A Year On – Riots, Olympics and Inspiration

A year ago this week, as Londoners, we went  to bed amid  chaos, conflict and fear  in Croydon, Tottenham, Ealing, Hackney, Clapham as well as many other places throughout and beyond London. We woke up to the desolation and disbelief was something that shattered that self-assurance and confidence. Broken glass yes,  but also a break in that delicate social contract that exists to retain public order. We could see how narrow that ‘thin blue line’ can be. And it’s scary.

Riots and looting had spread bringing a wave of fear, confusion and anger with them that had flooded the city and beyond.

There were local initiatives to ‘rebuild’ communities, and much (too  much in my view) quick-fire speculation about causes and reasons which ended with much blame being placed and misplaced by those politicians and media junkies looking for instant answers. Answers were needed but sometimes it isn’t the first thing you think of that will provide the most learning.

It was a ‘youth’ problem we heard or ‘problem families’. I never really believed that. Firstly, the riots were not exclusively carried out by young people or by ‘poor people’  and blame needs to move beyond broad pasting of people based on background and income. If there is a problem (and I never really fall entirely for the ‘Broken Britain’ agenda) it is one that has to be shared through to those who lead our political and social culture that creates divisions and marginalised. But I’m not about explaining the riot phenomenon – academics who spend time researching rather than speculating are far better placed than me.  I’m more about explaining feelings.

It’s hard not to compare those feelings I had at the beginning of August 2011 to those I have now, in August 2012. I was scared, I was confused, I was also disenfranchised, I felt, by politicians spouting about  casting  blame  had no similarity to the reality that I was experiencing. If anything taught me about the detachment of politicians in their privileged ivory towers, it was their collective responses to those days and continued games of ‘divide and rule.

And this year, how do I feel? I have been carried away by the Olympics, I’ll admit it. I was beginning to feel the excitement as I went to see the Torch Relay and saw it was bringing a feeling of genuine joy. Although I’ve been privileged to attend a couple of events, I’ve also wholly taken part in the free events.

I am not blind to the problems that this country faces – we only need to reflect on the past year and the surmounting war on those who have the least and the games of ‘divide and rule’ which continue to be played but we have to take the positive focus on youth that can be garnished by successful sport but also participation by all and use it to counter some of the perceptions of blame – particularly blame of youth – that entered into general discourse.  These problems don’t go away for two weeks, they are still very much alive.

The feeling of pride and the happiness generated in London is about sport at the moment but it isn’t just sporting achievement that can bring these feelings of pride. It is about receiving support and encouragement to excel and to find the area in which you excel – whether that’s athletics, painting, writing or being a compassionate person no more or less – we need to find more ways to celebrate the positives and use these Games as a spring to motivate – not just in sport but beyond.

I’m going to use the example of Mo Farah, 10,000m gold medallist and his story of the support he received from a PE teacher, Alan Watkinson.

Mr Watkinson said: “If he was going to have an chance to progress, someone was going to have to take him under their wing – there were so many distractions that could get in the way.”

He entered Farah for a cross country course and finish second.A few weeks later he finished fourth in a county championship, despite not having spikes.

Soon afterwards Mr Watkinson told him he could run for Great Britain.

And if there’s a lesson to learn from this, I hope it is that. I hope the government and local authorities pick up on that. We have to find people to encourage and push us towards achievement. It doesn’t have to be sport and it doesn’t have to be world-class – but having someone who can mentor, guide and encourage is crucial. It’s not age-specific either. Doubts can emerge at any age and at different stages in life.

photos by Autr Films and Michael Hirst

Researching and Improving Dementia Services

Today the government has announced an increase in funding for dementia research, indeed, the figures given by the BBC talks about raising the money put into dementia research from £26.6m to £66.6m by 2015.

Great news, really it is. I think it’s essential that there is a focus on dementia and what can prevent and assist those who suffer from and potentially suffer from dementia in the future.

As well as research though there were other strands to the government’s announcements about dementia.

Mr Cameron will set out plans to step up research into cures and treatments and to ensure that the health and social care systems are equipped to deal with the problem.

The highlighted part is the area that sticks a little in my throat as I read it. I do wonder how much the government and ministers are aware of the services that have been decimated (probably more than decimated if we are going to be talking literally) over the last couple of years and the disinterest shown by the general public in terms of improving both health and social care outcomes for those who have dementias.

