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Social care - "a new vision"??
Under the headline "Social care - a new vision", the main article in our May newsletter (Click here to see it) outlined proposals for the future of care services in the Government's Green Paper "Independence, Well-being and Choice". It provoked a vehement response from our membership secretary, Pru Gibson:

I read this article with interest. However, I could hardly believe the spin - "one of the most imaginative documents to emerge for many years" - that had been put on it. As I read on, it turned out to be even more outrageous than I had thought. Who do they think they are kidding?

It certainly represents "a dramatic change of direction" but basically amounts to a withdrawal of present state support and replacing it with a number of options or "choices":

(1) They will give you a lump sum (no amount stated) and let you make your own arrangements. This would obviously allow the better-off a big advantage, as they would be able to top-up more generously. To most, it would not offer much "choice".

(2) Day centres, care homes and other facilities are rapidly being scrapped; people needing these facilities would have to rely on the private sector.

Other alternatives are designed to allow us to stay in our own homes, again with a choice of how this can be arranged:

(3) We are offered intermittent shoppers, cleaners, carers and advice.

(4) They propose (and this is the most terrifying of their proposals) to instal a system called "Telecare" which allows Big Brother to monitor you day and night to make sure you are doing the right thing.

Most old people would like to live in dignity in their own homes. But this is clearly not possible if they are bedridden or suffering from dementia, Alzheimer's, Parkinson's, incontinence, or just the usual disabilities that go with old age. They are vulnerable, confused, lonely and afraid. What they really need is constant, skilled, tender loving care - not robots.

It is clear, particularly from the "What next?" paragraph, that this is a thinly-disguised cost-cutting operation. Whilst I agree that we should be saving money, at least we could be honest about it. Are there no other expenditures that we might be cutting? Wars? Use of helicopters where a train would do? 4x4 gas guzzlers? Part or full privatisation of many of our public services? Excessively high salaries?

Are these more important than the welfare and comfort of our elderly?

* * * * *

Pru is not alone in seeing dangers in the Government's new approach. Ivy Douglas, a member of Southwark Carers' committee, also sees the emphasis on keeping people out of hospitals, nursing homes etc. as a way of meeting the needs of growing numbers of old people without any increase in cost. She writes:

As a carer I have anxieties about the proposals in this Green Paper. I already accept responsibility for looking after my husband at home, but I do not wish to see a political climate develop which diminishes his right to go into hospital if he needs more acute care. The use of the word "choice" in their proposals is wholly misleading because there comes a time in most people's lives where admission to hospital has nothing to do with "choice". It is a surrendering of independence, due to sheer necessity, in order to safeguard their wellbeing.

It is evident that the new system will rely heavily on carers and volunteers in order to succeed. But carers in particular need the reassurance and guarantee that they can expect hospitals or nursing homes to be readily accessible at critical times.

* * * * *
So were we wrong in describing the Green Paper as "one of the most imaginative documents to emerge from a government department for many years"?

We were certainly not alone in taking a positive view. Paul Cann, Director of Policy at Help the Aged - an organisation that is not slow to criticise government policy - calls it "the most significant development in adult social care in 15 years".

But, of course, it is actions, not words, that count. Giving people more choice and more control over the way in which care services are delivered is surely a desirable aim, but it cannot be the only aim. As the Liberal Democrats' new health spokesman, Steve Webb, said the other day in the House of Commons,"Who could be opposed to giving people new choices and new options? However, when our constituents come to talk to us about the health service, I have yet to meet someone who says, 'If only I had more choice and diversity.' Ninety-nine times out of a hundred they say, 'If only I had prompt access to quality health care.'"

What we need to do, therefore, between now and the end of July (the deadline for responding to the Green Paper), is to go through the proposals in detail and ask "Will this result in better quality services and a better quality of life for those receiving them?" And if the answer is "Yes, but only if more public money is provided", we must insist on that being done. More choice, limited to those who can afford to pay for it out of their own pockets, is not an aim that either needs or deserves our support.