The Tory answer to the question “who pays for social care?”: You!

Inheritance
Image via WikiHow

Two excellent responses to the Conservatives’ social care manifesto proposal: Torsten Bell at the Resolution Foundation and, of course, The King’s Fund.

It took me quite a long time to figure out the main implications of the proposals (I’m not sure I understand them even now).

We can summarise them as:

  • If you have assets under £100,000, you’re a winner
  • If you have assets over £100,000, you’re not a winner

In essence, the Tory answer to the question “who pays for social care?” is “you, not us”.

Coupled with the proposal to scrap the universall Winter Fuel Allowance, one argument is that the Conseratives’ proposals are progressive, redistributive mechanisms that will benefit people from lower incomes, or working-age people who have been reliant on social care for their adult lives (and are less likely to have built up assets).

The counter argument – including when comparing the proposals against the Dilnot Commission’s proposals – is that these proposals create a further breakdown in the inherent universalism and sharing of risk that only government can provide (see also: the NHS).

These proposals may provide a financial solution to the social care crisis*, but they certainly don’t shore up the idea that “we’re all in this together”.

*Though deferred payments from housing still requires large short- and medium-term injections of cash, and we don’t know how inheritance law and behaviour will respond to these announcements.

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The institutionalisation of successful social movements: peril or pragmatism?

Nesta’s #peoplepoweredhealth event earlier this week was hugely enjoyable. It built on the vast range of work Nesta has done on this topic over the last few years, and brought together a wonderful and diverse range of people.

“Work” shouldn’t be this much fun.

It was a privilege to be part of the session on “People powered health: how to make it stick?” I’ll write up what I said another time, but wanted to share something else that occurred to me through the discussion and after reading this excellent related report on health as a social movement (pdf).

It focuses on the question of what success looks like for innovative approaches:

What if social movements were so successful that what they advocated for was completely taken on by institutions (such as the NHS)? What if people powered health became so sticky that the NHS completely appropriated it?

social movements and institutionalisation

If this happened, would this count as success? Or would it represent too much of a compromise or dilution of what the pure approach was when it was outside the grip of a big institution?

We don’t need to look very far for examples of where this has happened before. In social care, Direct Payments in 1996 were an innovation proposed and owned by the disabled people’s movement. Fast forward to 2014 and personal budgets are the default delivery mechanism for all community-based social care. Along the way, many disability campaigners have become anxious about the compromise of notional budgets or the use of resource allocation systems.

More recently, social prescribing could be argued to be an example of an innovation whose adoption by the formal health system has meant it has moved away from what it was originally intended to be.

And yet in the case of both personal budgets and social prescribing, their ultimate net benefit is greater for their adoption by large institutions than if they’d have stayed as small but perfectly formed innovations.

I wonder if most social movements start out with the hope of what they advocate for becoming part of the system? And I wonder if the inevitable pragmatism that’s needed to reach that point imperils the very value such approaches represent?

My personal view, as I’ve written before, is that if such appropriation makes things a “bit” better for a “few” more people, then it’s worth doing. But it would be fascinating to know what you think!

Avoiding a hierarchy of equalities

There was a major general election announcement over the weekend that focused on mental health policy. Whilst this is great news in itself, I’ll bet someone, somewhere, has written that there should be an equivalent for people with learning disabilities, or for people with sensory impairments, or for carers, or for older people with x condition etc. etc.

This is not where we want to be.

As I’ve written before:

Whilst there are arguments which could be made for each [impairment group requiring something separate], to my mind there is no overarching framework within which all of them hang together. There is no agenda around which all people with a commitment to disability rights and equality for all disabled people can coalesce.

In the absence of an overarching disability rights and equality framework, what we end up with is a hierarchy. In such a hierarchy, mental health is currently doing (relatively) ok, but learning disability less so. And if learning disability ends up with a new cross-government strategy then what about… and so on. Goodness knows what happens if you’re a person who happens to tick more than one box.

The point can also be extended to other equality groups: there is common cause, for example, in closing the gender pay gap and the disability employment and pay gaps (as exemplified by the nonsense suggestion that people with learning disabilities should be paid below the national minimum wage).