Money into research and cure is a hopeful statement  – it looks forward and it helps us who are the electors of today have more hope for our future with the fear of losing cognitive functioning in our later (or not so later) years.

Money into equipping health and social care systems to ‘deal with the problem’ of dementia are altogether something else because it isn’t ‘us’ who will benefit – we, todays electors, are the ones who will pay and experience (or at least, the lack of political will on all sides)  shows that no-one wants to pay for the true costs of providing good quality care for older people with dementia in real terms.

I’ve seen a lot of simplistic talk about dementia over the past weeks, months, years. It is not a single diagnosis and it does not affect people in a single way. People with dementia walk and function among us and they are not all older people sitting alone in bungalows waiting for pity – although it’s important to remember that some do live alone without sufficient support or interaction. They are not all people who want or need pity – there is hope for positive life experiences even when ones cognitive functioning is impaired.  We infantilise the process of ageing and those who merely have a diagnosis of dementia and it says far more about those who are speaking and talking in those terms that those who may be bearing the progress of their diagnoses in as many different ways as there are people.

However one thing does need to be addressed and I hope it is addressed by the government today – with money. That is the issue of treatment and assumptions made about people with dementias in institutional care settings. We have had talk about ‘dignity in care’  – particularly in hospital and residential care. This must be approached and tackled in the ways I have previously discussed by putting more people on the ground in terms of nurses in hospitals and increasing staffing levels in residential and nursing homes. We need to back up a determination to provide better care for some of those people who won’t be ‘shouting loudly’ or have families to ‘shout’ for them by placing independent visitors and advocates in these institutional settings and improving regulation and quality control for those who need these services.

As for changes in home care – we need to embrace truly personalised care and the ‘personalisation’ agenda beyond managed budgets of block contract agencies providing 15 min ‘spot checks’ to put a microwave meal in the oven for older adults with dementia in their home. This is not dignified and it is not cost effective. Over time, putting more good quality and accessible care into people’s homes will keep people out of residential and hospital settings over the longer term but it will cost.

So I hope these announcements the government makes will look at quality of care and will look at funding of care over the long term for people with dementias who live both in the community and in residential settings.

I hope to see, alongside better funding for research

1) Better support for family/friends as carers

2) Proposals to make personal budgets work well and for different support to be used for those who are not able to engage in the process of choice themselves either because they don’t wish to or don’t have the mental capacity (or family) to do so.

3) More thought put into the funding mechanisms of care for people with dementia both at home and in residential settings. Dilnot or not Dilnot. I’m not in agreement with all the tenets of Dilnot (I’d favour the so-called ‘death tax’ to be honest) but its better than that awful hotch-potch that we have now and what we can’t afford is to allow things to continue and to leave matters up to different local authorities to manage in their own different ways and at different levels.

4) Better non-directed advocacy with muscle for those who don’t have family/friends/community around them (by non-directed advocacy, I mean advocates who specialise and are trained in working with people who may lack mental capacity to ‘direct’ or instruct their advocates)

5) Robust regulation of dementia nursing and residential homes and wards in hospital with random spot checks and high standards.

I’ll be back tomorrow and see how the government does on this announcement.

One day though, I’d like to see a government of any political flavour that truly does look at national interest and not political expediency in terms of policy making.

The triumph of hope over experience.

photo by Ruth Flickr

The case for health and care privatisation

Yesterday, the Health and Social Care Bill finished its passage through Parliament. Today is the budget speech.

Saturday’s Guardian had a piece entitled ‘What will the 2012 Budget mean for you?‘. It was not about the NHS, nor privatisation, just about how the budget affects the lives of ordinary people. But one of the ordinary people – acknowledgedly ‘the high earner’ – caught my attention, because he works in the field of social care. His name is Tony Stein.

According to the article,

Tony Stein is founder and director of Canterbury Care, which operates 11 care homes across the UK. Last year his earnings “just about touched” the £150,000 level…

Although Tony signed a letter in the Telegraph last month arguing that the 50p tax rate “puts wealth creators like us in an awkward position”, he is an ordinary guy:

It’s not as if I’m earning millions. Actually, what has me shouting at the telly is the executives of big banks who earn millions but aren’t putting their own money at risk.

Is Tony making out a persuasive case for private enterprise running social care, the case for privatisation? Let me make clear, I don’t know him personally, nor do I have any dealings with his company. Nor, frankly, have I done much by way of research, though I have done a little digging.

