Here's a letter of mine, in response to the Observer's Will Hutton, as it appeared in the paper today (08.01.2017)
The care we’d want ourselves
For better health we need a better society, writes Will Hutton (“Good health is born of a good society. Little wonder that we’re suffering”; Comment, ). Less inequality, fairer taxation and more support for those of us, old and young, who most need it. But that may also require abroader shift from dependence on top-down, centralised provision, the array of goods and services we pay for but can’t control or understand. Somehow, we must get a better grip on what we can understand, agree and do together for ourselves.
That’s where society begins to make sense and social care is a natural starting point. It’s a face-to-face and hands-on business, with the expertise of experience and fellow-feeling. Hospital and social service departments would collapse without a threadbare but resilient safety net of family and friends, neighbours and workmates. And among the self-appointed carers are hundreds of thousands of children with parents or siblings who depend on them.
Two recent proposals suggest ways forward: Liberal Democrat former minister Norman Lamb has proposed a dedicated tax for health and social care, while the chief nursing officer for England, Jane Cummings, calls for more systematic support for care at home. A clearly costed and targeted national insurance would help. Priority for home-care, paid or otherwise, would save a lot of institutional and hi-tech provision. It’s also what most of us would want for ourselves.
Greg Wilkinson
Swansea
Of course Hutton is right that the secret of good health may lie in a good society. But he can never quite admit that what's bad about society as we know it is an economic system based on private wealth and bureaucratic hierarchy, a built-in trickle up of wealth and power from the many who have less to the few who have most.
The care we’d want ourselves
For better health we need a better society, writes Will Hutton (“Good health is born of a good society. Little wonder that we’re suffering”; Comment, ). Less inequality, fairer taxation and more support for those of us, old and young, who most need it. But that may also require abroader shift from dependence on top-down, centralised provision, the array of goods and services we pay for but can’t control or understand. Somehow, we must get a better grip on what we can understand, agree and do together for ourselves.
That’s where society begins to make sense and social care is a natural starting point. It’s a face-to-face and hands-on business, with the expertise of experience and fellow-feeling. Hospital and social service departments would collapse without a threadbare but resilient safety net of family and friends, neighbours and workmates. And among the self-appointed carers are hundreds of thousands of children with parents or siblings who depend on them.
Two recent proposals suggest ways forward: Liberal Democrat former minister Norman Lamb has proposed a dedicated tax for health and social care, while the chief nursing officer for England, Jane Cummings, calls for more systematic support for care at home. A clearly costed and targeted national insurance would help. Priority for home-care, paid or otherwise, would save a lot of institutional and hi-tech provision. It’s also what most of us would want for ourselves.
Greg Wilkinson
Swansea
Of course Hutton is right that the secret of good health may lie in a good society. But he can never quite admit that what's bad about society as we know it is an economic system based on private wealth and bureaucratic hierarchy, a built-in trickle up of wealth and power from the many who have less to the few who have most.
I'm
fed up with saying this in more or less palatable ways, and almost as
fed up with an oppositional left that seems happier attacking its
enemies than coming forward with better ways of doing things. Yes,
everything could and should be different, but what are we actually doing about
it? No revolution will work unless we can find ways of
doing things differently among ourselves and seeing where to go from there. Sniping at
more or less democratically elected leaders gets us nowhere if we
have nothing better to offer, not just in theory but in practice.
Replacing THEIR leaders with OUR leaders will leave us with more of
the same unless we have a wider body of people already engaged in
doing things better and more democratically for themselves and others. To find those better
ways, we've got to get to choose good starting points, addressing more
or less immediate needs with means that come to hand.
Representative
democracy and elected governments will always let us down unless they
are grounded in and responsive to a commonwealth of more direct
democracy. Commonwealth involves common people (as in the House of
Commons, the millions of acres of Common land enclosed by propertied parliaments and the old word Commons, for a common provision of essential rations etc). When I referred to 'our depleted social infrastructure' I wasnt just thinking of in- or out-of-work benefits but of children playing in the street, women meeting in corner shops and over garden fences as they hung the washing out, men meeting and organising in nearby factories and mines, works outings, holidays and union branches, local pubs and clubs, congregations in their Sunday best etc etc. Facebook, online shopping and petitions cant fill that gap unless they help to bring us back together face to face with something to be getting on with when we meed.
