How the market has wrecked our lives

Governments should not be operational – it’s time for good governance!

“The Care Act requires local authorities to help develop a market that delivers a wide range of sustainable high-quality care and support services, that will be available to their communities.

When buying and arranging services, local authorities must consider how they might affect an individual’s wellbeing. This makes it clear that local authorities should think about whether their approaches to buying and arranging services support and promote the wellbeing of people receiving those services.

Local authorities should also engage with local providers, to help each other understand what services are likely to be needed in the future, and what new types of support should be developed. To do this, authorities should engage with local people about their needs and aspirations.

A wider range of high-quality services will give people more control and help them to make more effective and personalised choices over their care. They should therefore get better care that works for them.” Care Act factsheets – GOV.UK (www.gov.uk)

It is hard to conceive how many contradictions and indefensible assumptions can built into 4 short policy paragraphs. Deconstructed, it seems clear that the overarching purpose of The Care Act (2014) is to, via relevant local authorities:

· Deliver a wide range of sustainable high-quality care and support services, that will be available to their communities

· promote the wellbeing of people

· engage with local providers, to help each other understand what services are likely to be needed in the future, and what new types of support should be developed. To do this, authorities should engage with local people about their needs and aspirations

· give people more control and help them to make more effective and personalised choices over their care

· (and) get better care that works for them.

Surely, in any sensible and truly democratic form of governance and along with clarity about the delegated funding available to achieve this objective, that is central government’s job done?

But no! At odds with all those purposeful statements that should amount to a license for locally elected politicians and locally knowledgeable professionals to go out and with local citizens coproduce arrangements that deliver locally relevant and prioritised arrangements that build upon the relationships, gifts and assets that are abundant in local communities, the Act sets out ludicrous and innovation suppressing constraints.

Inexplicably, the impetus of the Act is to enshrine the silly idea that services and care are synonymous in law, and then instruct the priority allocation of time and resources to create and sustain a market through which this misconception can be ‘managed’ and, as we have experienced, miserably fail.

And it has abjectly failed. The current recruitment and retention crisis, impact of cut and run venture capitalists, decline into seeing older peoples’ services as a placement adjunct of the NHS, and constant demands for more and more money to be spent on ‘reanimating the dead horse’ are just some of the symptoms of this failure. Fundamentally, three decades of sequential POLICY FAILURES derive from a totally ideological and unsubstantiated, and possibly corrupt, adherence to the notion that the market should be the basis of social care. This has been accompanied by a concurrent corruption of the purposes and principles of social services. It’s been happening in plain sight of our consumer society and we’ve all been, to various degrees, taken in. It’s time to open our eyes!

Services, no matter how competent and relationship-nourishing, are supplementary and complementary to the real care that has its roots in our kith and kin, our friendships and acquaintances, and our

histories as contributing citizens, neighbours and participants. These are the foundations upon which real care and effective social services can be constructed.

Bob Rhodes