HOW can we develop a vision for care and support that enables everyone — regardless of age or ability — to flourish? This was the exam question we were set in the spring of 2021 by the Archbishops of Canterbury and York as they launched the Commission on Reimagining Care (News, 23 April 2021). Our task was to rise above the many immediate challenges affecting the social care sector — considerable though they are — and not to get stuck in conversations about funding — important thought that is — to consider the nature and purpose of care and support.
The answer we reached relatively early in our deliberations is that care and support must always be about human flourishing. Care and support should enable us to do the things that we enjoy, to build lasting relationships with one another, and to participate in our communities. At its heart, care and support is about interdependence, recognising the extent to which we all need each other in order to flourish.
Our work has been deeply rooted in theological reflection. The Commission’s vision is underpinned in particular by two considerations that have heavily influenced our conclusions: the first is our belief that all human beings are created in the image of God, and therefore have value, dignity and worth; the second, which flows from being image-bearers of God, is that we are called to love one another. This command of love finds its ultimate expression in the life, death, and resurrection of Jesus Christ.
WE NEED a vision for care and support that reflects the perspectives, experiences, and aspirations of everyone: people who draw on care and support, unpaid carers, care workers, and everyone who, at different times in their lives, will be giving and receiving care and support.
It was a privilege to hear from many people at meetings and round-table events, and to visit a variety of projects during the course of our work.
I went to a Renew Wellbeing Café in the diocese of Carlisle, which offers a welcoming church hall in the community for people to participate in activities together; Stockwell Park Community Centre, to participate in activities in the community for adults with learning disabilities; and a care home in Kendal, where residents benefitted from holistic care in a residential setting that emphasised the importance of building friendships and embracing community.
All of this listening, engagement, and discernment led the Commission to articulate a vision that focuses on three areas.
First, we must rethink attitudes to care and support. The evidence we received suggests that we need a fundamental shift in the way care and support is viewed. That will require us to challenge negative attitudes towards old age, disability, and mental illness in our society — including within the Church — by working together to promote a hopeful vision of what care and support could and should be like.
This is about societal change, shifting our understanding of care and support towards something that enables everyone, regardless of age or ability, to live a full life.
Second, we must rebalance roles and responsibilities. We heard consistently during our work that people do not know how to navigate the confusing care and support system, and are unclear about what is expected of them.
We therefore propose the development of a National Care Covenant, which would set out the mutual responsibilities of individuals, families, communities, alongside local and national government.
The notion of covenant recurs throughout the Bible — as God makes promises to His people and draws them into deeper relationship — and offers us a helpful theological and practical framework through which to reimagine care and support.
We propose that the Covenant is overseen by national government and developed through a sustained programme of public dialogue and engagement with different actors. Based on what we have heard, we hope that the Covenant would reflect more investment in communities, a new deal for unpaid carers, a stronger role for the State, and a commitment to our responsibilities as actively engaged citizens.
THIRD, we must redesign the way care and support is organised. We cannot simply tinker around the edges of the existing system; rather, we need to redesign the system to make it simple, consistent, and person-centred, with the long-term aspiration of making access to care and support a universal entitlement, free at the point of need.
In order to move towards this, the Commission proposes simplifying and separating the care assessment and planning process so that people have more say over the care and support they draw on, as well as independent advocacy to understand where to go for extra support. We emphasise the importance of community as the setting in which people are able to build relationships and flourish together, but supportive communities need nurture and investment.
The idea of a National Care Covenant reflects the fact that there is a duty on all of us to work together to reimagine care and support. This is not just about what the State should do, but about what we must all do as individuals, in our communities, alongside local and national government.
We believe that this vision of care and support would the transform the lives of all of us, as we share in the benefits of a society in which everyone is able to live a full life. Care and support is about more than contractual obligations and statutory duties, but rather a deeply profound set of relationships in which we are bound to one another.
The Rt Revd James Newcome is the Bishop of Carlisle, and Co-Chair of the Archbishops’ Commission on Reimagining Care.