In the aftermath of Andy Burnham’s speech to the Labour conference, media discussions are focusing on how to define social care and estimate its cost (How will Burnham’s national care service work – and how will it be funded?, 29 September). Most arguments assume that any new system will look like the existing one, with services outsourced to large companies, using contracts without scope for innovation, with rigidly defined targets, often delivered using poorly rewarded, precariously employed migrant workers. The reality is that many of the services needed by elderly and incapacitated people – such as cleaning, meal preparation, transport to medical appointments, household repairs and personal services such as podiatry, hair care, physiotherapy, counselling or therapeutic massage – are also required by others and are already freely available in local markets.
The trouble is that they are most often supplied by online platforms such as Uber, Deliveroo or Housekeep with no commercial incentive to address social need. One solution would be to set up local platforms that supply these services to anyone, regardless of age or disability. If these platforms made sure that all staff were suitably trained, qualified and security-checked, and their vehicles suitably adapted, they could be attractive to all local residents, whose commercial use of them would help subsidise their costs.
Social care recipients could be provided with access to them using a voucher system that would be much cheaper than setting up such services from scratch or bundling them in with huge outsourcing contracts. With suitable public oversight, using platform technology for public good would also bring other benefits to the local economy. Services would be better for all.
Workers could upgrade their skills and gain job security. And, instead of being siphoned off to tax havens, any profits could remain, as Burnham might put it, “in every postcode”.Ursula HuwsLondon Andy Burnham’s commitment to a national care service brings welcome clarity to a debate that has too often avoided difficult choices. But before deciding how to pay for care, we must answer a prior question: what should people be able to count on?
Reports that the proposed service may follow Scotland’s model of free personal care raise an important distinction. Removing charges for help with washing, dressing and eating could make a substantial difference. But social care is about much more than these tasks.
When we in the coalition government developed the Care Act, we placed wellbeing at its heart. Its purpose extends to dignity, independence, relationships, participation and people’s control over their own lives. There is a risk that defining a national care service primarily through free personal care narrows our understanding of what social care is for.
Extract — continue reading at the source.