Meanwhile, oppositional socialism, ritual protest against present evils, may help bring down top-heavy systems or it may provide a safety valve to keep them in place. To replace them with something better we need a more constructive socialism, doing the best we can for ourselves and each other with the means to hand. Only from that basis of shared commitment, organisation and experience can we build a bridgehead and get through to secure the help we will still need from more centralised powers, whether political or corporate, that now monopolise resources, expertise and power..
Meanwhile, oppositional socialism, ritual protest against present evils, may help bring down top-heavy systems or it may provide a safety valve to keep them in place. To replace them with something better we need a more constructive socialism, doing the best we can for ourselves and each other with the means to hand. Only from that basis of shared commitment, organisation and experience can we build a bridgehead and get through to secure the help we will still need from more centralised powers, whether political or corporate, that now monopolise resources, expertise and power..
Easier
said than done, and my letter to the Observer below is only a tiny step. Published or not, it helps
to clarify my own thinking, and lead me towards what could be further steps - with more than a bit of help from my friends.
Here's the last bit of my Observer letter that was NOT published, for more or less obvious reasons:
Here's the last bit of my Observer letter that was NOT published, for more or less obvious reasons:
'A
recognised, respected and properly funded Neighbourhood Care system
could pilot a revival of other depleted social infrastructure, giving
more content to so-called 'community'. From health and social care,
more of us could \reach out and work together on other matters of
common interest, in whatever space and time we can find between
homework and paid employment otherwise.
Greg Wilkinson
Greg Wilkinson
PS
The recent upturn in deathrates has a lot to do with funding cuts and
growing inequality, and research also shows a link between inequality
and obesity, an obvious cause of early death.On the other hand, a
longer life is not always a better one, and a society that allows and
encourages three quarters of its middle-aged citizens to fatten
themselves for the slaughter might also offer them a painless way
out. If we're free to self-harm, at whatever the cost to ourselves
and fellow citizens, we might also be free to die at a time of our
own choosing, with dignity and the agreement of loved-ones and
qualified medics.
(Ed:
If you prefer, the PS could stand as a self-contained alternative
letter. I'm 80, with vested interests. My first job was as a
ward-orderly in a workhouse refitted as hospital (c 1955, when the
NHS too was young), caring for old people with nowhere else to go.
About 50 years later I helped look after my own parents, in and out
of hospital when they became incapable of looking after each other.
The were not poor, which made things easier. At about that time, my
wife did respite days for young carers, who seemed very happy to be
making things out of willow sticks with her, playing and exploring
our then neck of wood and stream in Wales.)'
Other questions arising::when
does age become a disability, and who cares for the carers, young or
old? Do only those with special needs and disabilities need caring for? I once heard Dennis (Beast of Bolsover) Skinner ridiculing privileged people who call
for others to stand on their own two feet. 'That's easy to
say, when you're strolling down the fairway on a sunny day. But no one comes into the world or leaves it on their own two feet.'
But... Old Labour's great post-war nationalisations, and even the wonderful NHS,
were also top-down, centralising measures that made more and more of
us subject to remote provision and control, and opened the way to top-down privatisation. And now we must also wonder how
long can more and more of us depend on more and more expensive care while resenting every extra
penny it costs in tax? And how come that all professional carers are trained to get their patients or clients doing all they can for themselves, while the rest of us expect everything to be
provided and done for us.The
trouble with capitalism is that it turns us all into needy dependents and willing slaves to the big providers who employ and sell to us. Private and public state and corporate sectors interlock and fuse, and what difference does it make whether an enterprise is for profit or not-for-profit if their effective hiearchies and differentials of power and reward remain unchanged?
To reverse or balance this upward flow of wealth and power requires an effective counter force in the other direction, from base to summit if we accept the present pyramid model, with all ladders meeting at the top, and most of us nearer the bottom. For that we need to take back control of, and responsibility for, our own lives and circumstances wherever we can and as far as we can reach. As individuals, families, neighbourhoods, towns etc, we must decide and do what we can for ourselves and each other. That's what direct democracy means, and only when that falls short should we delegate our authority to more remove representative bodies. That does NOT mean we could ever be self-sufficient, and we will always need more centralised powers to do what's best done on a larger scale, and to secure communication and a level playing field between regional and local centres. The soon-to-be-late-lamented European Union had a clumsy label for the principle that could also apply within nation states. 'Subsidiarity' meant that each part could do what it reasonably could for itself and only become subject to more central authority when that became impractical, local self-sufficiency, in what might be seen as a community-of-communities.
