After coronavirus what could our future health and social care services look like? How could we use the tough experiences of these last months to create better care and support for people across our diverse communities in Ipswich, Suffolk, north Essex and beyond?
The tragedies and sacrifices of the pandemic are still with us. Even so we should be encouraged by so many positive actions, large and small, that have happened locally these last eight weeks. For example, all the heart-warming good will between neighbours and voluntary help that the EADT has described daily; or relaxing organisational barriers which so often stop the voluntary sector, Councils and NHS joining up what they are each doing in our interests.
Much of the good neighbourly care and effort of voluntary organisations has been supported out of the public eye by the linking-up, information sharing, advice and extra funding (public and private giving) which is being coordinated by Suffolk County Council, Borough and District councils, NHS Clinical Commissioning Groups, Community Action Suffolk, Suffolk Community Foundation, Suffolk Associations of Local Councils, Police and indeed the EADT/Ipswich Star, all working so well together. In Suffolk the county’s ‘Collaborative Communities Covid-19 Board’ has excelled.
Surely, nevertheless, with all the evidence of fundamental flaws in our health and social care systems even before coronavirus impacted, we do not want to return to how things were.
The most important messages must be for our government. Whatever we do locally, it needs government to act differently if we are to benefit from the hard lessons of this major jolt to all our lives.
I urge our local MPs and Government to consider these actions:
Public Health
Promote good health as a priority. Listen to the professionals who know what they are talking about, understand where and why they might have different views, and then act.
Governments had for decades knowingly ignored advice from public health professionals about pandemic threats and the need for detailed preparation, even as recently as the 2016 ‘Exercise Cygnus’. We must presume that global epidemics of infectious diseases will repeat. Be honest and treat us as an adult population.
Inequalities
Be serious about ‘levelling up’ in society and communities, not just regionally for political ends. Inequalities in health across the UK have widened over the last 10 years, said the Health Foundation’s commissioned Marmot Review in February 2020. We know this is equally true of Suffolk and north Essex. This means length of life you can expect, years living with disabling conditions and ill health. These have deteriorated significantly as a result of poverty; poor housing, living and working conditions; air quality; diet and other. All have worsened because of public policy choices. And, of course, all these directly affect your or my chance of dying if we contract Coronavirus.
It means government addressing all the interrelated aspects of public policy for which it has the key levers – environmentally-friendly business support; assured incomes; decent homes; healthy energy sources; educational investment; recognising the particular needs of different communities, cultures and localities, best known to those who live there.
Health and Social Care
Be serious for the first time in two decades about the ways in which these must work together differently. Focus on ’health’ not just ‘ill health’; on people’s wishes and the quality of their experiences of care and support, not ‘episodes’, or ‘delivery’ as though the services were Amazon parcels.
Sadly we have realised belatedly the effects of NHS care, especially acute hospital bed availability, being the only priority; and social care an afterthought. Some leading politicians have even found the words ‘social care’ difficult to mention. Treating it as secondary - undervalued, underfunded, fragmented, mostly privately operated with local government only partially able to influence, has been disastrous. At last publicity about deaths in care homes, and belatedly concerns about other forms of care at home for younger disabled people or vulnerable adults of all ages is exposing the true position.
Cease pretending that everything can be run from Whitehall, short term political gestures and crude notions of ‘integration’.
Instead, MPs and government should read again the abundance of advice about a wholly different strategic approach; valuing NHS, local government and publicly funded social care alike; respecting and paying properly the hugely diverse and valuable workforce; and build a unified national care vision with joined up policy and a long term sustainable funding settlement for the first time ever. West Suffolk’s Matt Hancock could become as historically venerated as Aneurin Bevan.
People’s lives at home
Don’t avoid looking until a media investigation exposes people’s distress otherwise hidden from view. We only know currently what we know from publicly available data or media interest. Many of us share concerns about mental ill health and stress, well-being of family carers, suicide, domestic violence, child abuse, hate crime, self-neglect and others; as well as people with untreated potential heart attacks and strokes, cancers and other life threatening diseases not going to hospital.
People living on the margins of our society or exposing uncomfortable truths are rarely attractive news stories unless someone wants to make an easy judgemental point, play to the public gallery, and then turn away. Government could make a start with funding permanent accommodation and support for rough sleepers.
Voluntary sector and Volunteering
Celebrate the successes, the heroes, the achievements overcoming circumstances and sheer generosity and good will of so many people. But remember what people are doing voluntarily is complementary alongside health and social care. They are interdependent and equally important. There is need for national policy vision; respect for diversity of interests, motivations and organisations locally; and most importantly sustainable funding not just during an emergency. What people in Suffolk and organisations in the county have achieved in recent weeks is remarkable and an outstanding example to others nationally.
My final hope is that, for the sake of the kind of society we all want to live in, as the shared experience of world war gave us our cherished NHS in 1948, seventy two years later coronavirus will do the same for our beleaguered social care services.
• Brian Parrott is a former Director of Social Services and NHS Trust Chair, and current Trustee of Community Action Suffolk and Suffolk User Forum (mental health)
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