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Who cares about social care? Volunteers, that's who!
Taking off my Scots bunnet just for now and putting on my English... er... Bowler hat? Top hat? What do folk wear on their heads down south these days? Well, anyway, whatever you wear to declare your Englishness imagine that I’m wearing that because I’m blogging today to talk about social care in England and what the UK’s coalition government are going to do about it, once they have got over the trauma of David Laws departure. If ever there was a story that could use the word ‘rocked’ without sounding wildly inappropriate, this was it. But I don’t have time to go there today. If his replacement, Danny Alexander, MP for Inverness, Nairn, Badenoch & Strathspey (that’s basically the Highlands for you guys) the here-today-gone-today ex- Scottish Secretary, now Chief Secretary to the Treasury, does anything exciting maybe I’ll use his Scottishness as an excuse to blog about him. But moving swiftly on...
OK: there’s a quartet of big headlines under the social care policy heading. There’ll be a Commission on long term care to report within a year, barriers between health and social care will be broken down, theree'll be more use of personal budgets and more use of direct payments. This is set in the context of the rest of the coalition agreement which includes a bigger role for the third sector in public service delivery, help for older people to live at home longer through adaptations and community support programmes (though it doesn’t specify what this will look like in practice), more spending on the NHS, more opportunities for public sector staff (presumably including NHS staff?) to run services themselves using the cooperative model, pensions re-linked to earnings, retirement age up to 66 by 2016 for men and 2020 for women and so on.
So what? Well, anyone with an interest in social care should, while keeping an eye out for the development of all these policies, get off the blocks as soon as there’s an announcement of the Commission chair and get on the blower to him/her to have their say (and if they’re really influential they should be calling the Health Secretary, Andrew Lansley and Paul Burstow MP, Minister of State for Care Services and making some suggestions about who the chair should be). It seems that, while, according to the coalition agreement, the Commission will have to consider both a voluntary insurance scheme and the Wanless recommendations, all other bets are off. The Commission was a Lib Dem policy, the Tories already had theirs worked up, so I guess we can take it that they couldn’t jointly agree on a social care policy or on any of the numerous proposals that have come out in recent years. We know this because if they had, well, they would have said so wouldn’t they?
Commissions are traditionally a way of ‘kicking something into the long grass’, as they say in political circles (i.e. if we talk about it for long enough everyone will forget about it and we won’t have to do anything) but this time the issue is too immediate and important for that, as well as there being a huge question mark over how its paid for. With an ageing population there has to be some sort of change to the English system to make it work for people, which may or may not contribute to solving the country’s economic woes, meaning it will cost the state less, although it really will have to will have to be economically viable if it stands any chance of going ahead. It seems certain that, whatever proposals emerge or are accepted, it will involve greater cost to individuals who need care. Why? Well, Liam Byrne’s (Labour ex-Chief Secretary to the Treasury) note to David Laws (you know who he is) saying "Dear chief secretary, I'm afraid there is no money. Kind regards – and good luck!" might have been flippant but it was basically true. Just how this ends up being squared with the social care budget remains to be seen but squared it will have to be.
But here’s a thought for you: WRVS runs on volunteers and the impact they can have in the social care arena has been made clear in a recent report. We may not run what you’d think of as ‘social care services’ but our services occupy a space very close to them and it’s obvious that if people can stay independent, healthy and happy in their own homes for longer and therefore don’t require NHS or social care services as soon as they otherwise would, pressure on health and social care budgets is eased.
WRVS – and thousands of other voluntary organisations – arose from an initial spark, an upsurge of energy and effort, a passion and a readiness in people to tackle social problems for themselves, to look after each other as opposed to waiting for the government to do it. And in many, if not all cases, such organisations started out without a brass bean in the bank. But they still got on and did things, thanks to voluntary effort.
