COVID-19 and the failure of social care policy

Getting better connection between public and politicians

It is difficult to escape the news headlines, which are often a constant battle between leaders trying to do what they think is best for the public and experts challenging their decisions. The COVID-19 pandemic has engaged people across the globe into an environment where everyone is involved, but inevitably some have been neglected with appalling results.

Professor Peter Beresford, Professor of Citizen Participation at the University of Essex and Co-Chair of Shaping Our Lives, reflects on the failure of policy for social care in this current crisis: devalued care workers and elderly and disadvantaged people in care homes leading to much higher losses than in the NHS. There are lessons to learn. Not least that public, patient and service user involvement are enhanced rather than diminished as seen over the past decade.

Rarely has the gap between people and policy seemed greater than over the COVID-19 pandemic. And rarely has populist presentation of a problem seemed so distant from the reality on the ground. If there’s one lesson that we must hope will be learned from the depredations of this virus it is that it creates pressure for greater, rather than less connection between public and politicians – and that public, patient and service user involvement are enhanced rather than diminished, as we have seen happen over the last decade.

Early warning went unheeded

The severity of COVID-19 was initially under-rated. But from early on, we knew who its victims were most likely to be. They were older people, people with long term and underlying conditions and compromised health and immunity. These are exactly the people that the UK’s crisis-ridden social care system is meant to support and protect.

We were quickly encouraged to clap for the NHS, but the issue was always social care. And we now know it was to social care – its homes and domiciliary services - that people were discharged from hospital to, to spread the infection. Long devalued temporary care workers working across different homes spread it further, their workforce suffering much higher losses than those in the NHS. Now at least 22,000 people are estimated to have died in care homes – homes where they were meant to be safe. There were earlier warnings, which went unheeded. 

A failure of policy for social care

What’s especially heart-rending is that social care is the policy field where some of the most advanced initiatives and thinking about PPI (patient, public involvement) have taken place. There has been central funding and requirements for user and carer involvement in social work education since 2002. There has been a commitment to developing participatory approaches to meet people’s rights and needs through person-centred support. But the thrust of government policy has been in a different direction – to support the privatisation of social care and the financing of residential care in some of the most risky and unaccountable ways.

We might expect in an advanced western society that the voices of some of its most vulnerable citizens – the elderly and those with disabilities - and their advocates would be paid particularly serious attention. Instead the pandemic suggests they have been ignored long term.

When the final accounts for the UK 2020 pandemic are written and due acknowledgement has been paid to the disproportionate loss of life, the failure to prepare adequately and the resulting economic damage, then we must hope that that there is at least proper recognition of the appalling failure of policy for social care, to listen to those directly involved and the terrible price many of them have then paid. It may be too much to hope that the awful costs of COVID-19 at last create the spur for social care’s radical reform and a renewal of impetus for involvement in public policy, but that must be a key goal for the future.