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The Corruption of Social Care Reform

Author: Dr Mervyn Eastman

Mervyn Eastman reflects on both the ongoing failure to explore what Social Care should and could mean and the role of cooperative principles might play in helping to redefine Social Care. He observes that that the seventh and final principle of the cooperative movement - care for community - rarely gets a look in when people start thinking about the use of cooperatives in Social Care.

Mervyn Eastman is Founder Member Change AGEnts: The Co-operative Guild of Social and Community Workers.

So What’s Fair About Care and Can Co-operatives Deliver?

Before exploring both the question and offering what reform could mean in the context of Co-operative Principles and Values, we need to be clear about what is meant by the term “social care.” Politicians, at national and local levels, commissioners, providers and, by and large the public, see it primarily through the lenses of addressing deficit, dependency and sickness. My contention is that that mindset has led to the provision of institutionalized, pathologized and paternalistic responses. It has become marketised, monetised, medicalized and perverted any meaningful responses to what should be the fundamental objective of social care. Namely that we all want to “live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us”.(1)

Who are these people? They are us.

The challenge is to benchmark current and emerging responses which claim to prevent deterioration, promote independence, social inclusion, life chance opportunities, strengthen families and communities and protect Human Rights).(2) Above everything else, to advance in any social care response citizenship for all. How do they measure up? They don’t!

Social Care, social welfare and Social Work post the Thatcher reforms of the 1980s created an almost impossible maze in which to navigate access to care. This has been compounded by successive Governments (pre and since devolution) that have left individuals lost, confused, marginalised, forgotten and more socially excluded, to say nothing of the current endemic breaches of their human rights. The very term Social Care is outdated and unfit to adequately describe the broad landscape that determines wellbeing, prevention, where and how we live, and communities of interest/belonging, accessing opportunities to do and experience things that matter to us.(3)

Citizenship for all? Not in Social Care I’m afraid.

Whilst Social Care remains in a maze of complex bureaucracy, based on rationing, under investment, and more like a Dickensian Circumlocution Department (Little Dorrit, Charles Dickens,1857), simply adjusting the tax thresholds and increasing NI contributions is a total abdication of responsibility to re-define, re-cast and re-invent Social Care for the 21st Century. At the end of the day the Government Reforms announced in September 2021(England) mean the wealthy benefit and the poorest, even more socially excluded and marginalized and out of any experience of citizenship, continue to be labelled sick, dependent and in deficit!

Using the term “Corruption of Social Care” implies there was a time when pre Margaret Thatcher, even pre the premierships of Harold Wilson and Edward Heath (1970) it was fit for purpose, citizenship based and somehow a “golden age”! This is debatable and potentially evidence of cognitive dissonance. That said, in my early Social Work career, practice was largely underpinned by community development (based on relatively small geographical neighbourhoods). 

We need therefore to define what is meant by community, especially when I later wish explore the potential impact of Co-operative Principle Seven - Concern for Community in the context reform and citizenship. The definition I have adopted as being helpful, at least to me, is that of Professor Peter Somerville, namely community “is a kind of state of being or existence” and whilst he rightly says the term community is ambiguous “its value as an idea lies in its core meaning as social attachments, bonds, ties of obligations beyond the family.”. (4)

Cormac Russell, Founder of Nurture Development acknowledges that despite the lack of an agreed upon meaning, it doesn’t mean it doesn’t have one. It is he says “so brimming with meaning that each of us must make sense of what it means to us”. This is powerful. Cormac argues that if we think of community as a verb instead of a noun asking ‘what is community’. It is reframed to asking ‘where is community to you’?(5)

Both Peter Summerville and Cormac Russell have had a profound effect on my thinking regarding community and, the notion of social care political and policy ideology. This led me to think about if and how Co-operative responses and Principle 7 measure up. 

