What is it about your job that you feel would surprise the public?
The size of the social care workforce. A lot of people think social care is the NHS or local government, but they’d be surprised that it is actually primarily provided by over 21,000 organisations, many of them small businesses. In fact, the social care workforce in England is bigger than the NHS workforce.
What’s been the biggest change you’ve seen since you started working in the NHS and social care?
The focus on social care – that it’s regularly in the mainstream press and it’s talked about in parliament. But I wish I could say it was a completely positive change. We’ve still got a huge amount of the public who don’t understand what social care is or what it does. And it doesn’t help our narrative to continually talk about it being in crisis. It feels disheartening that most of that national focus is on the problems within social care.
If you could make one change to the NHS and social care over the next 10 years, what would it be?
Parity of esteem for the health and social care systems. They are two sides of the same coin, ensuring all of us get the care and support we need. For too long, social care has been seen as the part of the system causing the problems or the bit of the workforce you go into if you can’t get a job in the NHS. They need to be equally valued and equally invested in.
Change from the top
If you could give Matt Hancock one piece of advice, what would it be?
He should change his title to Secretary of State for Social Care and Health. Everyone is so used to health and social care, but ‘social care and health’ would make people sit up and think differently. He needs to seriously recognise what a properly funded social care system can provide for our country and for our NHS. He wears his NHS badge, but where’s his social care badge?
What do you wish people at the top of the NHS understood?
We know what the answer is: social care needs more money. And it has to be paid for. It doesn’t matter how you dress it up, that’s the truth. We need to recognise what a great asset we have in social care. We have nearly 1.5 million skilled workers – nothing gets me more irate than people referring to the social care workforce as low skilled or unskilled.
Policy in practice
What policy have you seen successfully implemented, and why did it work?
Person-centred care. It wasn’t something we talked about 30 years ago, but now it is woven through social care. It recognises that the most important individual in any conversation or decision is the patient. It’s been successful because of the power and passion of the disabled people’s movement and other rights-based activists, who have been relentless.
What policy have you seen fail, or not be as successful as first intended?
I was hearing someone talk the other day about the Continuing Healthcare initiative. If there’s one thing that needs sorting out, it’s that. It’s been a debacle. In this particular case, somebody had been moved to a nursing care home for end-of-life care and was granted continuing care, but she didn’t die quickly enough. Her continuing care was removed and she's now at risk of being moved out of the nursing care home because the family can’t afford to pay the fees. What is that about? That is not a way to treat people.
What policy and/or change in behaviour are you currently trying to implement, and how’s it going?
Raising the profile and status of the social care workforce to get them recognised as professionals, which we are doing in many ways. I saw something recently about social care workers’ average pay compared to pay in the retail industry and it just made me furious. These people are taking care of the most precious part of our lives and we are saying it’s okay for them to be on minimum wage. It’s not!
The NHS is under pressure because...
It is trying to work with inadequately funded social care. The NHS is not going to be able to deliver the Long Term Plan without a sustainable social care system. And that’s a lose-lose in my book.