A while ago, I mentioned the The Seven Ages of Man, and continued the theme with The Seven Stages of Dementia . Then came the Seven Steps to end the scandal of malnutrition. I did consider then that the number 7 might be powerful, magnificent even and so would emerge again.
Then, along came The Seven Ps, all listed within The Seven Principles of the Vision for Adult Social Care: Capable Communities and Active Citizens.
Prevention – Personalisation – Partnership – Plurality – Protection – Productivity – People
I now have a vision of the brainstorming session that must have accompanied the conception of The Seven Ps. A kiss (Keep It Simple, Stupid!) was passed round the room, attracting and enticing members not to overstretch themselves. The Dictionary of Management-speak was lifted from the bookcase; it fell open to reveal the page of Ps. The Seven Ps were conceived immaculately, provided with perfect pre-natal care and delivered without pain relief.
The Dalai Lama said that if one’s life is simple, contentment has to come.
It’s somewhat strange to see People at the end of the list of principles, but I’m sure our Coalition writers have their reasons. Shouldn’t People come first?
There are a few missing Ps, as far as I can see, the first being the paradox. Is it possible to strip and slash local authority funding and budgets while demanding that local authorities assume responsibility for certain functions that were previously the responsibility of National Government? It does not make sense.
Creating capable communities is a great idea, but the word capable appears just once in the full text – apart from the title and as a heading on every page – on page 32 Delivering the vision demands a capable and well-trained workforce.
This capable and well-trained workforce has yet to emerge, and may struggle to emerge with all the cuts being in place overnight and without much in the way of consultation by our Con Dem Coalition. I almost resisted the temptation to mention the lack of mandate given by the Great British Voting Public (the real Big Society – the fictional Big Society remains a mystery to me) to this minority-marriage-of-convenience Government – but that really is another story, another irresistible temptation.
New career pathways will be developed, including more apprenticeships and a new care worker role in home and residential care, as well as more PAs.
Is this yet-to-be-trained capable workforce going to create the capable communities? Will there be a flurry of independent (for-profit private) providers emerging to provide the training? Will there be a move to create a genuine career for care workers? Will there be a decision to pay more than the basic minimum hourly rate of pay so as to attract care workers to care about the work they do? Or will the private profit preferences prevent progress? (Sorry, that’s only five Ps.)
Is the capable community to comprise family, friends and neighbours only, with the capable and yet-to-be-trained workforce retreating into the background? An ever receding professional workforce? The emphasis throughout the whole Vision is on informal support via kind and caring neighbours, willing and able to provide sufficient support to those in need; a Timebank reminiscent of the bartering of old (not much use to those who are already too frail/old/incapacitated to be able to give the little they can now in return for what they need now!). Active citizens?
The Royal Borough of Windsor and Maidenhead, one of the four ‘Vanguard Communities’ for Big Society, will test a web-based complementary currency approach for care and support, to assess the potential benefits both in reduced demand for formal care and in people’s quality of life. That might work in Windsor and Maidenhead, but it won’t work where I live! It may work in many places where an existing community spirit and involvement already exists – but it won’t work in areas where there is no community spirit. Recent decades have demolished communities in some areas; it could take as many decades to create flourishingly caring communities again. What happens to the people living with needs who happen to live in those decimated communities?
Personalisation and choice sound great, and both are long overdue. But I’m not convinced by the plan to increase rapidly the availability of Personal Budgets ‘preferably as Direct Payments’. Personal Budgets ‘preferably as Direct Payments’ won’t suit everyone in need of care. They will undoubtedly suit some recipients who have the physical and mental abilities and energies (or the family/friend/neighbourhood support) to become an employer, to research and search for a PA if that’s their wish, to hire and fire (if need be) a care worker/PA, to manage the financial aspects – and good luck to them. The Vision might be less rosy for someone with mental capacity problems, such as dementia, and who may not have family/friends to support them. Can the Vision envisage vulnerable elderly people coping comfortably to set up their own care package?
According to Pulse: patients shun personal health budgets
As for Demos: Personal budgets will revolutionise social care delivery, but only if local authorities are fully prepared
The Charities are changing rapidly, too – so if the reliance on charities increases just when some charities are crumbling, what then?
File on 4 programme on Charity funding and fraud – grassroots rebellion is underway
Transcript available if the programme is no longer.
The Oxford Student – ‘tax the rich minority and give to the poor majority’ – is on the right track. ‘The electorate have sleep-walked into a cannibalisation of public services and welfare that will push Britain back seventy or so years, as £8.1 billion of public spending has been cut.‘
To the people who voted for the Tories in May, think about this: who paid for the Conservative election campaign? Who bankrolled the triumphalist swagger of these men into Whitehall? Tax evader Lord Ashcroft donated £5.3 million to the Tory campaign. That’s a lot of money, and it doesn’t come without strings attached. Nor does the £1 million donated by hedge fund manager Michael Hintze, whose finance group CQS is based in the Cayman Islands tax haven. Nor still does the £500,000 donated by John Wood, boss of SRM Global, which also has 7 hedge funds registered in the Caymans. These donations makes it difficult to believe that the Tory promise to crack down on tax evasion is anything other than shallow rhetoric. And the fact that the chairman of Care UK, one of Britain’s largest private healthcare providers, donated £21,000 to Health Secretary Andrew Lansley also makes it difficult to believe that the (real term) cuts to the NHS were made in good faith.
Is the Vision the first step towards the privatisation of social care? The LibConDemolition of the Welfare State, of the NHS, of Social Care? Who gave permission for that? Not me.
So, Seven Ps from me to the ConDem Coalition:
Properly procured popular permission prevents public protest.