Bob Williams-Findlay reports: Saturday 10th October 2020 saw the launch of the Keep Our NHS Public and Socialist Health Association campaign for a National Care, Support, and Independent Living Service. As the proposed name of the Service suggests, its diverse nature is a contested area; currently, all aspects of service delivery are collapsed into the notion of ‘Social Care’. The original proposal for a campaign was criticized for excluding Independent Living and the involvement of disabled people. With so many differing perspectives on how to fix ‘the crisis within Social Care’, the campaign launch saw quite an array of voices.
The contributions illustrated quite well where the common ground and differences lie. The unions focused upon the pay and working conditions of the care staff with little mention of those who received a service. Quite a number of the speakers seemed entrenched in portraying the ‘crisis’ as being about the lack of resources, marketization and ‘the care of older people’. The disabled people speaking, on the other hand, whilst acknowledging these issues, sought to introduce a bigger picture which included the need for deinstitutionalization and co-produced services.
FIRST SESSION: Chair Tony O’Sullivan, co-chair of Keep Our NHS Public
Poem: Ann Pridmore, Director Being the Boss; EC of Disability Labour and ex-Chair of UK Disability Forum for Europe
Bob Williams-Findlay: Reclaim Our Futures Alliance (ROFA) of disabled people’s groups.
Sandra Daniels: Chair of Reclaim Social Care (RSC)
Jan Shortt: Chair, National Pensioners Convention (NPC)
Cllr Stephen Cowan, Leader of Hammersmith & Fulham Council
SECOND SESSION: Chair Brian Fisher, Chair of Socialist Health Association
Rachel Harrison, National Officer GMB Union
Cllr Barry Rawlings, Barnet Council
Heather Wakefield; Women’s Budget Group
Gavin Edwards, Unison
John McDonnell MP
The first three contributors are members of Left Unity’s Disabled Members Caucus. Below is the transcript of what Bob Williams-Findlay and Sandra Daniels said.
Sandra and I are here today to draw upon our knowledge and experience, not only as disabled people or as longstanding activists, but also as professionals in the field of advocacy and service delivery. We have a combined history, and also personal experiences of discrimination, oppression and being made invisible by arrogant nondisabled professionals with “we know best” attitudes. These are also the collective experiences and encounters of many older and disabled people.
There is a saying, “if it isn’t broken, don’t try to fix it” – everyone here knows how deep and serious the crisis is around the misnomer, “Social Care” – but how we address this situation is another matter. I’m here today to represent the Reclaiming Our Futures Alliance, and as its name suggests, it believes the original values, philosophy, and politics of the Disabled People’s Movement still offer a firm basis for our people’s emancipation – the right not to be seen and treated as burdens on society, the right not to be excluded from or marginalized within mainstream communities or denied the right to self-determination as defined by the UN Convention on the Rights of Disabled People. Our Movement was forged upon overthrowing the systems that excluded and marginalized us in segregated setting with no or little control over our lifestyles. From the Poor Laws through to the 1990’s Community Care Act and beyond, the treatment of people considered non-productive, has been shamefully oppressive. To be candid, the current system isn’t just broken; it was never fit for purpose in the first place.
It is totally inadequate to talk about reforming or reclaiming the system. Whilst ROFA hopes the campaign for a National Care, Support and Independent Living Service will gather momentum around its demands, there remains a fear that the emphasis will only be on:
• Taking services back into public ownership; ending privatization • Increasing resources through taxation and free delivery • Improving services, pay and conditions
Of course, these things are crucial for the way forward, but unless attention is also paid to the historical dependency model which underpins “Social Care” – perpetuated by disablist and ageist stereotyping – we will simply be sugar coating a turd. There is a need to replace Social Care, and we collectively need to work together to produce an alternative vision. ROFA through its position paper on Independent Living as presented a vision, but this is not a ‘one size fits all approach’, it recognizes the need for partnerships capable of protecting the Human Rights of people of all ages who need support by addressing difficult questions such as the culture of institutionalised living for older and disabled people
This campaign’s demands need to be woven into short, medium and long term objectives. Advancing these demands requires a strategy which combines resistance, education and a challenging vision and practice. Our immediate concern during the pandemic has to be the protection of residents, service users and staff; promoting the rights of families and friends.
I am in a unique position as acting chair of Reclaim Social Care, an organisation that brings together people from professional backgrounds, carers, service users and campaigners. We are a rainbow coalition; our aims are within the seven demands underpinning the NaCSILS campaign. Our task from today, I would argue, is to campaign for a new system that ensures dignity and respect by enabling appropriate support for choice and control over diverse lifestyles. At the heart of this campaign must be the development of a national framework capable fostering a culture of support delivered through community based services. This framework has to be, as already stated, through partnership working, what is often referred to as ‘coproduction’.
As Boyle and Harris pointed out, coproduction is a new way of thinking about public services and the approach has the potential to deliver a major shift in the way services are designed and delivered, making them much more effective, more efficient, and so more sustainable. For this potential to be realised, a number of issues need to be addressed. Firstly,”… as always with new ideas, coproduction is often used loosely to cover a range of related concepts. There is no agreed definition, nor are many people yet clear about where the idea came from or its full implications.” Disabled people have experience of good and poor examples of coproduction, but recognise that it does have value if correctly applied. It is a way of realizing what lies behind the Disabled People’s Movement’s slogan, ‘Nothing About Us, Without Us’.
It is vital to acknowledge existing inequalities in power relations, knowledge, and practices, often including a lack of inclusivity. In order to foster a culture of support delivered through community based services these types of inequalities will need to be addressed. Coproduction should involve all areas and decision making processes. We would subscribe to how Boyle and Harris define coproduction:
Coproduction means delivering public services in an equal and reciprocal relationship between professionals, people using services, their families and their neighbours. Where activities are co-produced in this way, both services and neighbourhoods become far more effective agents of change.
The reason we agree with adopting a model of ‘co-production’ as it ensures services are “….planned and delivered in mutually beneficial ways that acknowledge and reward local ‘lay’ experience while continuing to value professional expertise. Service users should be regarded as an asset and encouraged to work alongside professionals as partners in the delivery of services… Real and lasting changes are possible with approaches that build or strengthen social networks and in turn motivate people to learn about and exercise their powers and their responsibilities as citizens. Networks of friends and families should also be considered positive co-contributors to success in this approach.”
In our opinion, this approach has to be central to delivering on NaCSILS, but it also needs to underpin how we build our campaign. Differences in how to move forward will exist, but with openness and transparency, mutual respect and tolerance, we have an opportunity to turn the crisis into a pathway which mirrors the vision of a founding father of the Disabled People’s Movement. Vic Finkelstein wrote:
“….If we look at the conceivable lifestyles of disabled people then we are faced with an infinite variety of situations which might be entered and many diverse activities that could be carried out. Disability, quite simply, is concerned with the barriers that may prevent this. It is not about who we are or what might be wrong with us, as professionals and politicians … would have us believe. A dynamic approach means we look at the total social situation in which everyone interacts.”
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