Care and Support Reimagined
Author: Joseph Forde
Dr Joseph Forde is Honorary Research Fellow in Historical Theology at the Urban Theology Union, Sheffield. He researches and writes on welfare and Christianity and is author of: Before and Beyond the ‘Big Society’: John Milbank and the Church of England’s Approach To Welfare (James Clarke & Co, 2022). |
The problem with reimagining something is the danger that the vision can become disconnected from the reality ‘on the ground’, making it less credible. I suggest the jury is still out on whether that has happened with the recently published report by the Commission set up in April 2021 by the Archbishops of Canterbury and York, to examine the future of social care in England: Care and Support Reimagined: A National Care Covenant for England.
Certainly, as the report makes clear, the nine Commission Members consulted widely before making their recommendations: speaking to people who get care and support, to those who provide it, and to academics, policy makers and politicians. Their terms of reference were framed in a way that gave them much scope for developing what it describes as: ‘a radical and inspiring long-term vision for care and support in England, underpinned by a renewed set of values and principles, drawing on Christian theology and ethics.’ Yet, it did not include a specific requirement for this vision to be costed, a requirement for advice on how it might be resourced, or even a requirement for how its resourcing might be prioritised in relation to other competing demands on the public purse (although some suggestions are made along these lines in its findings). One is left to ponder, therefore, whether Christian values, principles, theology and ethics will be enough to convince many readers of the merit of the report’s recommendations: or whether the report will be seen by some (including some politicians) as little other than a well-intentioned but idealistic endeavour, and hence one not to be taken too seriously.
It would be a pity if that is what happens, for there is much to be commended in the report, at least from a Christian perspective. For example, it rightly argues that disabled people and the elderly should be able to exercise their rights to live life to the full. It rightly argues that the levels of human suffering due to a lack of care and support are unethical. It rightly argues that creating good care and support jobs is a matter of fairness and equality, and that increasing the pay of care workers would address the gender/ethnicity pay gap. It rightly argues that properly funded care and carers’ rights are essential to the social infrastructure of society, in a way that is similar to child care. It rightly points out that we are wasting money in the NHS when people who are medically fit to be discharged remain in hospital owing to a lack of social care provision. And, along similar lines, the report makes some broad-based but important points about how the care sector is a large and growing sector, projected to increase as the number of over 65s rises from 12 million to 18 million over the next twenty years; hence, it advocates that investment in: ‘businesses producing products and services for care consumers would generate economic growth and enable the UK to tap into the global market.’ Further, it argues that: ‘Care is part of the vital social infrastructure to enable labour market participation, especially of women’, and so there is an economic and social case for investing in it. Yet, how many people from across the political divide or business communities are likely to disagree with statements such as these?
Cross Party Support
I suspect that all of these points would command the support of a sizable number of politicians from across the political spectrum, at least on a theoretical level. For politicians, however, as well as for many of their constituents, the difficulty with turning this vision into a reality may arise when these points are set against other competing funding priorities (one can hear echoes of how, ‘if we didn’t have a magic money tree before the Covid-19 pandemic, we certainly don’t have one now’). This is a dimension that the report touches on, but hardly fleshes out.
‘Lift Our Gaze’
Hence, my beef with the report stems - in significant part - from my scepticism of its stated view, that: ‘The task of reimagining required us to lift our gaze from the challenging realities of today’s situation.’ Perhaps it did, but I am not sure that it should have, at least to the extent that is apparent in its analysis and, arguably, in its recommendations. By taking that approach, the Commission has limited the report’s relevance to what is, essentially, a values based study (though, admittedly, in some respects, a good one). As such, it is a study that might be easier for some politicians and other welfare stakeholders to ignore, precisely because it may be seen by them as too disconnected from the political, economic and financial realities that the country currently faces.
A key recommendation of the report is for a National Care Covenant to be developed, that clearly sets out the mutual rights and responsibilities of stakeholders: citizens, families, communities, and the state, both in providing support and paying for it. It suggests that this should reflect: a greater role for, and investment in communities; a new deal for unpaid carers; a stronger role for the state in guaranteeing access to care and support; and acceptance of what it terms as, ‘our mutual responsibilities as citizens, including as taxpayers, neighbours and members of communities, and as people who draw on care and support and family members.’ It envisages that such a covenant ‘would require a major and sustained programme of public dialogue and engagement.’ I hope that by advocating a need for more public dialogue and engagement, Care and Support Reimagined: A National Care Covenant For England, will be able to demonstrate its true worth as a catalyst for change, by stimulating rigorous debate and analysis at a national and local level on the way forward for social care; a debate that is rightly underpinned by a shared sense of values that will help shape the direction that is taken, whilst also being grounded in a realistic sense of the economic, financial and political constraints that exist, and informed by possible ways of overcoming them.
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Dr Joseph Forde |