Care by the community

Hardly a day goes by without a new story about the crisis of care. Yesterday a report from the Daycare Trust highlighted the continuing and deepening problems of childcare affordability. Costs are highest in London, where the average cost of a full time nursery place for a child under two is now £14,000 per annum. Provision beyond the school day for older pupils is also becoming much more expensive.

Today there was research from Carers UK showing that more than one in five adults have seen their work affected by caring responsibilities. An estimated 2.3 million people in the UK – among whom the hardest hit are 45-54 year olds – have left jobs to care for a loved one, with many more reducing their hours.  And just in case we thought the problem was all about quality not quantity there is this reminder from Wales  of the frequency of scandals in care settings.

As I said in an earlier post, society’s capacity for providing care is a diamond comprising the market, the state, close family and the wider community. Thinking about how to generate more and better care involves looking at the contribution from each source but also, more importantly, understanding the relationship – sometimes additive sometimes subtractive – between them.

Arguably, for example, the problem of informal care by families is oversupply. As the Daycare Trust and Carers UK are pointing out, the need to provide care and the costs of buying it are the crucial factor inhibiting maternal employment and increasingly important in keeping older people from full time work.

Voluntary care by the wider community is by far the least substantial of the major sources of care. But is has a vital advantage; unlike the other sources, increasing it does not have problematic knock-on effects.

So how might we go about achieving a step change in the contribution made by the community? As with all complex social problems, the best solutions combine the forces of individual aspiration, collective values and hierarchical leadership and capacity.

This suggests a number of ingredients:

Incentivised volunteering: there is often a false dichotomy between paid and voluntary labour. In fact, small incentives – well below – market value can be enough to persuade someone to do something which gives the non-material reward of pride and satisfaction. I think, for example, the debate about the possibility of providing some remuneration to school governors is entirely welcome. As well as various ways of giving people rewards for volunteering, one idea might be to link the need for care to another great and growing need – affordable housing. How about providing a fast track to social housing for people who agree to give a certain number of hours of care to neighbours?

Structured reciprocity: Perhaps I am being unfair but despite a hundred and one experiments, it remains to be seen whether time banking can make a really big and sustained impact on community capacity. Most people’s reaction to the Japanese scheme in which people who have moved away from their ageing parents ‘swap‘ responsibility for supporting them is that it wouldn’t work in our culture. So although it must be part of the solution there is still some way to go in finding ways of building reciprocal capacity.

New norms: I have written before of my idea of a national young people’s care service. Whatever anyone thinks of that we need to explore how we can make helping to look after people other than ones loved ones as normal and common as, say, spending time getting fitter.

Enabling regulation: We all know how the necessary measures to ensure child safety have acted as real and perceived block to voluntary work with kids. We need forms of hard and soft regulation which are developed to make it easier and less risky to care. For example, (I know Alex Fox will correct me if I am wrong) I think one part of the Shared Lives scheme in which families offer support to adults with problems is a guarantee that if things go wrong the charity will relieve the family of its responsibilities no questions asked.

In all these areas technology, and especially big data and social media, could play an important role in innovation.

There are elements of all these ideas happening somewhere in Britain or around the world. The problem is finding sufficient investment, commitment and patience to take new ideas for voluntary care to scale. But unless the alarming headlines are to continue indefinitely we really have no choice but to keep trying.