Dignity in care: we need the tools to deliver solutions

By Diana Smith / @mulberrybush

We go through phases when the question of how we are going to care for an ageing population comes briefly to the top of the media’s attention for a couple days and then sinks without trace again.

This is a pattern I have been watching for about ten years now, and at times I find it a little frustrating. For the last couple of days I’ve been unable to escape it. It started with my reading some of the transcripts from the Midstaffs foundation trust Inquiry. I spent an afternoon this week at Stafford University, meeting with a symposium of health and care experts who are considering the implications of the equality bill for our Health and Care services. Then I watched Dispatches with Fiona Phillips talking about her father’s Alzheimer’s disease.

Then I listened to the BBC’s Thought for the Day, which dealt with how changing our attitudes to the elderly is central to the delivery of better care. Later, I listened to You and Yours, with dignity champion Sir Michael Parkinson. They didn’t use the audioboo I sent them so I’ve included it here.

Listen!

Tomorrow I will be seeing the chief executive at Stafford Hospital and I expect the quality of care and how we can continue to improve this to be a key issue in our discussion.

In discussions about the challenges that our health and care systems are presenting I find myself using a stock phrase “old age is not what it used to beâ€. If we look at what has been happening over the last couple of decades, the general improvements in health mean that people live far longer, and the highly dependent period of increasingly old and frail people at the end of life extends not just for a matter of just weeks or months, but in many cases years. Because I went through eight years of this with my mother’s dementia, I have a pretty clear idea of the impact this can have on families.

Like many people who have been through a difficult experience it matters to me to try and ensure that not too many other people have to go through the same problems.

There was a common theme running through all these programmes: that when we see problems with care we are very seldom looking at deliberate culpable cruelty or neglect. We are virtually always looking at a combination of overstretched and undervalued staff, who are working in surroundings that may not have been well designed for the purpose, and who are exhibiting the same kind of casual ageism that is present in virtually all of us. Sometimes this amounts to inappropriate behaviour, more often it is just a failure to relate to the person who is at the receiving end of the care as a person.

The simple graphic above compares the shape of the population structure in 1950, 2000, and 2050. I think it shows pretty clearly why Health and Care systems designed in the 1940s are creaking under the strain now, and shows even more clearly why they will simply not cope by 2050.

Over the last couple of years we have perhaps been reaching the point where the problems of caring for the elderly have become a little more visible to a public who might have preferred not to see.

For me personally I find the continued media focus on the individual stories very frustrating. I know the problems. I also think that a lot of very important work has been done which moves us a lot closer to the possibility of real solutions. The green paper on care with the possibility of putting care funding on a realistic basis, and creating a National Care Service are to my mind some of the most important legislative proposals around. This is something that was built around lengthy and in depth consultation with stakeholder organisations. I have personally been taking part in these consultation exercises for five years now. The Green Paper was seen as a hugely positive step by the stakeholder groups, and I believe it would be welcomed by many ordinary people who are concerned about the possibility of losing their life savings on care, if they know of its existence at all. It is a proposal which can potentially win very strong cross party support, but it is something that only the Labour Party is proposing.

For me, the astonishing thing about the Dispatches programme and You and Yours is that they never mentioned the Green paper or the National Care Service.

The Dignity in Care campaign and the Equality Bill are both important in helping to create the climate for better care. The creation of a National Care Service is vitally important for providing a framework to deliver it.

If we want people to understand not merely the problems associated with elderly people in the health and care services, but also the solutions we are going to need, then I think we are going to have to work a lot harder to get this message across.

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1. Proposal #1: Create a National Care Service offering a minimum standard of long term care for all older people
2. The Social Care Bill is only the start of what we still need to do to reform adult social care and support
3. Why the social care green paper matters
4. Our social care workers must be well trained, well-paid and well-respected
5. Today’s social care green paper is overdue – now Labour has to be more decisive on funding