The future of the left since 1884

People first

The social care reform we need will require bold action, writes Anna Dixon



Imagine a future where everyone has the care and support they need to live life to the full. This might sound a fantastical exercise given the current state of social care, but it is what the Archbishops of Canterbury and York asked us to do.

Over the past 12 months, I have had the privilege of chairing the Archbishops’ Commission on the future of care and support in England. We have listened to the experiences of people who draw on care and support, their families and those who work in care, not only to understand the challenges they face today but to help shape a vision of care and support for the future.

There have been countless reports and White Papers setting out the problems of social care and the solutions needed over the past 20 years. Governments of all political parties have committed to and then failed to ‘fix’ social care. The problem has often been defined as people having to sell the family home to pay for care in old age and the proposed solutions have focused on technical and financial matters.

As a church-sponsored commission we were asked to draw on Christian theology and values to inform our work. This has at times been challenging but has brought fresh insights and pushed us to think more deeply about what care and support means as humans who are created equally and in the image of God.

It turns out it is hard to fire the imagination when the current reality is so tough. It is against the backdrop of cuts to local government funding, providers on the edge of bankruptcy, and significant staff vacancies that we have sought to imagine something better, something different, more universal, fairer, and rooted in love. To achieve our vision we propose three major changes.

First, we must rethink attitudes to care and support. There are negative perceptions of social care as services provided to older people – who are themselves perceived as ‘needy’ and ‘vulnerable’ – when in fact almost half of social care expenditure is on working age adults. Most people are supported to live at home or in the community. Care and support should not be limited to the practical tasks of washing, dressing and eating but includes a wide range of personal, social and emotional support that enables us to live, work, and play regardless of disability or age. We must make more visible and value the full range of care and support from the informal support provided by communities, the care provided by personal assistants in people’s homes, and the huge contribution made by unpaid carers.

Second, we must rebalance roles and responsibilities. Our fundamental belief is that access to care and support should never depend on how wealthy you are. That will require a stronger role for the state in securing a more universal entitlement to care and support. Unpaid family carers who take on significant caring responsibilities need more financial and practical support to do so. Communities, including faith communities, need more investment and support from local authorities to ensure there is a robust network of community support in every area. Reimagining care and support is not simply the responsibility of the state; we all have a role to play in our communities to ensure that people have access to the care and support they need.

Thirdly and finally, we must radically redesign the system, putting people in the driving seat in directing the care and support they need. We must reduce the bureaucracy and complexity so that people are confident about what they are entitled to, how to get the care and support they need, and those who work with them are free to do their job and rewarded fairly for doing so.

All too often, the debate around social care feels weighed down by short-term thinking in response to immediate and urgent problems. As part of a new settlement that balances roles and responsibilities fairly between individuals, families, communities and the state, we believe it is now time for politicians to commit to a long-term vision and plan for care and support. Change is long overdue. It is vital our dreams do not remain a fantasy for years to come but are made a reality. It will require bold action from our leaders and collective action from all of us.

Image credit: Lambeth Palace from the herb garden by Marathon via Wikimedia Commons


Anna Dixon

Dr Anna Dixon is the chair of the Archbishops’ Commission on Reimagining Care which will publish its final report in January. She is Labour’s parliamentary candidate for Shipley


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