This is a really helpful breakdown of all the different perspectives on this topic, Martin. (And thank you for including my article!) I especially like Maurice Hamington's idea that we can "push care at all levels, in all directions". Different levels of action don't have to be incompatible! And different actors can have both overlapping roles and their unique contributions: a state won't ever be able to love someone the way a family can, but there are some basic services that could never be properly provided to everyone by another institution than the state.
Thanks for your comment, Mélina. I love that line 'a state won't ever able to love someone the way a family can', but your reporting on initiatives in Latin America and Cambodia demonstrates that local and national authorities don't need to 'take over' caring from families and communities in order to support them - but can provide vital support and coordination to enable and facilitate their caring.
I must admit, it's hard to read the theory and aspirations when I've encountered so many harsh realities in the UK, Martin.
I haven't read your book, but from what you've shared here, your perspective and that of Melody Escobar are what many in the UK are already endeavouring to do, right now, to compensate for the delay in Government social care reforms and underfunding of the NHS.
For example:
- Unpaid carers are leaving work or, at a minimum, reducing hours to care for loved ones, and some people wonder why over-50s are 'retiring early' or not returning to work.
- In some areas in the UK, whether you are seeking paid carer support privately or by the social services, the agencies could be the same. There is limited availability of resources outside London its a 'postcode lottery'
- Charity is already playing a huge role in palliative/hospice and end-of-life care. NHS funding accounts for less than a third of operational funding.
- hospice home care is so limited (e.g. nurse care overnight) that families can only hope they'll be called that day to be told someone could come that night— not 'on-demand'. Charities are doing amazing work to prioritise those most in need.
I appreciate the different perspectives and opinions as you've laid them out.
The increased need for care has already outpaced changes in government policies and infrastructure; local projects are working hard to fill the gap.
Thanks for your comment, Victoria. I'm sure much of the theorising about whether the state should do more to support care can seem very abstract if you're fighting these battles every day. I agree with Melody Escobar's point that even the most dedicated unpaid carers need practical support from the wider community - which often means the state - in order to support their care for loved ones.
As you can tell its frustrating to watch. We'll see what The Baroness Casey Commission says. Cllr Martin Tett, Adult Social Care Spokesperson for the County Councils Network, response to the announcement of the commission Jan 3 2025:
This is a really helpful breakdown of all the different perspectives on this topic, Martin. (And thank you for including my article!) I especially like Maurice Hamington's idea that we can "push care at all levels, in all directions". Different levels of action don't have to be incompatible! And different actors can have both overlapping roles and their unique contributions: a state won't ever be able to love someone the way a family can, but there are some basic services that could never be properly provided to everyone by another institution than the state.
Thanks for your comment, Mélina. I love that line 'a state won't ever able to love someone the way a family can', but your reporting on initiatives in Latin America and Cambodia demonstrates that local and national authorities don't need to 'take over' caring from families and communities in order to support them - but can provide vital support and coordination to enable and facilitate their caring.
I must admit, it's hard to read the theory and aspirations when I've encountered so many harsh realities in the UK, Martin.
I haven't read your book, but from what you've shared here, your perspective and that of Melody Escobar are what many in the UK are already endeavouring to do, right now, to compensate for the delay in Government social care reforms and underfunding of the NHS.
For example:
- Unpaid carers are leaving work or, at a minimum, reducing hours to care for loved ones, and some people wonder why over-50s are 'retiring early' or not returning to work.
- In some areas in the UK, whether you are seeking paid carer support privately or by the social services, the agencies could be the same. There is limited availability of resources outside London its a 'postcode lottery'
- Charity is already playing a huge role in palliative/hospice and end-of-life care. NHS funding accounts for less than a third of operational funding.
- hospice home care is so limited (e.g. nurse care overnight) that families can only hope they'll be called that day to be told someone could come that night— not 'on-demand'. Charities are doing amazing work to prioritise those most in need.
I appreciate the different perspectives and opinions as you've laid them out.
The increased need for care has already outpaced changes in government policies and infrastructure; local projects are working hard to fill the gap.
Thanks for your comment, Victoria. I'm sure much of the theorising about whether the state should do more to support care can seem very abstract if you're fighting these battles every day. I agree with Melody Escobar's point that even the most dedicated unpaid carers need practical support from the wider community - which often means the state - in order to support their care for loved ones.
Thanks, Martin.
From a carer's perspective, the question was answered - multifaceted, person-centred care reforms were recommended, but implementation and funding have been delayed - specifically care in the community: https://www.cqc.org.uk/press-release/cqc-warns-lack-investment-community-services-threatens-shift-towards-care-outside
As you can tell its frustrating to watch. We'll see what The Baroness Casey Commission says. Cllr Martin Tett, Adult Social Care Spokesperson for the County Councils Network, response to the announcement of the commission Jan 3 2025:
https://www.countycouncilsnetwork.org.uk/independent-commission-on-adult-social-care-announced-ccn-responds/
appreciate this round-up, Martin!