Insteaf of separate policies we should be calling for a reignited overarching disability equality strategy, which builds on the heritage of the Life Chances report, the Independent Living Strategy and Fulfilling Potential. Underneath this could easily lie dedicated action plans and analysis that relate to particular impairment groups, and so still taking account of the specific barriers some groups face. Such a strategy would clearly link to a general equalities strategy, showing common cause across all protected characteristics. This should all be backed by a strong central government presence, including through a significantly rejuvenated Office for Disability Issues, through the Government Equalities Office or, perhaps, through proper resourcing and respect for the Equality & Human Rights Commission.

By avoiding a hierarchy of equalities, the common cause of everyone will be improved.

Are you feeling lucky?

Dirty Harry

We tend to remember the obstacles we have overcome more vividly than the advantages we have been given.

This quote comes from an article about what this tendency (or cognitive bias) to remember how we overcame adversity instead of remembering the easier times might imply for public policy to try and make things more equal for people.

I found myself agreeing with this on at least two fronts:

  1. “Hard” levers of change, such as legislation, regulations and targets, focus much more on addressing obstacles than they do on creating better opportunities to address equality issues
  2. I’ve often thought of my own luck at various points in my life (making a good friend, having a good teacher, having a godparent who was very interested in sharing books).

We can easily translate this into the “luck” of having a good social worker, doctor, employment adviser etc. and ensuring the opportunities and experiences that public services provide are equally available and good to everyone. I have always been motivated by ensuring that this luck (or “luck”) systematically comes the way of as many other people as possible.

Three pieces on Future Labour

Crack

I continue to struggle in the aftermath of Brexit.

Not, necessarily, just because of the result – it was a long time coming, and perhaps has woken the individualised and consumerised winners of the last 30 years from their torpor.

But also because of where it leaves Labour – stuck, somewhere, fighting the battles of the 20th century.

I’m not sufficiently informed, connected or clever enough to know where the Labour party should go and to offer a view on where the destination is and how to get there. There’s also little I feel I can personally do to help steer or jump on board with where Labour should go. I do know, though, that (1) I have been a Labour party member since 1998; (2) even now, I’m not sure if there is another “party” I would want to belong to; and (3) the current party cannot be or do what it should.

I therefore continue to look for the best diagnoses of Labour’s current situation in order to understand it as well as I can, and for glimpses of what the future could be and how Labour might plot a course to get there.

Three pieces I’ve found particularly useful of late are from John Harris, Neal Lawson and Anthony Painter. Here they are on where we are:

1. John Harris in the Guardian:

As with the centre-left parties across Europe in the same predicament, Labour is a 20th-century party adrift in a new reality. Its social foundations – the unions, heavy industry, the nonconformist church, a deference to the big state that has long evaporated – are either in deep retreat or have vanished completely.

2. Neal Lawson on Open Democracy

Everything that once made Labour strong and the 1945 settlement possible; a unified working class, a bureaucratic system of governance (Fordism), memories of the war and the depression and the existence of the Soviet Union as a global counter to capitalism had gone. They have been replaced by forces inimical to traditional social democracy, namely financialisation, globalsiation, individualization and consumerisation. Labour, I argued, was a ‘Kodak party in a world of instagram’.

3. Anthony Painter:

The point is that the working class – Labour’s alleged base – is irrevocably split. Moreover, there is no going back now. The schism is permanent.

And here they are on where to go.

John Harris:

The left’s future will involve many Labour people, but also some in the Greens, Liberal Democrats – even one-nation Tories – and thousands of people with no affiliation at all. However it is organised, it will have to start with an understanding of the fact this is a crisis of democracy, and support a change to the electoral system and a move towards multi-party politics.

Neal Lawson:

[We] must recognize that no single party or movement has all the answers. The future will not be imposed but negotiated. Most immediately it needs to be negotiated by all the progressive parties in a Progressive Alliance to try and counter the massive shift to the right we are experiencing.

Anthony Painter:

Instead of expending energy on saving Labour, something entirely new is needed. Labour was a movement before it was a party and so should whatever replaces it from within or without be.

This movement would seek to build from the cities out. It would embrace pluralist progressives – from the remain labour working classes to social liberals. It would be a movement that sought to build the right networks and platforms for social justice.

