The vision is accompanied by an outcomes framework and by a number of supporting papers. These are ‘Practical Approaches’ to building stronger communities, market and provider development, co-production, and safeguarding and personalisation, one called ‘Personal Budgets, checking the results, and one which doers not begin with P, called , ‘Enabling risk, ensuring safety – self directed support and personal budgets’. Together they represent a continuing roll out of existing policies on personalisation, rather than a revolutionary new direction. Continue reading “‘P’s in our time – a vision for social care”
Care Services Minister Paul Burstow’s latest idea for alleviating the deepening social care crisis is Hureai Kippu , or ‘caring relationship tickets’. This is a scheme which originated in Japan, whereby people volunteer to help older people who require care and support . In return they receive a credit which they can bank in anticipation of the day that they need care themselves, or they can transfer their credit to a relative so that they can obtain care. In the UK we have for many years had a not dissimilar system of exchange called ‘money’. People make a contribution to society and in return receive ‘money’ which they can then put aside to buy care.
So what’s wrong with money? Well for a start local authorities don’t have much of it. The monetarisation of relationships can also be criticised for de-humanising relationships, and it can be seen as a sad condemnation of society that many people who need care never see anyone who is not paid to be there. On the other hand, cash payments that are supposed to turn people into empowered consumers of care services, are seen by many disabled people as the key to independence and choice.
In fact evidence from Japan indicates that Hureai Kippu works. Older people prefer to receive care from someone who is being paid with ‘care relationship tickets’ rather than someone who is being paid cash. And there is a growing body of literature on the benefits of alternative systems of exchange, such as time banking and Local Exchange Trading Systems. These alternative currencies can foster local relationships and, since everyone’s contribution is valued equally, promote equality.
The problem with the latter argument is that not everyone will be able to accumulate credits, or has children to do it for them. The success of such local schemes is likely to be based on the characteristics of the community – for example whether people have free time, whether they have strong roots in the area or are transient.
Hureai Kippu seems distinctive in that, in order to work, it has to be rolled out on a large scale, and people have to trust that their credits will still be valued by future generations. In a climate where people don’t trust the state to care for them in their old age, don’t trust insurance companies and don’t trust banks why should they trust in the value of ‘caring relationship tickets?’. It might also be the case that the success of timebanking schemes and LETS derives from the fact that they are usually small and that their character would change if they were developed on a much larger scale.
So Hureai Kippu might be worth trying out, but as with the ‘Big Society’ the trouble is not so much the idea itself but the ambitious claims being made for what it can achieve.
‘Caring Relationship tickets’ along with other big society ideas for encouraging small scale, neighbourhood and mutual support can make a significant contribution to changing people’s lives. But replacing social care services, or even mitigating the impact of cuts to services is another matter altogether. Social care services for older people are now concentrated on those with the greatest need. Family carers often have to develop skills comparable to those of specialised nurses in order to provide such care – it’s not a role for untrained volunteers.