I was rather taken aback by Sajid Javid preposterous announcement at the Conservative party conference when he said people shouldn’t always go first to the state.
What kind of society would we be, “Health and social care begins at home. It should be family first, then community, then the state.” I sometimes wonder what planet some of our politicians live on.
The idea that the British public need to be lectured into caring for their own family will be news to the more than 9 million people who are already unpaid carers for their loved ones. As it will to the additional 4.5 million people who have started caring unpaid since the start of the pandemic. This country’s reliance on family carers is so extreme that we even expect children to do it.
Insult to caring families
In my opinion it is an insult to these families to imply they need to do more. Many have been pushed into poverty as a result of giving care and are struggling with their mental or physical health. Countless others are racked by guilt because they can’t help their loved ones, either because they live too far away or are too old or disabled themselves to cope with caring demands.
The Health Secretary’s comments are not just uncaring but simply offensive. If taken as read, they are a worrying sign about the future of social care. It is worth reflecting on what Javid’s speech means: the health secretary is suggesting that government should not take overall responsibility for health and social care. That is not a minor thing. It is a radical rewrite of the social contract, and an abandonment of the responsibility of government.
Fixing social care
Last month, Boris Johnson’s social care plan gave minimal extra funding to the sector, and no word on how to meet unmet care needs.
It isn’t “fixing” social care for the government to tell families to do the care themselves. It is passing the buck. Why bother solving staffing shortages or unmet care needs when you can just shift the burden on to the public?
Putting the burden of care on individuals rather than the state is clearly ideological, but it has real consequences. It leaves those without family – or those without family with flexible jobs or who live nearby – alone. It creates a mental and physical health crisis, where unsupported relatives give 24/7 care. Is the call for care “to begin at home” really a call for carers to go out to work all day, fitting in the care they give to their loved ones on top of their work. Or to quit their careers altogether and labour at home for free.
A threat to the welfare state
The Health Secretary’s rhetoric seems to be at odds with the spirit of the 1948 National Assistance Act (based largely on a report by Sir William Beveridge, Social Insurance and Allied Services (1942)) set out the basis for an insurance-based system for health services and unemployment support. The Act established the framework for the establishment of the welfare state, which separated local responsibilities for welfare from national responsibility for social security. This created the National Health Service (NHS) as a universal service free at the point of need, alongside selective social services provision organised through local authorities.
Social safety net
Sajid Javid seems to have forgotten why the 1948 Act was enacted. Sir William Beveridge recognised that people in our society should no longer be asked to rely on philanthropy or charity when we are sick or old. What was needed was a well-funded social safety net that provided security and dignity, something that even the most loving individual will struggle to do.
Family and friends will always be part of the care system, but they should never be its centre. Similarly, care should be undertaken out of choice because it suits both the care giver and user, not out of desperation because public services are underfunded. That’s what people pay their taxes for, as do the taxes of their unpaid carers.
People who give up their careers and opportunities for work must be seething about Sajid Javid statement. He fails to recognise that for many years, family carers have been the backbone of this country’s broken care system. These people don’t need lecturing about a caring society they are the ones that underpin it.
In trying to gain transient plaudits from the party faithful, Sajid Javid is prepared to turn the clock back to pre-1948. He should remember the contribution of Sir William Beveridge and his vision of a state where support and help were provided by social services when people were assessed as in need of it. Surely, this is why we all pay our taxes. Albert Cook Albert Cook BA, MA & Fellow Charted Quality Institute Managing Director Bettal Quality Consultancy