It has become commonplace to say that there is a crisis in adult social care in the United Kingdom. This comment reflects on empirical and conceptual work on care, and feminist perspectives on re-valuing care, to make the case for a fundamental re-appraisal of how we resource and regulate adult social care. The problems generated by the uneven implementation of contemporary legal frameworks and the chronic underfunding of social care are explored, to demonstrate how regulatory, governmental and policy choices shape the everyday experience of delivering and receiving formal care services. Once these relational connections between regulation and everyday life are exposed, the need for a different, fairer and more just approach to care regulation becomes clear.
We are often told that, in the United Kingdom, there is a “crisis” in adult social care (Ferguson and Lavalette, 2013), that the social care system is at “breaking point” (Butler, 2017), and that a “dementia time bomb”, which will cripple our health and social care services, is the inevitable consequence of increasing longevity (Cooper, 2014; Maguire, 2017). The challenges of an ageing population, and the prospect of increased care needs and expenditure are not limited to the United Kingdom: it is estimated that over two thirds of those with dementia live in low and middle income countries, and that the direct costs of dementia care alone will reach over a trillion US$ by 2018 (ADI, 2017). As global populations enjoy greater longevity, the issue of how to provide care for older people has become a pressing social, legal and political issue. Most commentators agree that something needs to be done to tackle the social, economic and political challenges posed by increasing needs for social care. Less attention, however, has been paid to the socio-legal dimensions of this issue in the United Kingdom and beyond. The immediate causes of the contemporary care crisis in the United Kingdom are often attributed to a lack of funding for social care, an issue exacerbated by the austerity politics of the Conservative led UK Governments from 2010 to 2017. While underfunding is certainly a problem for social care, and has led to increasing levels of unmet care need, it is not the sole cause of the current social care “crisis”. As a result, simply spending more money on social care in the current system and within the current regulatory framework will not suffice. Instead, solving the crisis in adult social care requires innovative solutions that take account of the complex, intersecting causes of the current systemic crisis.
The causes of unmet care need, beyond “underfunding” include: the relational reality of care, and the ways that policy choices interlock with legal and social norms to shape personal experiences of and responses to care needs; the privatized nature of the social care system in England and Wales which both creates and iterates unfairness in the system; and complicated regulatory frameworks for care providers which generate complexity and unaccountability in care provision and contribute to the abuse and neglect of care recipients. I will deal with each of these issues in turn.
How to cite this article: Harding R (2017) A relational (re)view of the UK’s social care crisis. Palgrave Communications. 3:17096 doi: 10.1057/palcomms.2017.96.
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Care Act 2014, s. 30, and the Care and Support and After-care (Choice of Accommodation) Regulations 2014/2670, regulation 5.