Reviews and Contributions

A review of adult social care is underway in Scotland. A huge exercise to be concluded in a short period of time. Out of interest, I have taken the opportunity to read several submissions, most of which are thorough, detailed and well intentioned. I have however, been struck by the fact that had these submissions been anonymous, devoid of any logo or signature, it would have been clear which organisation or part of ‘the sector’ they had come from.

A common thread running through these documents is that problems with the adult social care lie elsewhere, whilst solutions reside in doing more of what those who have written the submissions believe they do well. Each contributor in this, at least partially, dysfunctional system points elsewhere for the root of the problem, whilst simultaneously attempting to shore up the territory on which they reside.

Terminology used in these submissions can confuse even the most discerning reader. Words with meaning and heft become blandishments through overuse. ‘Person centred’ is one such phrase. It is used to convey the idea of individual agency and involvement. However, I am reminded of at least one long-stay hospital I was involved in closing, which had a Person Centred Planning Co-ordinator. In a place where most residents slept with a curtain around their bed and didn’t have a choice of whether they had sugar in their tea (it was made in an enormous teapot and you took it as it came), this seemed at best odd.   

Being person centred is not a badge an organisation can award itself. To do so is oxymoronic. Organisations may try to ensure their practices are person centred, however the only credible evidence to support that assertion is if people being supported say it is so. Person led is far clearer terminology. It supports greater accountability for the provision of evidence illustrating individual agency. It also requires greater humility about what is being achieved.

Words are important. They can provide clarity but can also be used camouflage that which should be exposed. So, rather than considering the priorities each constituent element of the social care system may find beneficial and navigating from there, might we be bolder? Could we take this opportunity to raise our gaze and consider the most effective lens through which to survey the adult social care landscape and bring reality into sharp relief? A human rights based approach would provide a focus through which to examine the current system and how effectively it operates to respect, protect and realise the human rights of all those who live, love and work in Scotland. Whatever the outcome of the current review of adult social care, the fulfilment of these rights should be the vision, the North Star by which we navigate future developments. The vehicles we use to make that journey may be open to debate, the direction of travel however should not be.

1 thought on “Reviews and Contributions

  1. Replace person-led with person-financed.
    Give *every* citizen from birth an annual #socialcare payment e.g. in proportion to their National Insurance payments, but age-weighted.

    Each person can then
    (a) save their payment in their social care account, interest accruing &/or
    (b) transfer it to someone in need, typically but not necessarily a family member &/or
    (c) spend it with an approved provider

    Lots of details and safeguards to be worked through, not least how to incentivise provider efficiencies and collaborative working across specialities, and how to ramp up payments for complex needs.

    But at least the person – & their family & advocates – has some chance of calling the shots.

    And *everyone* has a direct interest in how much gets paid into their #socialcare account each year.

    And what it can be spent on.

    Like

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