Does the following clarification help us better frame the debate over care?
Our care system is in a state of disrepair, bordering on crisis.
Just to recap the main evidence:
From such a base line it can seem inconceivable that we might create a care system (by which I mean a social system not just a policy framework) which is:
In a context of rising needs and severely constrained private and state resources the long term continuation of a gap between our care aspirations and the reality is inevitable. However, understanding the scale of this gap in terms of both material needs and political values (the denial of rights and justice) is an important starting point for a deeper debate.
But why is it that the public discourse about care focusses on a series of symptoms of crisis but rarely explores the more fundamental dilemmas and problems from which these symptoms spring?
One is surely the ambiguity over whether care is primarily a matter of personal moral choices or public political choices. Take these three examples:
In a good care system there may be social approbation for self-sacrificing parents and carers and (in the same way as medals are awarded in the military precisely for doing more than can be reasonably required) for caring professionals who choose to go above and beyond the call of duty. But a system which demands substantial sacrifices be made by carers is one which is implicitly denying a collective interest in and responsibility for creating future generations and caring for the vulnerable.
Whatever we might hope that carers would choose to do in a good system the point is that these things should be choices (and thus in Avner Offer’s terms aspects of the ‘gift economy’ or ‘the economy of regard ‘) not requirements or unavoidable realities.
The point of identifying clearly the gap between a good system and the current system is not simply to generate some depressing and impossible numbers for the funding shortage. As I have argued in an earlier post, the care system is a diamond comprising the market, the state, the family and the community. And, as I also argued, it may be that the aspect of the diamond which has the greatest scope to be enhanced without negative trade-offs is the one that currently receives the least attention, the community.
Learn about the twelve-month journey of The Good Work Guild and the recommendations its global network of Fellows and work practitioners have made.
Our healthcare system needs transformational change that creates the space for a new paradigm to emerge. Read about how our public entrepreneurship project can support this.
Ruth Hannah is inspiring you to submit your creative and courageous political project to the Innovation in Politics Awards 2022.