Social Care For Social Justice
It’s almost official! Levels of public spending are set to soar to 1970s levels under both Conservative and Labour Party election plans, according to a respected think tank. But we would be very unwise to assume that this means in one way or another social care will finally escape the crisis it has long been embroiled in. This has resulted in a worsening pattern of fewer people receiving support and that support constantly diminishing. And this has been happening when all the evidence continues to indicate that we can only expect the numbers and proportions of disabled and older people needing support to increase given the changing demographics of Western societies like ours. Putting it simply, for a raft of reasons many more of us are likely to be around as older and disabled people, with a commensurate increase in support needs.
The Conservative government’s response to this situation since 2010 has been disastrous. It goes beyond their financial attack on local government and the NHS, they have disinvested in social care and compounded the problems by not addressing the failures of privatization and high-risk private financing arrangements. Their concerted attack on welfare benefits has taken billions of pounds out of the pockets of disabled and older people and their failure to achieve health and care integration has damaged service users and both policies even further.
Whether or not Boris Johnson will deliver on his promises – and 31st October will go down as a day of infamy confirming he doesn’t – they are unlikely to provide the basis for a sustainable system of social care. Even when his predecessor Mrs May tried to – with her borrowing of Labour’s ‘death tax’, it would not have addressed social care’s existential problems, even though it succeeded in destroying her political chances.
Labour’s plans for free personal social care, the refinancing of social care and a National Social Care Service are much more ambitious. But if they are to break the chains of the past that have undermined modern social care, then they will need to couple this with further clear commitments. These will need to include:
- Getting rid of the needs and means tests in social care that perpetuate the spirit of the ‘poor law;’
- Basing social care on the same underpinning principles as the NHS; free at the point of delivery and funded from a progressive system of general taxation - the only true way to achieve real integration;
- No longer categorizing social care according to age in a way that penalizes disabled children, working age and older disabled people;
- Ending the perverse incentives that continue to force people into institutional care;
- Basing social care on the philosophy of independent living developed by the disabled people’s movement and now embodied in the UN convention on the rights of disabled people (UNCRPD);
- Transforming the welfare benefits system by basing it on the same philosophy to enable disabled people to live their lives on as equal terms as non-disabled people;
- Encouraging the development of a national network of user led/disabled people’s organisations – the direct and valued voice of service users;
- Seeing social care as an economic generator for sustainability rather than a draining cost on public money;
- It is essential to log unmet needs so that we can begin to estimate social care’s funding gap and rectify it over time, in line with the UN’s helpful idea of ‘progressive realisation’ for independent living.
Just before the millennium, I had the privilege of leading a national research and development project with a team of disabled researchers. We aimed to find out what disabled service users felt about the residential and domiciliary support they received and how best to support them to be more assertive and independent in their lives. One of the surprising findings undertaking the project was that some of the disabled people in residential services we met realized their impairments were less far-reaching than those affecting the researchers on the project. This challenged everyone’s assumptions and at the time helped some people in services aim for and live more independent lives. Policy has gone backwards since then.
All this cannot be achieved in a day but the next government must commit itself to a vision for social care that restores such hopes and possibilities for the growing number of service users who should have the right to expect this.
By Professor Peter Beresford, who is the author of All our Welfare: Towards Participatory Social Policy, Policy Press. He is emeritus professor of social policy at Brunel University London, professor of citizen participation at Essex University and co-chair of Shaping Our Lives.