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Interdependence is key to overhauling adult social care, peers are told

31 March 2023

istock  

THE system for providing the nation’s statutory care and support is too complex and difficult for people to navigate properly, the Bishop of Carlisle, the Rt Revd James Newcome, has told the House of Lords.

“Phrases such as a ‘baffling range of organisations’ and a ‘fog of confusion’ abound,” he said. “Dealing with the complex and circular bureaucracy is time-consuming and frustrating.”

During a debate in the House of Lords on Thursday of last week, on the future of adult social care, Bishop Newcome, who co-chaired the Archbishops’ Commission on Re-imagining Care, emphasised its conclusion that the whole care system needs to redesigned rather than merely adjusted.

The commission’s report, published earlier this year, had also recommended the development of a national care covenant  (News, Comment, 27 January). “This covenant would emerge from a major programme of public engagement with cross-party support, and significant co-production,” he said.

It would reflect four main themes. The first was the empowering of communities. “We all know that supportive and inclusive communities do not just happen by accident; they need investment and nurturing. They also need local authorities to work in partnership with them, to provide a network of community-based support for everyone.”

The second theme was a new deal for carers, recognising their value — something acknowledged in the Government’s 2021 White Paper on reforming adult social care, People at the Heart of Care. The third theme was a universal entitlement to care and support; and the fourth was an acceptance of a mutual responsibility as citizens.

“A covenant of this kind would make it abundantly clear that social care is not just the state’s responsibility,” Bishop Newcome said. “As citizens, our rights come with corresponding responsibilities; the principle of interdependence emphasises the simple fact that, in this arena, all of us have a vital part to play.”

The Archbishop of Canterbury told the House that a national care covenant would “clarify the mutual responsibilities of us all — individuals, families, and communities, alongside local and national government — in relation to care and support.”

Interdependence is the “revolutionary value” that should be at the heart of our social-care system, Archbishop Welby said. “It replaces the myth of autonomy for each person. No one is autonomous: we all rely on others at every point of life and death. Interdependence builds community; autonomy creates atomisation. Autonomy ends up with dependence on the state, because we all need support.

“Interdependence takes us away from a narrow argument about who should provide care, and instead says that responsibility lies with all of us to different degrees: with families and communities; with government, with regard to funding and implementation; and with NGOs, the voluntary sector, and community actors such as churches, with regard to participation.”

He said that the Church, “in common with those of almost every political, religious, or social belief”, believed that the current care system was broken. “It cannot be tweaked; it needs re-imagining. We have had the same reason for the church reports on housing, and, I regret to say, the same indifference to them from the Government, despite the enthusiasm of the industry in both cases.”

The way to succeed was to establish the system before determining how it was financed. “If [funding] is our starting point, we will fail,” he said. “Once we know what kind of care system we are aiming for, we can begin to see how it could progressively be paid for. Much as I admire His Majesty’s Treasury, if we start with it, we will be pragmatic but are unlikely to be imaginative.

“So, I ask the Government and the Minister: will they begin, as we move forward, to re-imagine the care system and to look at setting out clearly through a national care covenant the mutual responsibilities we all have?”

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