SOCIAL CARE – Why there will never be enough money to fund this silly idea

There is a vital story to be told about how we might successfully care for each other (as Beveridge put it, “from the cradle to the grave”) that is very different to and much more relevant than the constant bellyaching regarding the likely impossibility of ‘reforming’ and fully funding ‘Social Care’.

It seems to us that, in order to design an effective system, it is firstly imperative that one is clear about purpose (what constitutes Care in this instance) and what are the key principles that underpin your approach. In the case of Social Care both, if ever adequately addressed, were subjugated to an ideology.

The simple fact is that seeking to deliver Care (which needs to be defined) as a marketized commodity was always a silly idea and was always destined to fail. It was, as our colleague, Professor John Seddon has demonstrated, inevitably going to generate failure demand and escalating costs.

Mrs Thatcher was wrong. There is such a thing as community and the role of effective ‘Social Services’ is tosupplement and complement those essential things that only citizens, families, and communities (citizens in free association) can do for each other.

The market seems to us to be the antithesis of community and, above all, it should be patently obvious that Care is not a commodity to be traded. Services cannot deliver love, belonging, financial security, contributing citizenship and so forth.

Human connection, love, shared interests and fellow feeling are fundamental to the human condition.  The relational or, as Edgar Cahn described it, ‘core’ economy is the basis of our individual and collective wellbeing, and this cannot be successfully supplanted by traded transactions or prescribed interactions.

And yet, underpinned by the flawed notion that care can bought and sold, our market-obsessed public service system too often reduces ‘social care’ to a list of quantifiable tasks bereft of purpose and lacking genuine care.

Our political class and policy geeks don’t get it – or, perhaps, are determined not to get it!

At LivesthroughFriends we do get it and so do so many of the service commissioners, human services professionals, principled service providers and, above all, people and families with whom we collaborate.  Our people have spent decades – usually against the grain and mainly supporting folk who have acquired extremely complex and challenging reputations – learning, demonstrating and promoting a different approach. And we don’t pretend to be unique – although we may be a little different in that independent commissioning instead of service delivery is our primary activity. While most of our work is highly specialised around ‘hard cases’ we have also worked as system change consultants and found that our approach lends itself to whole system change in human services.

Purposeful Practice for an individualbegins explicitly from creatively envisioning and then supporting people towards their best imagined life.    

Outlined in an ambitiously drawn Good Life Plan,our approach is to progress by melding those things that knowledgeable, skilled and principled professionals and services can do really well with those gifts (love, commitment, social capital, belonging, true reciprocity, opportunities to contribute to others) that are the unique currency of communities or the relational economy.

This has to be an intentional process.  One that sees resources committed to enabling deliberate action to be taken to build community connection, as much as to meeting physiological needs; one that statutory bodies commit to, but don’t seek to dominate. Our approach demands a radically different skill-set of professionals delivering support and usually a fundamental culture and systems shift in employing organisations. Over the last three decades those professionals who used to practice locally to coproduce care solutions with citizens have been reassigned to assess need (not potential nor aspirations), establish eligibility, and supervise transactions with services. The social services infrastructure has been largely dismantled. The abundant assets of the relational economy are being devalued, ignored, and wasted.

However, it seems impossible to get this demonstrably more sensible, affordable, effective and sustainable approach discussed. It seems that the ‘sanctity of the market’ over-rides any other considerations and is set in the DNA of Whitehall. This is reinforced by the inevitable self-interests of those actors, including the voluntary sector that is no longer truly charitable, that are trapped in the transactions of an illogical and eventually catastrophic system.

There seem to be obvious parallels with the climate change situation – the stupidity that derives from short-term self-interests; the evil implicit in self-delusion; the compromised ethics of business.

Bob Rhodes