Norman Lamb, the Care Minister, gave an interesting interview in the Telegraph over the Christmas period, which was given the rather unfortunate headline, “Neglectful Britons blamed for forcing elderly into care homes”. This picked up on the Minister’s view that we have become a “neglectful society” and that we need to rebuild “neighbourly resilience”, without which, he was quoted as saying, pensioners lead dismal, lonely lives.
Mr Lamb was given a hard time for this by Sarah Ditum, writing in the Guardian, who said that “The government has some cheek to say we’re not caring enough” and pointed out that more unpaid family carers are caring for more hours per week than ever; a huge contribution which Ditum argues the coalition is undermining with cuts to public services.
Ditum is right that, as social care services are being ever more tightly rationed, whilst the impact upon the NHS is starting to show, the impact upon family carers is often hidden, yet very real.
However, I don’t read the Minister’s comments as being about unpaid family caring. His suggestion that we have become a “neglectful society” is strikingly reminiscent of John McKnight’s suggestion, that we (in his case, the ‘we’ being US citizens in the 1990s) have become “a careless society”, in his book of the same name. McKnight was one of the founders of ‘Asset Based Community Development’, an idea which Lamb’s predecessor, Paul Burstow, talked about approvingly in the run-up to launching the social care White Paper. ‘Asset-based’ or ‘strength-based’ approaches start with the premise that seeing only people’s needs and vulnerabilities (their ‘deficits’) will lead to services being designed to impose outside ‘expertise’ at the expense of individual, family and community resilience. In other words, poorly designed, if well-intentioned, social services can become part of the problem, ‘colonising’ communities and ordinary human relationships and leaving citizens who have, in McKnight’s words, “grown doubtful of their common capacity to care”.
So McKnight was not arguing that people had stopped caring about each other, but that they had stopped seeing the active support of those around them as their role, instead believing that only the state was qualified to provide support. It’s a powerful – and by virtue of its power, a dangerous – argument, but one which needs serious consideration.
A small-state fanatic could see it as an excuse to cut services in the naïve belief that people will start supporting each other as soon as the state ‘gets out of the way’. McKnight was instead arguing for services which were more led by people and which worked alongside and supported their relationships, rather than supplanting them. You only have to look at the isolation of thousands of older people or the disempowerment of many people with learning disabilities living in ‘service settings’, to realise that even well-funded traditional services cannot address isolation, in all its many forms.
I met Mr Lamb a number of times in the Autumn, including to discuss asset– and strength-based approaches, and he struck me as someone genuinely interested in empowering communities, not just in making savings. The Care and Support White Paper last June signalled that community development should start to be seen as a core part of social work again, as it often was in the past. In a period in which, whichever parties are in government, there will be drastic cuts to social care which will in many cases leave vulnerable people at great risk, it will be easy to dismiss community development approaches as ‘cover for cuts’, but to do so would be to see the resources which remain in social care reserved only for increasingly rationed services which in some cases are not able to help people live the lives they would like. The politicisation of the debate around community development, which was one of the few tangible results of the poorly thought-through Big Society story, has only increased the risk that ideas which have been thoughtfully developed around the world for many decades, are drowned out and pass us by.
On Tuesday, we will be launching our briefing on the draft Care and Support Bill, which will set out strength-based ways in which the state and voluntary sector organisations could approach people who come into contact with the social care system, which help people to build upon their relationships and skills, without ignoring their needs and the risks in their lives.
Viewed in this way, the growing burden being placed upon unpaid family carers which Ditum sets out, is not an argument against a more community-focused system. Family carers have unmanageable caring burdens partly because so many care in isolation, without the back-up of a wide network of relationships to draw upon. In a society in which we are increasingly nervous about intruding into other people’s lives, caring is itself isolating and it is no surprise that ‘heavy-end’ and full time caring roles are becoming more common. Informal networks of support rarely spring up spontaneously, but they can only be fostered by workers and organisations who are willing to take a radically different approach to working alongside many others, as part of a networked model of care, not by professionals who see their role as providing expert support to the needy.