5th July 2018
We should be celebrating a joint 70th birthday
Today the NHS turns 70 and I do feel quite proud of it – proud that it came into being and proud that it is still alive if not completely well. It is a symbol of the rich diversity of Britain and of what an aspiration of hope, equality, and fairness can produce. It is still rated as one of the best and most efficient health services in the world. However, the celebration is bittersweet – especially for those of us working in local government. Social care, the overshadowed twin in the corner, is also turning 70 but there is no birthday cheque and the lack of fanfare is deafening.
The contrast is nothing new – but after 10 years of austerity, with both the NHS and social care now at crisis point – the failure to see the fate of both as inextricably linked has become much more painful and frustrating. So, why despite the growing amount of research and experts calling for equal investment in social care, has the government chosen to kick social care investment into the long grass again? I think the clue is probably in the question, it’s the experts, policymakers, and professional bodies calling for equal investment in social care, not the public.
I have friends, family and a partner who work for the NHS – many of whom have wanted to be a nurse or a doctor from a very young age and are extremely proud of getting there. They shoulder huge amounts of stress and long hours on the basis of still feeling privileged to wear the NHS badge and be part of something valuable. Those working in adult social care outside of the NHS may also have wanted to be a social worker from a young age, and they definitely shoulder huge amounts of stress and impossible workloads but their sacrifice does not feel as valued. Of course, neither workforce should have to put up with unsustainable workloads as they do – but the point is that the lack of recognisable badge and public sense of value in a workforce is why it’s possible to ignore the calls for major investment.
Social care means different things to different people and I think many associate it with something they hope never to find out about. In contrast the NHS is there when you’re born, it lives in big buildings that we see on our way to work, it gives you colourful plasters after your first injections, saves lives and generally, you get your screenings, prescriptions, and referrals when you need them. It’s a shared public experience whereas social care is not – despite the fact it’ll keep many people out of hospital for 70 years, turns lives around, and helps people live independent, fulfilling lives for longer, many will never meet a social worker or receive social care.
Every policy unit and think tank that I know including the NHS Confederation has told the Government that the only way to support the NHS meaningfully is to bridge the £2.5 million gap in adult social care funding, agree on a long-term sustainable funding plan work towards better integration. With Solace I’ll continue to work with the LGA, ADASS and others to try to ensure the Green Paper responds to these calls. However, the lesson for me on the NHS’s 70 birthday, is that as a sector we haven’t done enough both before and since the crisis, to bring the public with us on the importance and value of social care. Some may think that’s the job of politicians but I think we all need to be involved.
Part of the reason the focus is on the NHS today is that they’re good at publicly promoting the incredible work they do. Social care might not be present in everyone’s lives in the same way as the NHS but one way or another it will have a huge impact on our communities. In the same way as we need to get better at engaging people in a positive vision of what a council is and does, we need to present a clear story on social care, why it takes up over half of a council budget and why it’s a good use of public money when we do it right.
Perhaps in 10 years’ time, we’ll have real devolution and fully integrated health and social care systems up and down the country. We can certainly try our best from inside the policy world but in the ethos of “nothing about me without me,” I will try to help us make it everyone’s business, and for a valued and rewarded social care workforce to be as big of a source of national pride as the NHS in 10 years’ time.
Vanessa Lucas, Senior Policy Officer at Solace