.
You might think that personal experience is no basis on which to make (or even suggest) public policy. Policy absolutely must be based on research and evidence, on rigour and analysis. Debate about desired outcomes must be couched in what's best for society as a whole - mustn't it? Well, it's an argument that I understand, but when it comes to issues around social care, I can't help but feel that the focus on research and analysis is just serving to dehumanise what is at root a very human issue.
For me there are three main factors - professional, political and personal - that are driving the rising importance of social care. Firstly, at a professional level, the absence of housing organisations from the centre ground of social care debate continues to flummux me. From housing ministers (from all parts of the political spectrum), through the support organisations of the CIH and NHF, to (most) individual housing associations, the issue of the supply of new homes has way greater prominence than the issue of care and support for people living in existing ones. Yet, by any statistical analysis, the reverse should be true - while we argue about whether 150,000 or 250,000 new homes are needed each year to solve the supply crisis, there are in excess of 500,000 households receiving home-based social care each year.
Another factor that exists at a professional level, too, is that it saddens me that we continue not to learn the lessons of what makes a difference. Experience tells us that prevention is better for the person and cheaper for the provider than crisis intervention can ever be. History has revealed how "just in time" social care remains a pernicious bean-counter's myth. We need new voices in these debates and new partnerships need to be forged to make change happen.
Even then, there's no guarantee the new approach will stick: last year, I shared "Freda's story" which brought together police, social care and housing people in response to just such a crisis, we were united in our outrage that "the system" had failed Freda. Now, the chief superintendent and the main social work contact who were involved in that case have both moved on and so the energy and ability to create change inevitably dissipates.
Politically, I watch, hopeful but not expectant that some consensus will emerge about how the demographic forecasts and the financial ones can be reconciled to create a better social care system. But the facts are stark and there is no easy answer. More old people will rely on the taxes from fewer working people to fund their needs in old age; more old people will have less by way of family support - 20% of women born in 1964 are childless compared with half that number from a generation before; and medical advances mean that more old people will live to be very old, with a consequential impact on care levels and budgets.
Finally, at the personal level I have had three direct, and quite different, experiences of social care in the last 12 months. I've seen quality residential care, so I know it can be made to work. I've also witnessed the effect of the benign neglect of institutional incarceration; and I've seen the not-so-benign neglect of a profit-driven domiciliary care provider and the consequential hospital readmission of a sick and vulnerable old woman.
Over the next four posts, with your input, I'd like to address social care from these different angles, share what I've learned and experienced on the topic and suggest some ways forward, because the one thing that we all agree on when it comes to social care is that we can't go on like we are - can we?
Share your thoughts in the comments, on Twitter or to me directly by email.
You might think that personal experience is no basis on which to make (or even suggest) public policy. Policy absolutely must be based on research and evidence, on rigour and analysis. Debate about desired outcomes must be couched in what's best for society as a whole - mustn't it? Well, it's an argument that I understand, but when it comes to issues around social care, I can't help but feel that the focus on research and analysis is just serving to dehumanise what is at root a very human issue.
For me there are three main factors - professional, political and personal - that are driving the rising importance of social care. Firstly, at a professional level, the absence of housing organisations from the centre ground of social care debate continues to flummux me. From housing ministers (from all parts of the political spectrum), through the support organisations of the CIH and NHF, to (most) individual housing associations, the issue of the supply of new homes has way greater prominence than the issue of care and support for people living in existing ones. Yet, by any statistical analysis, the reverse should be true - while we argue about whether 150,000 or 250,000 new homes are needed each year to solve the supply crisis, there are in excess of 500,000 households receiving home-based social care each year. Another factor that exists at a professional level, too, is that it saddens me that we continue not to learn the lessons of what makes a difference. Experience tells us that prevention is better for the person and cheaper for the provider than crisis intervention can ever be. History has revealed how "just in time" social care remains a pernicious bean-counter's myth. We need new voices in these debates and new partnerships need to be forged to make change happen.
Even then, there's no guarantee the new approach will stick: last year, I shared "Freda's story" which brought together police, social care and housing people in response to just such a crisis, we were united in our outrage that "the system" had failed Freda. Now, the chief superintendent and the main social work contact who were involved in that case have both moved on and so the energy and ability to create change inevitably dissipates.
Politically, I watch, hopeful but not expectant that some consensus will emerge about how the demographic forecasts and the financial ones can be reconciled to create a better social care system. But the facts are stark and there is no easy answer. More old people will rely on the taxes from fewer working people to fund their needs in old age; more old people will have less by way of family support - 20% of women born in 1964 are childless compared with half that number from a generation before; and medical advances mean that more old people will live to be very old, with a consequential impact on care levels and budgets.
Finally, at the personal level I have had three direct, and quite different, experiences of social care in the last 12 months. I've seen quality residential care, so I know it can be made to work. I've also witnessed the effect of the benign neglect of institutional incarceration; and I've seen the not-so-benign neglect of a profit-driven domiciliary care provider and the consequential hospital readmission of a sick and vulnerable old woman.
Over the next four posts, with your input, I'd like to address social care from these different angles, share what I've learned and experienced on the topic and suggest some ways forward, because the one thing that we all agree on when it comes to social care is that we can't go on like we are - can we?
Share your thoughts in the comments, on Twitter or to me directly by email.
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