Why Is the Social Care Debate So Primitive?

I read the Chief Inspector of Social Care’s, Andrea Sutcliffe, recent article in the Guardian with disappointment and concern at her arguments, as well as the wider debates within social care. Social Care has been politically reduced into simply being about warehousing older people, as loved ones simply waiting to die, with no contribution left to offer society.

The fact younger people like myself have remained caught up in this stereotyping makes it even worse. I had to reflect on my own assumptions as I realised that the aspiration to make a meaningful contribution to family, community and society remains the same at any age, even if people’s individual goals are very different. There is a terrible myth that the onset of chronic illness or impairment gives a guaranteed spot on a conveyor-belt to dependency and meaningless, which does not have to be the case.

If we explore the endless claims that there is a funding crisis within social care, it depends what you want from social care. If you want anyone who appears to be dependent on others in any way to be left doing nothing in a care home for the rest of their lives, all in the name of dignity and compassion, then this is no longer going to be affordable again. I am glad this is the case as it seems a lack of money has been the central motivation for the many innovations within social care to enable and empower individuals.

Direct payments, paying money directly to users to manage their own support, has been the greatest advancement in social care over the last 20 years. It however seems that too many resources have been used by professionals to reduce the power of direct payments, so they can retain their power and their jobs. The greatest criticism I have about the current discussions within social care is there are still incredibly low expectations of the quality of life, in terms of opportunities and experiences, of service users generally. So long as I am alive, reasonably healthy, eating, sleeping, able to get dress, and feel safe in my own home, the job is ticked as done.

I would like to suggest the current warehousing outcomes of social care is neither good for users nor cost efficient. By providing proper support to enable and empower users of all ages to maximise their full potential, however that looks, can only bring benefits to their families, communities and the wider society. While funding will always be an issue, it is the quality and attitudes of the support provided that will make the real difference.

When we stop trying to look after people like children, and start supporting them as adults, is when we can start to feel proud of social care. But to achieve this, we need to overcome a number of things. These include the difficulties many social care staff have in letting go of the power they wield within a system of passivity. We also need to change the public’s obsession with perceiving all service users as vulnerable beings who deserve their pity due to their own fears about frailty.

Both Politicians and civil servants like Andrea appear to be mostly unable to see social care as a tool to enable and empower people. They prefer to portray social care as an act of charity upon the weak and vulnerable, which a civilised society has a responsibility to simply take on the chin. But this attitude is helping no one except those who are dependent on this disempowering warehousing for their livelihoods.

from Simon Stevens http://ift.tt/1NnY79D

My Labour MP is undecided to whether I should keep the right to life

A few weeks ago I attended a lobby of MPs, at Portcullis House near the Houses of Parliament, to ask them to oppose Rob Marris’ Private members bill on ‘Assisting Dying’. I was pleased to see that my own Labour MP, Geoffrey Robinson, had turned up to meet me, although that was as far as my pleasure went.
I tried to explain my position on the matter to him and quickly realised that due to my speech impairment, he was not getting a word of what I was saying. I grabbed one of the eager organisers of the lobby, who started explaining the issues we all had with the bill and then invited my MP to have his picture taken with me and a placard saying he opposed the bill. This is when Geoffrey went white as a sheet and started repeating he was undecided. I tried to ask him what were the points he was undecided about, but he simply ignored me.
The conversation ended bizarrely when he talked to the organiser and said ‘I think I met this constituent in Coventry before’, which was absolutely true, but he said it in a manner where I felt he assumed I had ‘learning difficulties’, and I was not really part of the conversation. I raised my eyes up to the ceiling at this point in disappointment and dismay to his actions. I was also glad that this time, I had not voted for him in the last General Election, he was certainly a dinosaur of politics!
But for me, the event raises a wider concern of what is Labour’s unwritten policy on Assisted Dying? And indeed the left in general? The green party, claiming to support independent living for disabled people, also publically support Assisted Suicide, raising questions to what this equality utopia looks like! It is also important to note that Kate Green, Labour’s current Shadow Minister for Disabled People, has recently shown her support for the Assisted Dying bill, but how can you publicly defend the right of all sick and disabled people to enjoy a good life when you also publicly believe some of them are better off dead?
If this is what the supposed good guys of disability think, what about the bad guys? In talking to the organisers and others, I realised that most Tories in both chambers of the House are opposed to the idea of assisted suicide. While the vote on the Assisted Dying bill on 11th September will supposedly be a free vote, it is likely the Government will oppose the bill, including David Cameron and the Cabinet. This is a very significant point, has it questions the whole purpose of welfare, as defined by the Left, and what the people shouting about protecting the lives of sick and disabled people really think about us.
If you are unwilling to fully commit to my absolute right to exist, without fear of state sanctioned killing based on my health status, then very little else matters. Is welfare simply about warehousing society’s unwanted, out of sight and out of mind, until society is ready to accept a more proactive eugenics agenda? Social Darwinism is nothing new although political correctness has made any meaningful debate with those with that mindset difficult as they are not often public about their beliefs.
My MP clearly has the right to make his own decision in his own time, but how can I trust Labour is truthful when it proclaims itself the natural friends of sick and disabled people, when one of its more experienced MPs is unwilling to even pretend to care about my worries over Assisted Suicide?
The impact of who does or does not support Assisted Dying/Suicide can not be seen in isolation, as it goes to the heart of their long term political objectives, including their vision of welfare for sick and disabled people. Does Labour’s implied support for the Rob Marris’ bill offer an insight to what an anti-pc Corbyn government may mean for me?