A little digging revealed that Canterbury Care is headquartered in Worcestershire, where a local Green Party member in 2010 criticized the Council’s Chief Executive for not taking a pay cut:

Mrs Haines is contracted on a salary band ranging from £167,977 to £183,725 a year.

Worcestershire County Council’s accounts suggest it is rather a larger affair than Canterbury Care with its 11 care homes; its Chief Executive gets paid more, but hardly in proportion to the size of the enterprise. Among the information I extracted from Worcestershire’s balance sheet are that it has long term assets of £1.695 billion and long term liabilities of £1.056 billion. I went looking for that figure to compare it with Tony Stein who says Canterbury Care has “£14 million in borrowing”.

I venture to suggest it is pretty plain that Tony Stein has a salary chasing that of the Council’s Chief Executive, for a far smaller venture. Measured by debt, the Council’s financial headache seems to be about seventy five times the size.

At this point, I start to speculate that it might be 75 times cheaper to have debt presided over by a local authority than a private enterprise, and that Tony Stein really hasn’t made out a persuasive case for privatisation of social care.

But, to be fair, it isn’t just the size of the financial headache that Tony relies on to convince us. It’s the fact that

…We employ 455 people, but we have £14m in borrowing, and a big mortgage on my home. At the end of the day I have my neck on the line. Yes, I earn £150,000 or so, but it’s me who has sleepless nights over the borrowings and operations of the business, and it’s me who works all weekend.

So he can shout at the bankers on the telly like the rest of us, because of the fact that his pay is justified because his own money is at risk in his enterprise. And he works all weekend – though I am presuming his residential care homes are staffed all weekend also.

I’m sorry, Mr Stein, but I’m afraid you have actually made out a case to be relieved of that risk and that income. I’m just not getting what is the benefit to the public of the liabilities and risks being borne by wealth creators like you instead of the taxpayer. If residential care were run by local authorities, no individual would have to have sleepless nights because of their personal investment and risk. No individual would therefore need to be paid £150,000 to preside over just 11 residential care homes. The tax payer wouldn’t need to worry about where the money came from and whether there might be a Southern Cross-like disaster. The case for privatisation is not made out.

And I haven’t even begun to explore the market arguments about quality, efficiency, competition and the like. This commentary is just about the apparently extraordinary cost of privatising capital and investment risk.

Did I mention, yesterday the Health and Social Care Bill cleared its passage through Parliament?

Allan Norman (@CelticKnotTweet) is a registered social worker and a solicitor at Celtic Knot – Solicitors and Social Workers.

How can I change the world? Or Thoughts from #TedxObserver

I was fortunate enough to attend the Tedx event sponsored by the Observer last Saturday. Fortunate in the sense that I had both the time, money and wherewithal to remember to book far enough in advance to acquire tickets. All of which, especially the financing part, require an element of having a fortunate life with disposable income and time.

Having watched some of the videos from TED (and TEDx) events over the last few years, I half knew what to expect but I had some trepidation about my own ability to retain concentration through a whole day and have to say I half expected to leave before the final session. I didn’t. I stayed to the end and gladly did so with few lapses in concentration through the day. I had some reservations too about the ‘bite size’ reduction of arguments and ideas into accessible information but actually, I probably overestimated my own ability to engage as the timings worked well for me (and my levels of concentration).

I was also boosted by some of the conversations I had with other attendees and particularly was glad to catch up with Russell Webster (very interesting blog – highly recommended!).

I don’t want to go through the speakers one by one because I think my response is better dealt with as a composite. The theme revolved around inspiration and change, particularly regarding youth. The difference that one person can make in the world.

That’s quite a compelling view. We saw some truly inspiring people and I wondered how is it that one becomes ‘inspiring’. There were people who actively set out to change the world and others who may have stumbled into the process but the message of the day to me, was to never aim too low when the stars are within the grasp of all of us.

Linking it to my ‘day job’, was rather poignant for me. I went into social work with a strong sense of striving for social justice. I wanted to make a difference and to make the world better. While I dabbled with vague interests in politics, I never have (and still don’t) feel desperately loyal to a particular political party – certainly not enough to agree with everything they say or propose right or wrong. There are issues I strongly support but not an umbrella party as such.

