Today, many see care as an act of charity or protection; or the management of helpless incapacitated dependents by able autonomous superiors. However, within dictionary definitions of care, there is a distinction between the practicalities of ‘caring for’’ and the emotions of ‘caring about’, and this allows us to consider care as a two-way street.
I would argue that ‘the dependent’ may not be able to do practical tasks for their ‘carer’ – but that does not diminish the extent of their feelings of anxiety, concern, or fondness for them and their ability ‘to help’ in other ways. As Robin, the disabled husband of Laura says:
“I get very involved with Laura’s work … she knows she can bring it all home and dump it (stress at work) on me …. But I do like to feel I can help her to look at it from a distance.’ (1)
Such a ‘two-way’ street within the ‘helper / helped’ relationship exists whether that be between the ‘helped’ person with little communicative ability and her carer, or the personal assistant employer and her assistant. Indeed within the current system of ‘self-directed support, under employment law, the employer (the helped) has ‘a duty of care’ over her assistant.
Disabled people within the “Independent Living Movement” advocate that the outcome, or objective, of ‘care’, or what they call ‘personal assistance’, should be the promotion and sustenance of full and equal citizenship. The recipient of social care should have choice and control over the assistance required; and such assistance should be based on social justice, directed to supporting the recipient’s rights and responsibilities as citizens.
However, I would maintain, the majority of today’s social care provision does little but maintain dependency, via its eligibility criteria, and poverty, via what local authorities euphemistically call, ‘the client contribution’; but what disabled people and their carers increasingly refer to as ‘the care tax’.
Public services today are said to be controlled by ‘neoliberal managerialism’. The ethos of which has been to strip them of any moral or ethical values; replacing such with the market language of costs, efficiencies, profits and competition. (2)
I would argue that such neoliberal managerialism has devalued social care by devaluing the ethics and professionalism of front-line workers alongside the dignity and human rights of recipients; inflating recipient’s isolation from family, friends, as well as their community at large; and restricting the recipient’s ‘choice and control’ over their lives by diminishing opportunities and resources to ensure real ‘choice and control’ is viable.
Far from the harsh charitable outlook of Oliver Twist’s Mr Bumble towards the ‘deservedly needy’, which is so prevalent in today’s social care system, the prime function of social care needs to be viewed in terms of citizenship. This would place a duty on the state to promote and sustain such citizenship.
Fundamentally, that citizenship should be seen as including the ‘classical liberal’ idea of having ‘the status’ of citizenship (of belonging). This would benefit those whose impairment, or medical condition, is such that they cannot physically contribute to society.
However, citizenship also includes the ‘civic republican’ concept of participative citizenship where everyone has an equal right to be involved in economic, civic and cultural life. It is only when the state accepts these two basic duties of social care that no-one merely uses it to get up in the morning then has nowhere to go.
(1) Morris, J (1993) ‘Community Care or Independent Living’, Joseph Rowntree Foundation York
(2) Lynch, K (2014) ‘New managerialism’ in education: the organizational form of neoliberalism’, Open Democracy,16 September 2014 https://www.opendemocracy.net/kathleen-lynch/%27new-managerialism%27-in-education-organisational-form-of-neoliberalism