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Baroness Jane Campbell DBE, EHRC Commissioner. Government stakeholder event to launch six month deliberative period on the future of adult social care
I'd like to begin by offering support to the vision laid out by David in his presentation. Clarity of vision and purpose is critical to a debate which has too often been fragmented. And those of you who know my recent views on how we proceed with this debate, will know it is the fragmentation of partial solutions that I worry about. Rather than separately debate how to offer independent living to disabled people, support for carers and fund long term care for older people, I believe we need to begin by agreeing a single aim to which we will all work, namely: How do we deliver a support system which enshrines human rights and where everyone's life chances are equally valued and supported? It is the question we must keep coming back to in determining the approaches we take and how we are prepared to pay for them. I would like to congratulate Ivan Lewis for getting the debate to this point and for his leadership in ensuring that, whatever direction reform goes, control and personalisation will be guiding principles. They are the cornerstones of promoting independence, choice and well-being. The vision David outlined refers to 'everyone'. We need to be clear who that 'everyone' is. We do not see the benefit or importance of our health and education systems being confined to individual patients or pupils. They are central to our social and economic success as a country. Likewise we need a more expansive view of the role social care (or whatever notion replaces it) will play in defining our national life. I believe the analysis of demographic change and its implications here and in Wanless, are given far too much prominence. It is important but it should not be central to the debate. We need to be asking; how we are going to prosper through this demographic change? What is the role of all our public services in helping us to do so? The debate must not simply be reduced to the question of how to pay for more older people needing care? What too about younger people? I am not accusing Wanless of failing to take account of younger disabled people on purpose but the omission has been repeated in debate playing out on the airwaves since the Prime Minister launched this debate yesterday. The numbers of disabled people requiring support when they are of working age is also set to grow. Whatever the outcomes of this debate, we must have long term solutions for them too. We may need an entirely different formula for those born with an impairment and those who become disabled earlier in their lives, to the one designed to meet the needs of older people. But even that throws up tricky questions. If a person becomes disabled on their 59th birthday which system applies? If a disabled person has received support throughout their working life, should they also be paying for that same support in retirement? I am watching the clock myself, and I do not like what I see for my 60th birthday. Not much of a party!
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A wider debate will relate to a far greater audience and help build the public benefit case for reform and investment. In that way everyone's life chances are maximised and Social Care does not become a fault line. We also need to be thinking about how to maintain a sustainable workforce as millions more have to balance work with caring. We need to ask what the impact will be on productivity and economic growth if more leave work to care. Women still provide the majority of unpaid care, especially whilst still of working age. Are we going to risk putting progress towards gender equality into reverse? With one in three children living in poverty already having a disabled parent, we must ask, what is the relationship between this debate and ending child poverty? After the credit crunch, are we going to see the care crunch? How will working families paying mortgages, their children's higher education fees, saving for their own retirement, step out of paid employment or finance their parents care? Will we see new patterns of inter-generational disadvantage being passed on from parent to child towards the end of their lives rather than at the beginning? Can family life sustain such pressures? No it can’t. This is serious and must not be left to social care alone. The word 'care' obscures everyday realities. Increasingly, disabled and older people are being left to ‘go it alone’. This subverts ordinary family relationships, creating greater risks of family breakdown and abuse. I once told Ivan Lewis that, should I lose any of my public service support, I would require another service - Relate! Because he and I could not tolerate the burden of his need to care for me. Care, in its truest sense, is not unrelenting and unconditional. ‘Love’ maybe, ‘care’ no. We need to be careful in this debate not to contribute to propping up a 'go it alone' society, where care and support becomes solely a private matter - where choice and personalisation means market individualism and little else. I am confident that this is not the vision of the people on the platform however others could easily translate it in that way. Achieving our vision will demand social cohesion. Care and support is a vehicle for promoting and sustaining the social and economic participation of disabled and older people and their families. To be successful, we must find ways to bind people into mutually supportive relationships that empower one another. This needs to be more tangible than simply trying to cultivate a 'caring society'. For example, I believe there could be huge potential in developing models of local cooperatives and mutuals, as vehicles for expanding choice and control for people of all ages. Collectively helping the money to go further through investments which develop everyone's potential at different stages of their life course. Could this be the model for the next generation of genuinely user-led organisations? That brings me neatly back to David's first question: what more do we need to do to make our vision of independence, choice and control a reality? Well that's easy. We must use the opportunity of this deliberative period to coproduce the way forward with older and disabled people and their families, as well as the broader public. Then, once we know the way forward, we must continue to coproduce all the decisions along the way. Nothing about us without us” will then truly be at the heart of supporting people's life chances.
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