THE BLOG

Do Politicians Understand Social Care?

23/04/2015 10:35 BST | Updated 22/06/2015 10:59 BST

With electioneering in full swing, I am a frustrated voter. Not because of the endless talk of the deficit, austerity and immigration, but because while the NHS and healthcare feature in pretty much every political debate, by comparison social care is the poor relation.

Of course this situation isn't new. Social care has been dwarfed by health for far longer than my lifetime. In political terms the reason given is that social care barely features in our MP's mailboxes, whereas they are regularly contacted about healthcare issues. Yet can everything really be so neatly compartmentalised?

I would venture to suggest that many of the healthcare issues raised have some element of social care provision attached to them. A classic example is the son or daughter who write to their MP because their mum or dad is languishing in a hospital bed and not receiving the care they need. Yes it's an NHS issue on the surface, but look deeper and that lengthy hospital stay is most likely to be due to a failure of social care provision, either for the person in their own home or in a care home, and the root cause is usually financial wrangling.

Look even deeper still and two other election issues could also have contributed to this person's hospital admission and delayed discharge. Housing (does their accommodation meet their needs or put them in danger?) and welfare, with the low rate of benefits like carer's allowance potentially affecting the care this person's family can provide for them without getting into debt.

The problem is these dots are rarely joined up in the political sphere. Politicians, it seems, mostly prefer to look at individual issues - the silo mentality - perhaps because it's easier from a budgetary perspective, but it certainly isn't reflective of the human experiences of their constituents.

Meanwhile social care is on its knees. Cuts of varying degrees in all areas of England have left people bereft of services and support when they are most needed. While politicians argue over how they will fund the NHS for the next five years, the deep and devastating cuts in social care budgets are hardly mentioned, and there isn't a politician who has been able to convinced me that there won't be far more attacks on social care in the future.

Next Government must put care first. from Arc Seven on Vimeo.

Yet this is all a terrible false economy. Anyone who knows anything about social care, and its value for families and communities, will tell you thus: if you properly fund, and make accessible, high quality social care for people in their own home or, if that isn't possible, within a well-run care home, you are going to keep them out of A&E and prevent them spending weeks in acute beds. Most importantly of all, these vast swathes of the population will also enjoy a better quality of life - a life that is directed by and of their choosing - and at the point where end-of-life care is needed, it will be delivered in a far more appropriate setting than a busy hospital ward.

To me this all makes perfect sense, and yet social care remains hugely misunderstood. People who need social care, or who've been failed by the system due to assessments, funding wrangles or poor quality care, are highly attuned to its importance, but those not touched by it do not realise its significance, and the inextricable link it has to the NHS and areas like housing and welfare. Indeed, I've spoken to people who believe social care is actually part of the NHS and is free at the point of use - big mistake (unless the Green Party win this election).

Politicians also don't want to tackle social care because it's expensive: to make it more freely available would mean huge cuts to other budgets. I would argue, however, that in a compassionate society aspiring to be the best place for people to grow older, there is nothing that is more important to fund than social care. Social care is also largely privatised, which is contentious in its own right, and who knows how many politicians benefit from the spoils of private care provision.

For this election at least, it seems the only billing afforded to social care is within the integration agenda. The problem is, integration has been talked about for years. Moreover, discussions over integrating health and social care still don't get to the heart of frontline social care issues - issues like provision, funding, quality, staffing, expertise... the list is endless, and it's a list I would love the politicians to be debating in this election. Sadly, I think I'm going to be disappointed.