Why Social Care is Failing

Why Social Care is Failing

Dr Simon Duffy, Centre for Welfare Reform

Pruitt-Igoe

1. Social Care has emerged out of the system of institutions and the Poor Law. It has not yet shaken off the legacy of its problematic past.

2. The system is now in a profound system-wide crisis, accelerated by austerity. It is breaching human rights and increasing rates of death and abuse.

3. The law and systems of advocacy has been wholly inadequate to defend the right to social care for individuals or society as a whole.

4. The system (commissioning, care management & regulation) is struggling to overcome the damage caused by the ‘purchaser/provider split’.

5. Genuine innovation is counter-cultural and it (a) promotes citizenship (b) strengthens family and (c) enables community cooperation.

6. We need a new system of social care to combine universal, non-means-tested entitlements with local systems to prevent need and strengthen inclusion.

7. Change will require new strategies and a leadership which can heal the fractured nature of the social care community.

1. Social Care

What’s wrong with Hayley?Absolutely nothing.

2. Crisis

The Committee is seriously concerned about the disproportionate adverse impact that austerity measures, introduced since 2010, are having on the enjoyment of economic, social and cultural rights by disadvantaged and marginalised individuals and groups. The Committee is concerned that the State party has not undertaken a comprehensive assessment of the cumulative impact of such measures on the realisation of economic, social and cultural rights, in a way that is recognised by civil society and national independent monitoring mechanisms (art. 2, para. 1).

UN Committee on Economic, Social and Cultural Rights:Concluding observations on the sixth periodic report of the United Kingdom of Great Britain and Northern Ireland 24 June 2016

UN declares UK Government fails to respect human rights

…there is reliable evidence that the threshold of grave or systematic violations of the rights of persons with disabilities has been met in the State party… The core elements of the rights to independent living and being included in the community, an adequate standard of living and social protection and their right to employment have been affected… freedom of choice and control over their daily activities restricted, the extra cost of disability has been set aside and income protection has been curtailed as a result of benefit cuts, while the expected policy goal of achieving decent and stable employment is far from being attained

UN Committee on the Rights of Persons with Disabilities:Inquiry concerning the United Kingdom of Great Britain and Northern Ireland carried out by the Committee under article 6 of the Optional Protocol to the Convention 6th October 2016

UN declares UK Government fails to respect disability rights

http://bit.ly/counting-cuts

In total, across England as a whole, the WCA disability reassessment process during this period was associated with an additional 590 suicides (95% CI 220 to 950), 279,000 additional cases of self-reported mental health problems (95% CI 57,000 to 500,000) and the prescribing of an additional 725,000 antidepressant items (95% CI 406 000 to 1 045 000).

Barr B, et al. J Epidemiol Community Health 2015;0:1–7. doi:10.1136/jech-2015-206209

• The battle for citizenship and lives of meaning goes on.

• Margaret had lived life blighted by institutional abuse from an early age.

• She left Lennox Castle Hospital 20 years ago and uses an Individual Service Fund managed by Inclusion Glasgow.

• Over time her service evolved into a wonderful form of shared living and family life.

• But today Glasgow Social Services are planning to move Margaret from her home into a Nursing Home.

3. Advocacy

• Little independent research

• Charities and advocacy groups co-opted or muted

• Regulation kills innovation

• Many MPs have shares in residential and private healthcare

Where are our defences?

http://bit.ly/care-crisis

Public policy is designed to promote stigma

4. System

Have direct payments hit their peak?

…confused responsibility & liability

5. Innovation

Citizenship is practical and inclusive

http://bit.ly/peer-power

6. Reform

7. Change

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