For the last few months, there has been endless talk within health and social care fields about a ‘social care’ crisis that reached fever pitch when the Chancellor’s Autumn Statement did not mention social care, let alone providing additional funding. Many people have commented on the situation but very few users have had a say, so here is my stab at it.
The first question to ask about the crisis is which one? Everyone has portrayed the crisis in their own way. I can think of at least four different issues that are portrayed as the crisis. The first is the potential collapse of the care home industry. Then we have the fact people with moderate needs are not receiving support in a traditional way. Next is the level of funding local authorities are not receiving to meet their current level of support provided. Finally, the last crisis is the delayed discharges in hospitals, particularly in A&E departments, that are being attributed to a lack of social care funding.
I would argue that there is a fifth crisis, which is what is the purpose of social care in the first place, but I will come to that in a bit. With all these different issues floating around, the next question is where should any new funding go and here we have the problem. I believe with so many mix messages on what the crisis is, the Chancellor decided to avoid the subject as oppose to getting embroiled in the internal politics of social care.
I believe just more money is not the answer and that any new funding has to come with major reforms. Without any kind of reforms, the new funding will simply be absorbed without producing great improvements and the begging bowls will quickly come out once again. But before we can have major reforms, we need to know what the purpose of social care is as we go forward.
And here as where my viewpoint of a service user comes in. My background is independent living, which is also in existential crisis, and a belief in social inclusion for everyone as contributing citizens. I believe the next generation of service users of all ages are going to be as proactive as myself with higher outcomes and expectations. They are not going to tolerate a continuation of passive and disempowering services designed to please their families more than themselves.
I also believe world economics have changed forever and that social care is never going to receive the funding required to maintain the outdated care system we currently have, where even its vanguard services is rooted in passivity. It is time for the many social care commentators to stop asking for something that is unlikely to happen, and start working on what reforms are needed to design a first class modern social care system within the resources available.
There is a lot of talk and self-congratulation about coproduction with service users in the design of some social care services, but it has been non-existent when it comes to the funding crisis. Yes, there has been a lot of feeling based research on what users think about social care, but users have never been asked about the in-depth issues as equals to other professionals. Even the Independent Living Strategy Group, headed by Jane Campbell, has decided it is not interested in the views of users, only asking organisational representatives to join and debate our futures without the expertise of users with many more years of experience of the issues.
The endless talk of crisis can also be seen as a fear of the changes needed in the social care sector to meet the real requirements of the next generation. Until the sector has a whole can come up with some consensus on how any new funding would be spent to reform social care, it is unlikely to get the respect from the Chancellor it has so desperately been craving for.