A movement of citizens that would over time seek elected office, it would espouse democratic, economic and social reform…

This movement would demand a new social contract; the current state fails to support the reality of modern economic life and leaves families and whole communities locked in insecurity and poverty. These would be new platforms for economic security such as Basic Income and social mobility. Security and mobility would be seen as dependent upon one another- holding no one back, leaving no one behind.

Remembering “Rise of the Meritocracy” was a satire

meritocracy

From the New Statesman:

But I am also a big problem. People like me, who get educated and quickly head off to London when things aren’t going our way. We invested in ourselves, sometimes at state expense, and never really thought about putting that back into the places where we grew up.

There weren’t the right opportunities back home and that still stands. But, rather than doing something about that, people like me lazily joined the gravy train for London and now we’re surprised we feel more kinship with a 20-something from Norway than we do with someone who we used to knock on for when we should have been at school.

Reading this reminded me that Michael Young intended his 1958 essay “The Rise of the Meritocracy” as satire, not as a platform for policy. As the Economist noted:

Young… conjured up an image of a society obsessed with talent. The date was 2034, and psychologists had perfected the art of IQ testing. But far from promoting social harmony, the preoccupation with talent had produced social breakdown. The losers in the talent wars were doubly unhappy, conscious not only that they were failures but that they deserved to be failures. Eventually they revolted against their masters.

The vote to leave the EU feels precisely like a revolt by the “losers in the talent wars” against their masters.

Young, at least, offered a positive vision for what it could, should be like:

“In the light of this approach [they] sought to give a new meaning to equality of opportunity.

“[It] should not mean equal opportunity  to rise up in the social scale, but equal opportunity for all people, irrespective of their ‘intelligence’, to develop the virtues and talents with which they are endowed, all their capacities for appreciating the beauty and depth of human experience, all their potential for living life to the full.

“The child, every child, is a precious individual, not just a potential functionary of society. The schools should not be tied to the occupational structure, bent on turning  out people for the jobs at any particular moment considered important, but should be devoted to encouraging all human talents, whether or not these are of the kind needed in a scientific world. The arts and manual skills should be given as much prominence as science and technology.

“[All] schools should have enough good teachers so that all children should have individual care and stimulus. They could then develop at their own pace to their own particular fulfilment. The schools would not segregate the like but mingle the unlike; by promoting diversity within unity, they would teach respect for the infinite human differences which are not the least of mankind’s virtues. The schools would not regard children as shaped once and for all by Nature, but as a combination of potentials which can be cultivated by Nurture.”

 

 

Breadline or Left Behind: social work schemes for graduates from the university of life

Frontline and Think Ahead are new routes into children’s and mental health social work respectively for graduates with a 2:1 degree or better. The principle behind them – derived from Teach First – is to attract the “brightest and best” into a job / career they may not otherwise have considered.

My feelings about these social work training programmes have developed over time. Initially I wasn’t keen, but now I feel that anything which promotes social work as a good profession should be, broadly, welcomed.

How my feelings have developed have probably reflected the way the programmes themselves have been refined since their inception. Where before there was arguably an elitist, Oxbridge focus on who the programme’s participants might be, now it feels they’re much more interested in good graduates from a broader set of universities.

I wonder, though, if by focusing only on people graduating from university with 2:1s or above we’re missing an opportunity?

What if, as well as this, we had well-resourced and targeted recruitment campaigns focused on bringing people into social work who are likely to graduate cum laude from the University of Life?

These would be people who never made it to university; a high proportion of them probably wouldn’t have A-Levels. They will have faced adversity at many points in their lives and been used to navigating a whole host of difficult environments. But, despite the many challenges they will have encountered, their character, resilience and way of thinking has meant they have flourished.

If people like this became social workers, imagine the experience and perspectives they could bring to social work! Imagine the difference they could make to people whose lives they would truly understand!

We could call such programmes Breadline or Left Behind – anything that reflected the exact opposite of what Frontline and Think Ahead represents. Without denigrating these existing schemes, though, I think we’d find ourselves with another group of people whose contribution to social work could be significant.

Now, if only we could a think tank to take up the idea…