Monthly Archives: May 2020

The Battle for the New Normal in Social Care

If Engels was living today he would be visiting care homes in Manchester, not factories.

In the Covid-19 pandemic more people have died in care homes than in hospitals, with current estimates north of 22,000 fatalities in care homes in the UK. This awful reality is being seen in Canada, USA, Spain, Sweden and across the western world. Further casualties must be expected. Social care is not just about elderly people in care homes, millions of people are living in their own flats and houses with support and 1 in 6 residents living in care homes is of working age. But care homes for elderly people are now the battle ground.

Care homes rely on low pay, zero-hours and migrant labour. They were financially unsustainable even before Covid-19, and the pandemic has broken the model wide open. A battle is starting for the new normal in social care and the defenders of care homes are lining up for the fight. As in a medieval campaign so far we can see four camps limbering up. For convenience we can call these camps the Corporatist, the Capitalist, the Collectivist and the Community. So let’s examine their battle plans in turn.

The Corporatist camp believes that good practices will prevail, and that better regulations and smarter procurement will provide the answers. It especially likes non profit providers such as the big charities and social landlords because they talk the same language. The generals in the camp are the Care Quality Commission and Public Health England, with their local lieutenants in the new Clinical Commissioning Groups. Their two weaknesses are their stores are empty and they don’t know when they have been out-manoeuvred.

The Capitalist camp believes that their ruthlessness (which in public they call innovation) will see off all other options. This camp has the best supply lines; donors with large levers inside government, thinktanks, and some media. The property bubble has given them superprofits by signing offshore mortgages and putting the winnings in a different company, leaving the care home accounts looking bleak, leading to more excuses for even less pay and worse job security. The big reductions in overnight wages is a recent example. Their weakness is they can’t help attacking each other, even though they pay lobbyists to say they have a united front and a common interest in serving humanity.

The Collectivist camp is newer. They believe that care homes as a business model are fine, it’s just the bosses that need fixing. Their generals include the TUC and the We Own It campaign, and their battle plan is to nationalise care homes as a sister arm to the NHS. Their battle cry is for a new National Care Service. This campaign has some merit, social care has always been the poor relation of the NHS. The mass eviction of tens of thousands of delayed discharge hospital patients (bed blockers as the troops would say) despite many being Covid-19 infectious will haunt many decent people in the NHS. The suspension of the Care Act and subsequent wholesale evictions from hospital wards showed what community care means inside the NHS when push comes to shove. The weaknesses of the collectivist camp are that they see care homes as an industry, and they underestimate the power of the big hospital barons to suck the money out of community care. To be fair, others make the same mistake.

Finally, away in the far corner is the Community camp, the smallest band of fighters. They aren’t new to the battle, they’ve been skirmishing in the shadows of policy since the 1960s and maybe earlier, with groups such as the National Campaign for the Young Chronic Sick which helped the Labour party pass a law in 1970 to liberate disabled people from a lifetime spent in a hospital bed to live independently by taking responsibilities away from the NHS and giving them to councils with social services departments. The 1970s and 1980s saw more campaigns against segregated care institutions, and the idea of independent living with support in the community started to take hold. Scores of disabled people visited Berkeley in California to learn how disabled people there passed on their knowledge to the next generation through centres for independent living. The campaign for independent living rumbles on, and the generals in this camp include the Reclaiming Our Future Alliance and Disabled People Against Cuts. Their weakness is that ten years of austerity, and marginal funding for years before that, has left their organisations empty or gone.

So, which of the Corporatist, Capitalist, Collectivist and Community campaigns will prevail in the coming battle for the new normal in social care?

We know that independent living has saved lives when compared with care homes. Given the international crisis in social care, the leadership failures in many western governments, and in response the rise of localism and mutuality as the most resilient response, it’s too soon to write off the community campaign for independent living.

On a new hub for disabled people’s organisations in Greater Manchester

I believe that many disabled people’s organisations (DPOs) in Greater Manchester would benefit from coming together by having a hub again for offices and meetings. The previous hub was closed seven years ago by austerity cuts.

Eight months ago I wrote about the need and benefits of a new hub – the link is below.

So it might seem odd during the covid-19 pandemic to be thinking now about being close together again. DPOs are campaigning hard on the appalling number of deaths in care homes, and on the lack of emergency support for disabled people who are shielding or isolating during the lockdown.

But I think we also need to put a marker down, to demand a say on the social designs of the future that are being started now, the “new normal”.

After the previous hub was closed in the years of austerity, many DPOs have been using offices which are much smaller than before, cramped, and dispersed, and often less accessible.

What if the “new normal” says that people who are younger and non-disabled can happily move about, socialise, go out to events, but the “vulnerable” will have to stay indoors and keep using zoom. And DPOs as responsible employers will be rightly worried about the thought of staff teams being asked to return to their small offices.

So some new thinking is required.