– If you like what I say, have a look at my website at http://www.simonstevens.com or follow me on twitter, @simonstevens74

Hooray! Dilnot’s Care Cap Has Been Halted

After two white papers from twp successive governments, the Care Act was hailed as a major victory as the next generation of social care for adults. The jewel in the crown of the act was the care cap, limiting the amount any one person would pay for social care within their lifetime. It was the brainchild of Andrew Dilnot, the current chair of UK Statistics Authority, who appeared to have little direct experience of social care, and the cap was perceived to be the end of the so-called social care funding crisis.

The cap was supposed to be implemented in April 2016, although after consultation with the Local Government Association, the government has decided to delay the implementation until April 2020, with many people including myself speculating that the cap will probably be scrapped all together. I am very pleased about this for a number of reasons.

Firstly, like the bedroom tax, it is one of those simple ideas that is actually more complex and costly to implement. In order to calculate the amount of care someone has spent before reaching the cap these ‘self-funders’, who currently have no dealings with local authorities, would be required to be assessed by social workers as if they were existing users, to establish a virtual budget that goes towards what they are seem to have spent. This means that self-funders will not just be able to present bills to social services when they feel they reached the cap, but will only receive the costs they are eligible for, which may be very different.

The initial estimates were that over 1 million virtual assessments across England would be needed within the first year of the cap! Not only will this pull social workers time away from service users in immediate need, but they will be required to confront a new type of virtual service user. Because these users, and their powerful families, will not be in crisis, and will have access to lawyers, if not be lawyers themselves, they will have the time, money and patience to demand every penny they can from social services, virtually, as they will not be interested in needs, risks or outcomes. I would foresee council’s legal departments being tied up for decades debating whether toilet rolls are a legitimate care cost.

Not only would the cap be extremely costly to implement, but I fundamentally disagree with the consumerism of social care it would bring. The reality is technology and policies like Personal budgets, and Personal Health Budgets, means there is no reason why anyone can not stay in their own home unless they require intensive nursing care. This means that care homes are now a lifestyle choice for middle class families, making the cap a tax break only they will benefit from, taking an estimated £6bn out of the social care budget in the next 4 years if the cap had been implemented! And remember this is what the charities fighting to end the crisis in social care funding have been asking for!

I feel that like health, education, and other services, social services should be about delivering the best possible outcomes for an individual, in a manner that is cost effective. This means investing in responsive services that enables and empowers people to be as socially independent as possible, taking the amount of money someone receives out of the equation. Personal Budgets and direct payments are an important part of this, but only to provide people with the support they need when they need it.

I knew from my own understanding that the care cap was going to be a disaster for some time, and it would have meant I may have been left without my support being review for years at a time, not always a bad thing, as social workers became overstretched. I am therefore glad the government has had the foresight to halt the cap before any damage was done, as it is now time to go back to the drawing board.

from Simon Stevens http://ift.tt/1K23pSE