Now, neither I nor WRVS are suggesting that the state should be let off the hook, to be allowed to do less and less while making us do everything for nothing yet still ratcheting our taxes up (Prime Minister Dave will tell you that’s a fundamental misunderstanding of his ‘Big Society’). No. What I’m suggesting is that if we can recognise that there is a tremendous energy out there for mutual support it needs to be developed in tandem with good state services – whoever delivers those, either the state directly or someone on behalf of the state – to make sure people get what they need and so we can make the best use of our money. If we face massive service cuts because the state hasn’t got the money - and, regardless of the rights and wrongs of how we ended up in this mess and who is really to blame and who will suffer as a result, let’s be clear: the state hasn’t got the money - shouldn’t we be thinking creatively about how the shoulder of voluntary action can best be turned to the wheel rather than ending up being exploited or mistaken for a substitute for paid jobs or, possibly even worse, just being discounted because of a lack of understanding about the potential role volunteers and the voluntary (third, charitable, social enterprise, whatever) sector could, can (must?) play.
I’m not suggesting we can run things like specialist cancer care on wide eyed enthusiasm and people who can manage to be around on alternate Tuesdays and Fridays and, God knows, sometimes even the most straightforward tasks involve hacking through reels of red tape and someone might have to be paid to do that, but there are many services and activities, social care being a good example, which could benefit from much more extensive volunteer involvement. And that energy and willingness is out there.
Look at it this way; if the alternative is saying goodbye to these activities forever or ending up with second rate services, hobbling along with only pennies in their pockets, what have we got to lose?
Putting People at the Heart of Care
Frantic. That's what it's been like. Frantic. In a job like the one I do for WRVS (Media and Public Affairs) the General Election is somewhat akin to the football World Cup in terms of all-bets-are-off madness, tension, excitement, TV gawked at, radio earwigged too, newspapers poured over,websites scanned, tweets and blogs and every-online-thing else sucked up, junk food guzzled and tea made (I'm not a coffee drinker, that really would send me over the edge). There are those that would find this level of interest in politics rather sad. In fact, I'm one of them but I have learnt to live with myself. And, for the avoidance of doubt, I am just as excited about the real World Cup 2010 that will take place in South Africa in June.
And its far from over. The now traditional 'congratulating of the new Ministers' which charities tend to do these days (i.e. a bunch of letters, usually suggesting a meeting that vaguely resembles some sort of date, to talk about how they can work with Government for the benefit of the people the charity supports) takes up some time. Then there's the policy detail itself. Ordinarily, the analysis of party manifestos that people like me and my colleagues do pre-election would serve as the basis for understanding what the new Government will get up too but in the uncharted choppy waters in which we are now swimming, that analysis only blows up the life raft so much. The tiny little eight pager that Dave and Nick put out last week was but a sliver of the forthcoming doorstopper that will arrive next week.
The official coalition document will get down to much more detail about the full range of policies (although not to the level they will eventually need to be worked out to). Only then will the true picture of Britain's future will emerge. Although I should point out that 90% of the policies this tome will contain are essentially for England and to a lesser extent Wales. It seems to me that few people in England really understand just how much policy is devolved to the Scottish Parliament (no disrespect intended; I'm English born and bred, the son of a Scottish faither and an English mither but I now live and work in Edinburgh).
From a WRVS point of view the two biggies are care and volunteering. Both devolved. And in the case of care, the Scottish Government is tanking ahead with proposals for a Self-Directed Support (SDS) Strategy and a Bill, in response to which WRVS has offered some comment, which you can read here. SDS is similar to Individual Budgeting and Direct Payments are a part of it. It advances the 'personalisation' agenda in Scotland, which is a big feature of the English care landscape and looks as if it will only grow in importance across the UK. That's certainly what the manifestos were suggesting in all their various UK, Scottish and Welsh editions - that was an innovation that quadrupled my bedtime reading for a week or so!
Basically SDS means handing control of care to the person who gets that care to a greater or lesser degree, depending on how that person wants to play it. It means really putting them at the heart of it. If they want to, they can decide what they need and who provides it and they control the budget, which gets given to them, usually by the local authority. It's the Scottish Government's hope that SDS will be the main way care is delivered in future and that almost certainly means a pretty radical shift away from monolithic care services provided by the state or by large private or third sector providers, to a greater variety of smaller more tailored services. It's more or less a market model and WRVS' interest lies in providing the kind of great, volunteer delivered services that, while not exactly 'care' services in the formal sense, can complement such a system and make sure older and disabled people can continue to live independently in their own communities, fully plugged into the life of those communities, rather than being isolated, lonely and stuck for a friendly ear or someone to help them get out and about. So, if you're interested have a read. And hang on for some more General Election related blogging coming here soon! Promise!
Posted by Andrew Jackson