If Co-operatives are about ownership, control and benefit of and to its members what’s the impact, if any, to its Principal of Concern for the Community generally and Social Care specifically? Equally Peter Beresford, Visiting Professor at the University of East Anglia and Co Chair of Shaping Our Lives provides us with a useful framework and critique in how we can “bring together theory, practice and the relationship between participation, political ideology and social welfare (care)”.(6) Peter’s work is important as it causes us to recognise that: ideas, beliefs, interests and policies whether collective, organisational or individual, have direct impacts on what we do and what is done to us.(7)

In recent times there has been an increased interest by the UK Co-operative sector in developing Social Care provision and services. I was initially excited by this as it had the potential to, through member ownership and control, shift the existing power imbalances that exist within both public and private social care provision. If users, the staff, families and local communities (as defined above) equally own and control the responses to “need” we might, just might, address the paternalistic and institutionalised service structures and cultures that exist. 

In addition, if we developed such multi stakeholder co-operatives and underpinned by the Principles and Values of Co-operation we are potentially able to turn the rhetoric of citizenship into a reality for so called 'recipients’ of social care. If citizenship is framed and understood in terms of civil, individual, political and social rights we must, absolutely must, reflect and take into account the right to visibility, the right to dignified representation, and the right to identity and maintenance of life style.(8) 

I have, over the years, frequently heard that users of Social Care are consumers (customers) but that implies choices, and it implies both the availability and access to a range of personalised services. Even the term service is problematic. Consumerism and marketization is the hallmark of present day Social Care and if Co-operatives want to enter this very fragile and expensive market place, using its ethical brand to attract commissioners to purchase, individuals to prefer over private sector providers and the community to support. Beware of the care wolf in sheep’s clothing branded Coop!. The citizenship of member-users will be sacrificed on the altar of balance sheets and expediency. A social care Co-operative chasing money in my book is not a co-operative I want to be associated with. 

What therefore does Principal 7 Care for Community offer which is different? What is the Co-operative offer? In terms of Social Care I would say nothing beyond gifting and benevolence. Care for Community can be, must be, rooted in a transformative and radical social vision and responsibility leading to civic participation and social justice. It has to be the very underpinning of social care provision, locally owned through a multi stakeholder. I have frequently said, and written, that Co-operatives are more than selling “carrots and coffins” but in the minds of managers and staff of High Street stores or funeral directors it is about selling social inclusion and justice.(9) 

Simply dressing up as Father Christmas rattling a tin for the local residential care home or donating cakes to its annual fete or summer Bar-B-Q doesn’t cut it. 

So what’s fair about care? Nothing. But Co-operative social care could begin by applying all its Values and Principals. Adopting a community development approach, committed to combating social exclusion, prejudice, inequality, poverty, disadvantage and discrimination that work toward citizenship for all is key. It means that we think differently about care and how we think about those individuals who by right, human right, want to live a life that experiences social care as full citizens, in control, participating and empowered. Physical and/or intellectual disability is about ability; mental health is about wellbeing; later life is about development and adventure but above all it requires home based natural and beloved communities. We want to live free from injustice and exploitation, safe, secure, economically engaged, co-creating care and shaping both civic and civil society. Adult social care must re enforce not diminish these rights of citizenship. 

The challenge for Co-operative care is to enshrine these rights, which in my view have the potential to not just redesign and reconstruct Social Care but to turn it upside down, ridding the corruption and making it fair, just and inclusive.

References:

  1. Crowther N (2019) Talking About A Brighter Social Care Future. London: Social Care Future. 
  2. Social Care Institute for Excellence 
  3. Eastman M (2021) Draft Policy Submission on Adult Social Care. (dis)Ability Network. London: Co-operative Party
  4. Somerville P (2006) Understanding Community: Politics, Policy & Practice (2nd Ed). London: Social Policy Association. 
  5. Russell C (2020) Rekindling Community (pp 177-178). Oregon: Cascade Books. 
  6. Ibid 
  7. Beresford P (2021) Participatory Ideology: From Exclusion to Involvement. Bristol: Policy Press.
  8. Harris J & White V (2018, 2nd Ed)The Oxford Dictionary of Social Work and Social Care. Oxford: Oxford University Press.
  9. Eastman M (2019) Co-operatives are More than Carrots and Coffins: Towards a transformative Principle Seven: Concern for Community via https://cooperativemervunleashed.blogspot.com 


The publisher is the Centre for Welfare Reform.

The Corruption of Social Care Reform © Dr Mervyn Eastman 2021.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.

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