Firstly, a covid-19 vaccine is not certain, and if possible it will take many months to develop, and no-one can say yet how long it would stay effective for. There are other coronaviruses in nature where no vaccine for humans has ever been made despite many years of effort. And secondly, many people now agree that we need to redesign our new social arrangements to make us more pandemic-resilient against any future plagues that will come our way. There is good scientific research on the increasing interactions between humans and wildlife which is accelerating the movement of viruses between species.

So what might a pandemic-resilient new hub for DPOs look like?

My early guess is that it will be flexible, but not open plan. Given the circulation space needed for disabled people who are wheelchair users, this means larger offices which are not over-occupied by people or furniture. The previous hub had some of this, partly by accident because it was a retrofit of an institution which typically has larger rooms.

The new hub will also need to have a range of good transport connections, so probably near but not in the middle of a city or town, with significant parking for disabled drivers, with good public transport links (trams, buses, trains), easily walkable and with safe cycling routes. These are all general desirable features, so it means looking for a hub design or location that might also attractive to other organisations with more clout – and not accepting the cast-off options.

In design terms, the hardest element of a new hub would be the meeting spaces within it. A core feature of the previous hub, as well as the synergies of many DPOs sharing the same place and all the conversations and joint working that resulted, was it’s ability to hold large meetings of disabled people without rubbish access. The parking was sufficient, the circulation space was (mostly) flexible, the necessary tech was built in, and the toilets were many and dispersed. Perhaps most importantly, the hub tenants were very skilled and knew how to run an accessible large meeting.

No-one yet has a blueprint for all of these requirements, but I feel the debate needs to start before DPOs are given “the answer” without even getting a chance to ask the question, what do we need now?

My previous blog post on a new hub

Keep well everyone.

Research Bulletin, May 2020

Hello and welcome to this monthly summary of research.

1. Independent Living and Covid-19

With deaths from the covid-19 pandemic raging through care homes in the UK currently, the focus of this bulletin is on research and history building on Independent Living (IL) and on radical Centres for Independent Living (CILs).

I believe the inevitable public inquiry will starkly show that many disabled people living independently in the community survived while their disabled comrades in care homes died.

Many people have emphasised how disabled people are being ‘othered’ in media and government messages once more as vulnerable people. But the lethal contrast between living independently and being an inmate in a care home shows how that deadly vulnerability comes from society, not from the person.

2. 1970 – Alf Morris anniversary

The current plans for celebrating the 50th anniversary of the Chronically Sick and Disabled Persons Act 1970 are some online events in September. Campaigns by disabled people in the 1960s have been outlined in recent bulletins.

A contemporary Labour Party MP of Alf Morris was David Owen. They both went to the House of Lords after being MPs. A recent email from Lord Owen has added the following context to the campaigns by disabled people at the time:

“… commenting on your paper and the National Campaign for the Young Chronic Sick. I knew its chairman, Marsh Dixon, because if my memory serves me right we were both members of the Chelsea Labour Party when I lived on a houseboat off Cheyne Walk from 1960-64. He was the power behind the Campaign. I think it was a few years later that Alf took up the cause. Also Jack Ashley.

I was due to present a Private Members’ Bill to the House of Commons when I was appointed Minister for the Navy in July 1968 and I passed the Bill on to Jack Ashley to present in the Commons and it was his first speech after having [become profoundly] deaf due to a viral infection. I was there to listen to him and Alf almost lay on the bench in front of Jack putting his index finger and thumb up in the air moving apart to indicate to Jack whether to be louder or quieter. It was quite a performance from both of them.” Lord David Owen, email, 27 April 2020.

3. GMCDP Archive

Last month I started a list of the collections in the GMCDP Archive, and the list below starts to add some dates for what’s within these collections:

Colin Barnes 1980-2018
Philip Mason 1980-2018
Manchester Disabled Athletes 1969-2012
Ian Stanton 1984-1998
Manchester Mind 1970-1990
UPIAS (Union of the Physically Impaired Against Segregation) 1972-1990
Kevin Hyett 1970s-2004
John Evans 1981-2020
Jane Campbell 1980s-2019
Maggie Davis 1966-2019
Ken Lumb 1968-2008
GMCDP Archive Project Group 2003-2020

In April the Lorraine Gradwell collection started to be formally assembled and so far it consists of around 400 items in 14 storage boxes from being a teenager in 1971 onwards, and catalogued. There is more to be done yet, but the progress is encouraging.

In 1993 GMCDP produced a booklet on the NHS and Community Care Act 1990, calling for better implementation of community care and independent living, and providing advice on how to challenge poor practice by official bodies. I scanned a copy of this booklet and circulated it in social media, especially because of its relevance now with the so-called easements of the Care Act. Link here: (online friendly) (print friendly)

4. Another Book

One disabled person reading the April Bulletin got in touch to recommend a book they had read in their youth. ‘The Empty Hours’ radicalised their politics, they said, especially on avoiding going into an institution with every resistance they could muster.

The Empty Hours: the weekend life of handicapped children in institutions by Maureen Oswin (1971, Pelican books)

Keep well everyone

2020-05-25 Alf Morris MP and disabled people’s National Campaign for the Young Chronic Sick ISBN 9781913148119