Changing the Conversation on Health and Social Care


We currently live in an environment of label based entitlements. By this I mean many people with impairments feel their labels mean they deserve specific benefits and support regardless of what they may actually need, and with little regard to what having the support would achieve. The fight to obtain the support is seen as the end goal, where what happens next is not considered. This creates passive recipients of welfare, and supports keeping people disempowered and excluded from society.

I would like to change the conversation, moving to a point when people ask for what they need to perform relevant activities that allows them to meet their outcomes. In the spirit of ‘best value’, they may need to explain why one more expensive solution is better able to meet their needs to deliver outcomes than a cheaper solution.

So instead of saying I deserve an electric wheelchair because I have mobility issues, I would say that having an electric wheelchair would allow me to go out to work, and a manual chair would be unsuitable as I can not push myself. It would clearly not be that simple but it gives the general idea.

It is easy to say ‘I need that support because I have extra costs’ but I believe it would be quite revealing if everyone requesting support had to explain what support they feel they required and what they intend to do with that support. Two people with the same impairment labels, like diabetes or depression, may have different needs met with different solutions for different outcomes.

For this way of thinking to work, advocacy would need to be put in place to empower people to understand their outcomes and needs, so they can be an active partner in negotiating solutions from relevant bodies. It would mean a move away from passive welfare and towards proactive and meaningful support,

The greatest barrier to this is the mindset of users, professionals and the public. An example of this is the way ’15 minutes calls’ are portrayed. The public outrage is based on the misguided assumption everyone who requires social care can do nothing for themselves, and are simply passively going along helpless without their ‘carers’. The reality is everyone needs are different and some people may need or even want 15 minutes for simple things like putting their shoes on. While 75% of local authorities may indeed use 15 minute calls, there is no data on the total percentage of users who have them, which is likely to tell a different story.

The other thing about 15 minutes is how they are used. Clearly, if someone needs help with having breakfast, preparing a bowl of cereal, and when the carer arrives they are still in bed halve asleep, waiting to be directed by the carer like a young child, then 15 minutes is not going to be enough. However if they are done as much preparation as they can to have breakfast, then 15 minutes will be plenty of time, possibly allowing assistance with other tasks. Again, it is moving from a passive perspective to an active one.

The system is currently broken but few people are willing to offer alternative solutions. My solution is for us to change the conversation from passivity to proactivity and empowerment.

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