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Care as a core capability

February 15, 2013 by
Filed under: Public policy, Uncategorized 

As I said the other day, there is a crisis of care in our country and it comes in many parts. For a start there just isn’t enough to go around; whether it’s deprived children or isolated elders, in our crowded society many people lack the human contact and support that they need to flourish. This is despite the fact – reported by the ONS today – that one in ten people provide unpaid care, that the proportion is steadily rising and most quickly among those who provide more than fifty hours a week.

Although the Coalition’s  announcement of a new funding framework is welcome, regardless of who pays professional care is proving increasingly unaffordable. Virtually every local authority in England has now restricted state funded provision to those with the most severe needs, and even they get a threadbare offer.

At a time when we need to maximise productive work, the expense of child care means UK employment rates among mothers are disappointing and much lower than many other European countries. And, as recurrent scandals in hospitals and care homes – of which Mid Staffordshire is the most recent and shocking – vividly illustrate, our institutions and professionals seem capable of ignoring the most basic care needs of their patients.

Meanwhile recently another debate has reopened; what should children learn in schools? Michael Gove’s policy shift on the EBacc still leaves him out of line with a growing international consensus that schools should equip children not just with subject based knowledge but the core capabilities they will need to be successful and responsible citizens. Below the u-turn headlines last week was a surprise reprisal for citizenship education, which contrary to expectations will remain a statutory part of the curriculum, with renewed emphasis on active participation in community volunteering.

This is an opportunity. It’s time we saw learning to provide care as essential to young people’s development. We learn about the joys, trials and tribulations of providing care in practice not in theory. Teaching care should revolve around a new ‘young people’s care experience’ through which all youngsters at some point between the ages of 14 and 18 are expected to undertake a hundred hours of work experience in a care setting such as a community nursery or a residential home.

There would be many benefits. Young people would have an experience which has a good chance of being useful to them in their career and which – unlike a lot else they learn at schools – certainly of value at some point in their life. The care institutions would get a flow of prepared young people to enhance the offer they make, especially around the face to face interaction which so often seems to be missing when things go wrong at places like Mid Staffs.

Having worked in Downing Street I am painfully aware that the implementation of an idea is as important as the idea itself. The devil is in the detail. I should thank my readers for some useful comments when I floated this idea last week and an insightful sixth form group at St Xavier’s college in Clapham who gave me forthright feedback when I recently floated the concept with them.

The Government decided some time ago to scrap mandatory work experience for older secondary school pupils. This didn’t get much push back, partly because the low quality of many work placements has given the whole idea a bad name among teachers and young people. So this scheme must be linked to accredited classroom learning and to high standards of supervision and support by the care workplaces. Pupils must be prepared for the experience and if they meet the standard they must get credible accreditation to put on their CVs. And the participating organisations –which could be from the public, voluntary or private sector – should be strongly encouraged to reward young people who successfully deliver the 100 hours – some public recognition and £50 can go a long way if you’re fifteen. Perhaps as Carl Allen suggested  we could make use of alternative currencies as the mode or reward.

It is also vital that the scheme is mandatory across all schools whatever their social mix. One of the problems with paid caring occupations is their low status. Feminist economists argue it is part a broader problem of downgrading what is seen as ‘women’s work’. The care experience should be seen as an opportunity and a privilege for all not a burdensome imposition. And, incidentally, this is vital for our economy. For all the talk of investment in science and high tech business, improving the quality of work in our ‘high touch’ service sector is vital to the sustainability of public services and the overall productivity of the economy.

The St Xavier’s students asked another question: Millions of young people are already care providers, looking after parents, grandparents or younger siblings. Isn’t it a bit much to ask them to add another 100 hours onto the several many spend every day looking after loved ones? It is a telling point and implementation has to leave room for schools to show common sense and compassion. But perhaps this is another upside. Far too often young carers lack the space or confidence to talk to their peer group about the challenges they face. By making care giving something we all value and all experience as part of growing up perhaps that too might change.



