The Ageing Process Does Not Stop to Wait for Politicians

Just 55 days after the publication of the Social Care White Paper, “Caring for our future: reforming care and support”, social care is once again in a situation of not really knowing what the future is.

The White paper was short on details on funding, after its publication Richard Humphries of the Kings Fund said “Despite its commitment in the “programme for government” to the urgency of reform, the government has failed to produce a clear plan for how care should be funded or a timetable for how these decisions will be considered.” (click here for full press statement).

Then in mid-august we start getting press reports that Prime Minister, David Cameron “has pledged to end the heartache of tens of thousands of elderly people who are forced to sell their homes to fund long-term care” (Daily Mail 16th Aug 2012) by introducing the Dilnot proposals and introducing a £35,000 cap on care costs.

What is unclear is the extent to which the Dilnot proposals will be implemented. The report by Andrew Dilnot applied the cap to care costs not stating that those in care homes should contribute to accommodation and food costs to the tune of £7,000 to £10,000 a year. Given that the current annual state pension is £5,587.40 pensioners in need of care home services would still need to find money from somewhere.

Because of this, as well as the increase in those who will be publicly funded and the greater overhaul of the system that will be needed if the full Dilnot proposals are introduced, the White Paper largely becomes redundant before its consultation period has even ended.

To top this all off the Ministerial architects of the White Paper and draft legislation, Andrew Lansley & Paul Burstow have been shipped out of the Department of Health, and the principle civil servant in creating the paper, David Behan, has now moved to the Care Quality Commission.

Where does this leave the thousands that need social care services, those who care for them, the thousands of workers providing care etc.

Whatever the political reasons for the change of heart about Dilnot and the reshuffling of Ministers we need, NOW, a statement from Number 10 on exactly what is happening, how things stand with the White Paper and draft legislation in order to reassure social care users and the social care sector that there will be no delay in implementing reform. Social care has become all too familiar with the prevarication of politicians and these changes in policy and the personnel delivering it must not be used as an excuse.

We have an ageing population with increasing need for social care services, the ageing process does not stop to wait for politicians so those politicians need to act now for the benefit of people who need care services now.

Social Care: The Public Perception Hurdle

Social care is something that impacts on the lives of millions in the UK, those who use services, those who provide or commission services, those who care, unpaid, for family members and those who work in providing care. Yet the general public and, more particularly, the national media seem less than enthused about the subject.

One clue to this may be found in the health/NHS debate that has been vigorously contested in Parliament and through the media.

A few days ago the Guardian published a list of 30 odd organisation connected with health and where they stood on the Health & Social Care Bill. Of this only 1 was an organisation that directly represented patients yet there were 10 ‘Royal Colleges’ representing various healthcare professions.

The Royal Colleges do, of course, command tremendous respect and it is easy to understand why. These organisations represent the people whom we may need to save our lives and while there may be a general social decline in the trust of ‘experts’ the Royal Colleges carry a lot of weight in terms of public opinion and media attention.

While there is a multitude of organisations connected with and campaigning for social care none carry the same weight and gravitas as those connected with health.

Naturally part of this has to do with history the Royal College of Physicians dates back to 1518 and even the relatively young Royal College of Nursing is fast approaching its Centenary. Yet social care, in its current form detached from the ‘medical model’ is relatively new and there are relatively few ‘professional’ organisations connected with it.

Obviously the College of Social Work has just come into existence and, perhaps, its most immediate task is to embed itself in the public domain as an authoritative voice on social care.

Aside from this though other organisations may be too detached from the public perception of the immediate issue, for example the Association of Directors of Adult Social Services represent the councils commissioning social care rather than being directly involved in delivering it. Compare a Social Services Director (essentially a civil servant) to a Surgeon or Physician who gives hands on (literally!) health care, we have to have more faith in the medical professional because their actions will directly affect us.

Aside from these ‘professional’ organisations most of the others either represent the care users themselves or the organisations providing care services. With the former the Guardian list has shown users groups do not command the attention that they perhaps should but unless the public attention is grabbed by social care it seems unlikely that the users of social care will either. Trade organisations will suffer from the same inertia of public interest particularly as the predominant coverage of social care is where the system goes wrong and providers fail.

The Royal Colleges also act as centralised points for dissemination of research and innovative practice and whilst there is an abundance of excellent research available in social care and many academic institutions carrying out that work the route through to public perception appears fragmented.

Even in terms of ‘think-tanks’ representation of social care is limited. The Kings Fund and the Institute of Public Policy Research both, certainly, provide excellent contribution to the social care debate but their primary focus is elsewhere.

Social care is diverse but no more so than health provision and obviously the two overlap in significant areas. We need to achieve greater public awareness and interest in social care but, at present, lack the structure and gravitas to engage the attention of the majority of the mainstream media and, through them, the general public.

Perhaps we need a Think-Tank solely dedicated to social care to disseminate research and practice, command media attention and generally raise the profile of social care or, perhaps, more professional recognition of those who work in front line care (a College of Registered Social Care Managers?) to add to the College of Social Work.

Putting social care high on the national agenda is important and we need to look at how this can be best achieved for the benefit of the millions involved in social care.