To reverse or balance this upward flow of wealth and power requires an effective counter force in the other direction, from base to summit if we accept the present pyramid model, with all ladders meeting at the top, and most of us nearer the bottom. For that we need to take back control of, and responsibility for, our own lives and circumstances wherever we can and as far as we can reach. As individuals, families, neighbourhoods, towns etc, we must decide and do what we can for ourselves and each other. That's what direct democracy means, and only when that falls short should we delegate our authority to more remove representative bodies. That does NOT mean we could ever be self-sufficient, and we will always need more centralised powers to do what's best done on a larger scale, and to secure communication and a level playing field between regional and local centres. The soon-to-be-late-lamented European Union had a clumsy label for the principle that could also apply within nation states. 'Subsidiarity' meant that each part could do what it reasonably could for itself and only become subject to more central authority when that became impractical, local self-sufficiency, in what might be seen as a community-of-communities.
In
my Observer letter I suggested that Social Care could become a pilot
for broader renewal of social infrastructure. Why should that human foundation for any succesful enterprise in life be cut back further and left to rot while new post-austerity goes to roads and railways,
runways and broadband? A revival of local, collective and communal activity could extend from interpersonal social care to a range of other more or less neglected activities, from children's play and after-school clubs to youth and sports, libraries and museums, parks and allotments, and green no-mans-land in older council estates.
It's
not a choice between voluntary effort and professional services, paid and unpaid labour but how to bring them together in better ways, so that formal training and institutional resources can reinforce grass-roots initiative.. An integration of popular and professional, top-down and bottom up. Some of this is already happening, but for the wrong
reasons and often the wrong ways, because local authorities and
public service departments have been forced to cut costs and replace paid with unpaid laboour rather than combine the best of both. It's not a matter of either/or, them-or-us, not win or lose, but both joined up. My
father once wept when, at the end of an early televised marathon, the
front runners joined hands and crossed the line together.
Beware abstraction, and over-the-rainbow fantasies. The link below gives a better idea of what I meant about fattening ourselves for the slaughter. How can any Health Service or Social Care take the weight of such an overhang?
Obesity, like mental illness, suicide and other sorts of self harm, increases with inequality, at least in better-off societies. It is not only or even mainly self-induced... It wasn't always that way and here are some verses I wrote about a scrawny old man - who am I to talk? - who was admitted to the hospital ward I worked in more than 60 years ago:
He'd lived in a house they'd condemned
Why not?
But at least my mother lived a lot longer and died quite happily. When she left us in Wales she went to a residential home nearer where she'd lived and knew people. After a year or two there she tired of getting weaker, ill and incapable despite good care. For a while she talked piteously about it being time to die, as if we might help. Then she stopped eating. The kind women who laid her out left her wedding ring on her finger and pinned a rosebud to her nighty. They'd noticed she could smell what flowers were in a bunch even before it was unwrapped.
Earlier this week, Ada (my wife) took down the little Christmas tree in the hall and pulled the cloth off the heavy garden flowerpot I'd stuck it in. Popping out of the soil were a dozen white shoots, and on one side, where the light must have got in, stood two wide-open dark blue irises.
A flash of hope in the Pandora's box of 2017. But for all of us, may tides of war and desolation turn before too long and let more humankindness in. Wherever we live, haves and have-nots cant get far without each other
He'd lived in a house they'd condemned
With
his wife and a yard full of hens
They
got them both out in the end
But
couldnt make him see sense.
They
broke the old couple apart
Two
bodies and one broken heart
In
a workhouse refitted as hospital
For
the aged and chronically ill
The
old man stood up for his rights
Got
out of his bed in the night
And
told us who came to push him back in
He'd
been feeding his chickens.
So
we tied a net over his bed
Put
sedatives in with his tea.
In
a week and a day he was dead..
Could
the same ever happen to me?
But at least my mother lived a lot longer and died quite happily. When she left us in Wales she went to a residential home nearer where she'd lived and knew people. After a year or two there she tired of getting weaker, ill and incapable despite good care. For a while she talked piteously about it being time to die, as if we might help. Then she stopped eating. The kind women who laid her out left her wedding ring on her finger and pinned a rosebud to her nighty. They'd noticed she could smell what flowers were in a bunch even before it was unwrapped.
Earlier this week, Ada (my wife) took down the little Christmas tree in the hall and pulled the cloth off the heavy garden flowerpot I'd stuck it in. Popping out of the soil were a dozen white shoots, and on one side, where the light must have got in, stood two wide-open dark blue irises.
A flash of hope in the Pandora's box of 2017. But for all of us, may tides of war and desolation turn before too long and let more humankindness in. Wherever we live, haves and have-nots cant get far without each other