  • Sam Earle

    Thanks Matthew. Timely and important piece.
    Perhaps there’s something though in encouraging volunteering, in v part-time capacities, among all citizens. I wonder if there is a contradiction in the idea of “mandatory volunteering”!! Interesting work in Self-Determination Theory would suggest, I think, that this probably wouldn’t have long-term benefits or resonance in values, attitudes and behaviour because the locus of control is removed. Similarly, voluntary volunteering (!) would avoid problems of value-suppression identified by e.g. the work of Common Cause (i.e. if you pay someone to care then the value of self-enhancement will perhaps suppress the values of self-transcendence). I think perhaps the challenge is how to encourage a culture of other-orientedness, in which spending time with lonely elderly people, or working with foodbanks, or with homeless outreach etc etc, was part of one’s weekly routine. This would evidently save Gvt money in caring, and the wider-reaching benefits e.g. (mental) health and strengthened communities, would be significant too. Instead of paying for caring, volunteers could be offered something like NUS cards,which would help mitigate loss of pay. Of course there are some areas of care that requires full time, skilled caring – but perhaps money could be freed up for more of the such if volunteering was de rigueur in rest of soc.
    Similarly, employers should be encouraged to offer volunteer days. And if NEF type ideas of 4-day working weeks were broadly taken up, there would evidently be more time for other-oriented activities like volunteering, as well creating more job hours to go around….

  • Owen Jarvis

    This is such an important and neglected area. I was really impressed by the points made by St Xavier students which seem particularly powerful. I agree more should be done to recognise and value the care work already being done by young people – they are right, rather than additional work experience perhaps this time could be better used to support them in their existing roles, either in additional time-out for study or care work or training. If we want to engage and inspire young people about the value of care, taking on from Heath and Heath in their book, Shift, in the task of nudging behaviour change it is always far more motivating to build upon what they’ve already experienced and achieved, possibly far more valuable than the sore feet and hands I experienced in my teenage years cleaning hospital floors and serving in high street stores.

  • Tom Brookes FRSA

    Greatly enjoyed reading both those comments.

    Rob & Sam, would you agree that your position is (broadly) that the problem of care is a deep (or ‘wicked’) one, which suggests faults in the ordering work and/or how we structure our society – schooling & life priorities, for instance?

    That’s my inclination – & that a scheme like this won’t work. Chiefly because it only addresses the symptoms not those structural causes; and because it’d risk teaching teenagers that care is a mandatory thing, a chore for which to expect reward. It’s too natural an impulse to codify it & time manage care training; I can’t help but think it maligns caring.

    School is a big part of the answer, but not adding to the curriculum – relaxing and mixing both it, and students. It seems evident that the bureaucracy of education detracts from learning in the same way overmanagement does healthcare – ensuring only a certain mediocrity.

    Let’s think bigger!

  • Zio Bastone

    ‘[I]t’d risk teaching teenagers that care is a mandatory thing, a chore for which to expect reward. It’s too natural an impulse to codify it & time manage care training; I can’t help but think it maligns caring.’
    (Tom Brookes)

    Indeed. That codification, time management and ‘training’ is part of what a number of anglophone commentators see (as indeed do the Italian autonomists and post autonomists, for whom the issue is central) as the capture of emotions and their transformation into what’s termed affective labour. It’s not a healthy process.

    Arlie Russell Hochschild for example (The Commercialisation of Intimate Life; her term is ‘emotional labour’) sees us leading ghostwritten lives in which ‘carers’ liberate us on the one hand whilst on the other we lose our most intimate selves, the import in effect of Mark 8:36. And there’s a wider parallel with how desire is captured and put to work (‘We can’t let the terrorists stop us shopping’ – George W Bush) by advertising and brand management.

    In Global Woman: Nannies, Maids, and Sex Workers in the New Economy Hochschild considers too the international trade in human feeling. That trade finds UK hospitals staffed not just with people from the UK who lack ‘core capabilities’ and are thus unable ‘to enhance the offer they make, especially around the face to face interaction which so often seems to be missing’ in MT’s deathless managerialism but with bank and agency nurses from the Philippines and Zimbabwe.

  • Sam Earle

    Hi Tom and Robert,
    Yeah, I quite agree that root-causes are an important part of solutions. I’m loathe to talk about this as a problem. It is another facet of society, and with clever, interegrated, and root thinking, it should be possible to devise policies that actually work…e.g. Volunteering is a good thing, it builds capacities for relating and empathising, and if done in conjunction with fewer working hours, would also free up time for more leisurely travel – bike and foot. And it may help generally to build pockets in society where it’s no longer called “volunteering”, it’s just called living in a community.

  • Sam Earle

    Robert, clever thinking refers to a method of thinking, and not its content…I don’t see why ” there have been bad policies previously and therefore all policies will remain bad” is necessarily true. And I think that disjointed policy making is not at all clever thinking.

    Am I waiting around? Or do I actually try to get involved in the sorts of things I suggested? And surely it becomes less likely equally because of apathy. No, we don’t have to wait around and wring our hands!

  • Tom Brookes

    Quite the debate!

    Sam I agree it seems like a cop-out sometimes to say ‘root causes’ – it’d be lazy to leave it at that, so I’ll try some ideas as I go. However I think it equally redundant, having recognised systemic flaws, to merely discuss methods to paper over these cracks or expect optimism to make them go away.