As I worked, as I understood, as I began to feel ground down by the process of care management and care planning which hardly works from an ideal, I realised that the real change I can make is in bringing a humanity to these systems which often seem to be designed as processes and designed by numbers.

As I stand in someone’s house and tell them there is no money left for them to access the respite services they have been receiving for 5 years, I do wonder at my role in ‘changing the world for the better’. When I tell someone that I have made a decision to apply for their detention in hospital I am certainly changing their world and the world of their family and it’s only done when I believe absolutely it is necessary but it’s hard to balance with this desire to change the world for the better when confronted with such distress.

So back to the TEDx talks, music and dances. It drew me back on what I can do to ‘make things better’. I can’t rely on my job to offer that as while there are perceptions of ‘social workers’ as change agents and yes, there are ways we can smooth the process through the statutory systems, I’m not sure how much we can say we are positive forces for change.

Then I thought, the fact of putting humanity into a role which governments have contrived to strip down into a quantifiable process at periods of great distress can be positive. But I need to do more.

We all need to do more. Inspiration isn’t handed to you on a plate to feed from, it is something we all can and need to seize in any way we can. It might be teaching singing or dancing in areas where music has not yet reached due to lack of access or opportunity. It might be writing about the issues that can make a difference. We have more tools to hand through the means of social media – we can all bang a drum and some will be heard louder than others.

If we sit still and wait for our opportunities, they might never arrive or we may have lost some of those people we could potentially have influenced for the better.

So what did I learn from TEDx ?  – that we can all be more and do more to effect positive change in the world that we share. We don’t need to start companies or charities with heaps of money behind us, it can be the small actions that start the change. Sometimes we may need to push ourselves in directions we never expected to go.  It’s  good to feel positive amid all the bad news and being surrounded by positivity and progress helps inspire others. I’d love to see these kinds of talks available more widely.

In the meantime, my resounding thought remains, what can I do today that will leave a positive imprint on the world? I’m sure I’ll come back to this and some of the particular talks and experiences over the next few weeks. It allowed me to think in difficult tangents, and that’s remarkably rich.

Maybe we need to start building Big Society by creating the Not So Big Societies around ourselves first.

International Women’s Day and Feminism

Today is International Women’s Day. Does there need to be a day specifically for women? Maybe, maybe not. It would seem churlish not to mark it in some way though.

I remember growing up with a sense that ‘feminism’ was of the aggressive variety and with the perception that it was about radical women who wanted to be men.  No one I knew identified themselves as ‘feminist’.

I realised over time how wrong I was and how wrong my perceptions had been. Feminism was being defined by those who  felt threatened by it. It was presented (when I was growing up in the time and area I lived)  as something to be embarrassed about. As a girl, I fed into the groupthink that feminism was about ‘man bashing’ or somehow undignified. I went to school and studied alongside boys, there was no reason for me to feel different. We had a female Prime Minister. The ‘battle’ had been won so there was no fighting left to be done. Women and girls were positioned to feel embarrassed about being ‘feminists’ as if striving for equality was some kind of struggle for equivalence.

I was wrong. I was very wrong.

In some ways, when we feel embarrassed by the labels, we are allowing feminism to be defined and marginalised. The word and the label is one to be proud of and not ashamed of. It isn’t about the ‘wanting to be men’ or ‘hating men’, it is about being proud, open and respected as women.

The world is not equal. There are discriminations and prejudices faced by women as there are for many who are marginalised for other reasons but we mustn’t be afraid or embarrassed of wanting to fight and project the need to be proud of who we are and respected as what we are.

I will never be embarrassed about calling myself a feminist. I don’t have to defend my position or pride in being a woman to anyone else. For those who feel that women have reached ‘equal status’ with men, we need only look through an average newspaper on an average day and understand the differences in reporting and tone to know that we still have a long way to go.

‘Women’s issues’ are marginalised and specialist. ‘Women’s jobs’ are lower paid and less respected. There will be exceptions but generally they will be exceptions which prove the rule.

My wish for International Womens’ Day is that we can promote feminism as a positive and inclusive which is about acceptance and understanding of different perspectives rather than using the word as a tool to oppress those who might feel differently.

We must embrace feminism and we must define it ourselves. Some feminists are feminine, some feminists aren’t, some feminists enjoy dressing up and some enjoy dressing down. We can’t  define who can and can’t be a feminist by what they do or say or are. We can all support and be feminists and should be allowed to feel proud of that.

