Reasons to be Cheerful #4: Transforming Care
Sue Goss of Compass on the ethic of care that runs through a good society
In the wake of a transformative General Election, the cross-party group Compass shares its findings on the positive, practical steps in the right direction already happening at a local level in the UK, and on a national scale abroad – exploring how these small but significant solutions could point the way ahead for an era of change for our country. In this series of short articles, which first appeared in the July print edition of Byline Times, Compass highlights just some of the work from its ‘New Settlement’ project.
Through a good society runs an ethic of care, and a shared responsibility for others.
Children are given the chance to enjoy a happy, flourishing childhood, and are offered the educational chances to shape their own destinies. The most vulnerable and disabled youngsters receive appropriate, individually tailored, care and support. Children’s rights are respected and their voices heard, with the state geared around their needs.
At the other end of life, older people are able to play a full role in our communities – through work, volunteering and activism – helped by age-friendly neighbourhoods, good transport links, and digital technology that meets their needs.
When people need help in a good society, it is offered with love, understanding, and compassion. This means we all need to be supported to care well for our children and dependents.
With promises to reform the care system broken again and again over the years, what could be done?
The UK now lags badly behind our European neighbours in support for workers with caring responsibilities, and so employment law could be changed to protect the rights of all workers to take time off to care for others, and create a better distribution of paid and unpaid work between women and men.
Sweden provides 480 days of paid parental leave for both parents (240 days each), and highly subsidised childcare and out of school care.
In Spain, parental leave is compulsory.
Germany gives all children a legal right to a childcare place for 12 months, partly subsidised by the state, with some states offering free public day care.
The Netherlands offers everyone who gives birth a maternity carer for a week afterwards, offering health checks, advice, shared tasks, and the ability to take a rest.
In supporting older people to live thriving, purposeful lives, the UK is also missing the mark. Alongside the growing health crisis of loneliness is the crucial value of intergenerational contact.
Germany has sponsored multi-generational living experiments, creating housing with nurseries and common rooms, so that people can socialise, pensioners can read to the children of exhausted parents, and teenagers can teach older people the latest computer skills.
The sense of shared responsibility, and of looking after each other that we all long for, would mean ensuring that each of us, when we need care, can afford it, and has a say in how it is provided, retaining the autonomy to live a life that we choose.
For that to happen, care workers need the space and time to act with compassion and kindness, and the autonomy to respond to the needs of individuals. They need access to good training and support, career progression, and decent pay.
Compass is of the view that the majority of care services should be provided by government social enterprise or community and charitable organisations, free from the profit motive – to ensure that support is of the best possible kind. The hospice system offers a wonderful example of what all care could be like.
Personal social care is already free in Scotland.
Initiatives like the Wigan Deal, an informal agreement between the council and the community to work together to create a better borough, show how care can be incentivised locally.
Good responsive social care, free at the point of delivery, should be extended across the UK.
But there is also much to do to change the culture and management within care.
Hilary Cottam, in her book Radical Hope: How We Can Remake the Relationships Between Us and Revolutionise the Welfare State, writes about the wellbeing benefits of inclusive and welcoming care systems. She observes that, while the welfare state transformed our lives, it has become a ‘management state’ with lots of gatekeeping, assessments, and referrals being made but no actual help provided to people. Her work, drawn from experience in community projects in Africa and Latin America, showed her that local solutions, made by the people who would live with them, were far better than the grandiose ‘at scale’ technical fixes of international agencies and corporations.
Pioneering projects in the UK have demonstrated the power of care which respects the judgement, autonomy, and knowledge of both caregiver and receiver, taking into account wider social networks and community, and doesn’t just ‘treat the patient’.
The Iswe Foundation, through its Good Help project, distinguishes between ‘good’ and ‘bad’ help. According to its analysis, ‘bad help’ tries to ‘fix’ things for people in the short term but doesn’t take into account a person’s priorities; while ‘good help’ equips people to be able to take positive action to improve their lives, understanding their own personal circumstances and what is actually achievable.
Crucial to a caring society is mental health support.
Yes, we need to ensure people have access to enough professional resources, but increasing numbers of mental health professionals and people with mental health experience suggest that the response should shift from a diagnosis centred on ‘what is wrong with you?’ to one that asks ‘what happened to you?’
Some of the most exciting projects in the UK are drawing on the volunteer efforts of communities of people helping each other with mental health problems.
PFG (People Focused Group) Doncaster won the Queen’s Award for Voluntary Service in 2022 for its work as a peer-led source of mutual support and social change. At PFG, “everyone is a member and a peer supporter”, working together with the local NHS, and in turn saving the Government a fortune.
We need to recognise that the tsunami of anxiety, depression, and loneliness many of us are experiencing is a signal of a society gone wrong – and reclaim the values and rebuild the social institutions and support systems that will make us well.