The BBC reported today on a ‘crisis in home care‘ suggesting the care industry is constrained by budgetary issues. All very interesting but probably not telling many who use health and social care services anything new. Arguably, a central problem in todays care sector is that it is now perceived by government as a product to bought and sold, and more importantly profited from much like baked beans and ipads, only less regulated!
There is no one answer to this issue but a series that could make a positive difference if taken together.
Firstly a change of discourse on care. Could it be possible the promotion of care as a ‘product’ is part of the reason we keep going around in circles on this issue? The commodification of care emerged under Margaret Thatcher out of the community care reforms of the 1980’s and 1990’s. Such an approach is now so firmly embedded within the health and social care sector it is difficult for anyone to conceptualize care as anything other than a product where “value” is equated to cost rather than any sense of ethical practice or notions of compassion for one another.
Secondly, we also have to ask are we recruiting the right people into the care sector, whether as carers, leaders or managers? Clearly there are many good carers/leaders/managers out there, but we need a lot more, however, this has to be based on suitability not availability. On the ‘frontline’ care providers, whether public or private, have had real difficulty in attracting people into the workforce. This is not surprising when you consider how government and wider society undervalue such work. Caring for people is a demanding, and rewarding job, but, carries little status and is seen as something ‘anyone’ can do.
Believe me it is not. From my professional experience I’d say the best front line carers are those who have a deeply ingrained respect for others, and who genuinely like people. This is not something that can be taught, but they are the characteristics that provide the foundation to developing a professional, and caring, workforce.
Recruitment of the right people will only occur however, if we address a third issue, the provision of high quality support and training for carers combined with decent pay and working conditions. These are central to turning the system around.
However, already I hear the cry ‘we can’t afford to’. Arguably, we cannot afford not to if we really want change.
Where our vision of care does not extend beyond a discourse of free markets and cost, a strong philosophical, moral, and ethical framework will be required to guide the provision of care. For care to become more than a commodity reform is required at a structural and individual level, founded on a new discourse that emphasises dignity over price, compassion over cost. We are at a moment in history where society is questioning our whole economic system. Whilst it has brought much in terms of material resources for some, the cost at a moral, ethical and philosophical level in the “care industry” leaves a lot to be desired, maybe it is time to say care is too valuable to be classed as a commodity to be profited from.