Oppression is when people attempt to define or change  how we define ourselves.

Happy International Women’s Day.

photo: European Parliament/Flickr

Fostering Aspirations As The Downturn Bites Hard In Tyneside

Another day, another report on the parlous state of foster care. Media coverage, such as it is, homed in on the shortage of carers, variously estimated at between 8000 and 10,000, and on the poor outcomes for children in care in fundamental areas such as educational achievement, incidence of mental health problems and offending behaviour.

None of this is new – the Fostering Network has rendered impotent the word ‘crisis’, so often have they used it over the years – although there is no harm in it being said once again. However the report itself, Fostering Aspirations by the Policy Exchange  has a wider scope, incorporating the views of foster carers and children in care into their analysis of the quality of care and emerging with radical suggestions for tackling the problem, most notably a salary structure for a professional foster care service and an overhaul of commissioning arrangements that would see local authority fostering departments competing alongside the independent sector in a tendering process for placements or a total outsourcing of fostering.

Suicide and Social Welfare

I came across this paper from the International Journal of Social Welfare titled ‘Role of social welfare in European suicide prevention’ – happily with open access so freely available. I thought it was useful to share as it echoes some of my concerns about the move towards stigmatising those who receive welfare payments that is becoming the norm amongst politicians and journalists in this country (with few, notable, exceptions).

One of the aims of this paper was to

Evaluate attitudes towards the welfare system in 26 European countries and how they are related to suicide mortality, among both men and women.

From Clicktivism to Activism

Reflections on Bevan’s Run

Yesterday, I went to the Department of Health to watch the end of Bevan’s Run. If you haven’t come across ‘Bevan’s Run’ it involved two hospital consultants, Clive Peedell and David Wilson – both cancer specialists in Middlesborough, running from Aneurin Bevan’s statue in Cardiff to the Department of Health based at Richmond House in London – 160 miles in six days. They did this to raise awareness of public (and professional) opposition to the Health and Social Care Bill.

My reasons for going to meet the runners (with a few hundred others) in London was to express my support for what they had done and my agreement in the agenda which they were promoting – namely that there is no mandate for this coalition government to dismantle and privatise the NHS – because that is what they are doing.

While I was there, I both chatted and listened to chatter of those around me – many with much more experience than me in the sector (there seemed to be a lot of doctors milling around) about the wish to demonstrate opposition again and again. The phrase ‘lions led by donkeys’ raised its heads in reference to professional leadership which had not (with some notable exceptions) provided  much leadership in opposing and disseminating the government’s plans.

The Not So Big Society – Lessons from Greece

As regular readers will now, I’ve been using the title of this blog as an excuse to ponder the kind of social changes we’re going through, and what it will mean for the most vulnerable in society.

I’ve been reading a fascinating article about a Greek island, and how it’s been affected by the economic collapse in that country. I suspect that we’ve got further hardships to come here in the UK, so I was left wondering whether it might have any lessons for us in the near future.

The article describes the island of Samos, and it’s clearly been hit hard.

Evidence of the crisis, the lack of jobs and the absence of money in people’s pockets is everywhere. In the two major towns of the island, Vathi and Karlovassi, approximately a quarter of the shops are now closed. Most of those that remain open are offering such discounts that we assume it is a matter of time before they shut too.

A friend who has a tourist shop in Vathi thinks at least another six shops will close by Christmas, with more to follow soon after. In our village we have two tavernas – and they only survive because their owners take no income. What income can you take from only selling a few Greek coffees and some beer and ouzo in the evening? 

Body Count of the Not So Big Society

Here’s a chilling bit of news. For years we’ve been congratulating ourselves on a steady reduction in suicide rates. Not any more.

In 2008, 5,706 people killed themselves in the UK, an average of almost 16 deliberate deaths a day. After close to a decade of annual declines, recession triggered a sharp spike in suicide. Recent figures published in The Lancet show that the UK suicide rate increased 8% between 2007 and 2009. The latest Office for National Statistics figures suggest a similar rise.

The problem is predominantly a male one, with three times as many men killing themselves as women. It is also a trend not confined to the UK. Suicide rates have spiked across Europe since 2008, with Greece, in particular, experiencing staggering increases. 2010 saw a 25% rise in suicide, according to the Greek parliament. In October, the country’s health minister warned that early signs suggest a further 40% jump in 2011.