    Zoe was kind enough to flesh out the suggestion that mandatory care is a great way to make careless people, and Sam you point out that volunteering is a good thing – which I couldn’t agree with more. Problem being the root of the word ‘volunteering’ is ‘voluntary’ – which is not the proposition we are discussing. Matthew’s suggestion is 100 hours of mandatory care between the ages of 14 and 18; which I, and evidently others, consider unworkable – hence the need to go back to those structural, root causes or suggest something better.

    I know, it still sounds vague – but I’d submit that solving the big, overlapping factors causing this care deficit is probably more sensible, harder and therefore of more real benefit than looking for a silver bullet regulatory solution. I’d go so far as to say I doubt one really exists.

    Robert, your polemic is delightful – I’m not surprised you get criticised for being negative on this blog. I don’t need to tell you there’s truth to your analysis and something of a curse of false optimism in these debates sometimes it’s good to see challenged. I’d direct your critics to the ‘smile or die’ RSA animate!

    Though I would hazard anyone against proclaiming with certainty on something like human intelligence – the best biology has to offer can’t explain our neurology – let’s not talk as if we’re privy to special insight. Similarly apathy, all we have is best guess about something as individual as that – and as such must experiment democratically to find our answers.

    What do you suggest forms part of the solution(s)? For my money a reworking and simplification of wage and taxation systems, economic adjustments to prices on a market basis and massive investment in education for all ages and infrastructure renewal might make a start. And the political system needs renewing. Perhaps moving beyond party politics to a parliament made up of independents might refocus politics on nation rather than power and infighting. I don’t subscribe dogmatically to any of those suggestions, they just seem like good starting points for discussing our structural faults. But that’s still all a terribly vague, isn’t it?

    So that’s where I’ll leave it, and hope for more contributions. Just like I don’t think there’s one magic policy for such problems I don’t think there’s a magic blog post with all the right words either – there is no theory of everything for society anymore than there is for physics – we have to evolve complex solutions mutualistically, not as one-man bands.

    Having suggested those broad areas in need of structural reform I’ll hope to encourage debate and see if we can’t crowdsource some detail for big ideas. Wouldn’t it be terrific if that was what politicians did? The pervasive expectation that leaders will come up with perfect solutions to our problems is, methinks, as much of a contributor to these sorts of horrors as anything else – and indeed is almost exactly contrary to how democracy should work.

    I look forward to more responses… and Matthew, what do you think?

  • matthew taylor

    Thanks for all this. Although ‘Robert Burns’ (which is, I fear, a pseudonym for someone who has previously posted under other names) I do wish you could stick to the point and lower the temperature.

    It’s interesting how quickly care opens up such fundamental questions.

    Tom, I agree that it is not useful to conflate ‘volunteering’ with my suggestion. However, I think we do underestimate the scale for what might be called incentivised volunteering – that is stuff we don’t do for a market rate but for which we value recognition and reward. For years I unsuccessfully lobbied DfE to negotiate a deal with restaurant chains whereby chairs of school governors and their families are given a free meal to thank them for all the efforts they have put in. I really don’t think that to do so would belittle or instrumentalise their volunteering.

  • Tom Brookes

    Not in the least Matthew… it’s self-evident people volunteering their time produces wonderful results which merits reward, but the notion of a good deed being its own reward extends to good treatment from others without the need to negotiate a deal.

    Does the doctor, who saves a restaurant owner’s life, negotiate when the man insists he comes for free dinner as often as he likes? No, it just happens sometimes – but if it was the hospital’s rule, it would come to feel an imposition on the restaurant owner despite his gratitude.

    I think, with your example, you rather inadvertently make the case against your 100 hours of care scheme – such things must evolve on their own as far as possible, not be imposed.

  • Sam Earle

    Yeah, Livvy, I agree. I had stopped reading. Partly because this polemic is not polemicism, just vitriol and spleen. I do feel that RB has intentionally misunderstood my points, and that therefore his comments are just disingenuous casuistry. So, sorry Tom, but this is not my idea of debate – I’ll duck out again now: Life’s too short to entertain unpleasantness! The other thing about the blog is that it does too often uncritically uphold the status quo.

  • Tom Brookes FRSA

    So much for a rational debate.

    So Robert thinks “I don’t mind them being in my country, as long as I know exactly where they are & what they’re doing.” Paraphrasing.

    Read Orwell much?

  • matthew taylor

    That’s it.

    Livy and Robert you are banned – sorry.

    No doubt Robert will re-emerge with another nom do plume sooner or later. Let us hope a new guise leads to a new and more constructive spirit

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