Thursday, 03 October 2013

Formal and informal care for older people: an example of ‘reverse crowding out’? I’ve been working on a literature review of older people and social isolation, which has necessarily involved tracing the history of some of the ways that societies support older people. All sorts of approaches lie scattered about – from almshouses through residential care homes, home help and sheltered housing, from community care and home-sharing to contemporary favourites like co-housing and age-friendly places. Are we building towards the optimum combination, or just working our way through a finite range of politically salient options? Let’s see what’s been happening in Sweden, a country known for its commitment to welfare in general. In a recent interview for the European Urban Knowledge Network, researcher Cecilia Henning observed: ‘What is interesting in the Swedish example is that we have had a very decisive policy towards ageing in place, but we have found that we have gone too far… we have closed a lot of residential facilities… because the politicians and the municipalities think that we should not have so much residential care, we should have ageing in place. So instead, we give home care in people’s homes. But at a certain point old people want to go to residential care units because they feel insecure and lonely.’ This seems to suggest that informal care provided in the home to older people in the interests of ageing in place has ‘crowded out’ the state’s provision of residential facilities. In a conference paper Henning and her co-researcher Magnus Jegermalm report that ‘After cutbacks and changed priorities concerning Home Help the public sector have focused more on helping people with ‘heavier’ tasks involving personal care (e.g. dressing, bathing, feeding, using the toilet). This development have most likely led to that informal caregivers and volunteers commonly carries out ‘lighter’ tasks for someone who is a relative but might also be a neighbour or a friend.’ Hmmm. This appears to be an example of ‘reverse crowding out,’ whereby ‘private provision of a public good replaces existing tax-supported provision of the public good' (Isaac and Norton, 2013). Just what the neo-liberal ordered? (Although to be realistic for a moment - not an attitude that can necessarily be associated with neo-liberals - there doesn't seem to be very much research that supports the crowding out hypothesis in the welfare context). What is clear is that the current ‘in-vogue’ approach, ageing in place, is, like all other approaches to support for older people, inescapably political.
Re-feudalising the country includes selling off common land (and hiding Cromwell) What’s this about common land? Jane Merrick in the Indy this morning tells us that there are 3,870 registered ‘village greens’ in England and Wales, covering 8,770 acres. Apparently that's less than half the size of the family estate of Richard Benyon MP, Parliamentary Under Secretary of State for Natural Environment, Water and Rural Affairs. Merrick writes: ‘We don't take up that much land, we commoners. Our families don't need 20,000 acres to take the dog for a walk, or let the kids kick a football.’ And without a hint of irony, it seems – these rich posh people tend to have a substantial intelligence gap in that department - Mr Benyon has said: ‘Towns across the country have been held back from getting the developments they want through misuse of the village green system.’ (Nothing then about damage to the country from misuse of the hereditary and political systems?) The Open Spaces Society response is here and the straightforward dishonesty of the department’s line is exposed here. File under Tory Arrogance. But take it more seriously. This is about their systematic attack on what is public and on the rights we have in common. It goes alongside the wanton, evidence-free and often costly decimation of the community sector, social support, public libraries and the postal service – things we own. Further down in her column, Merrick notes the irony in the fact that: ‘a new 10ft-high iron perimeter fence has been erected along the main public access area of the House of Commons. From the pavement, you can no longer see the statue of Oliver Cromwell which stands near St Stephen's Entrance.’ It’s a brazen stroke of sinister symbolism. Parliamentary democracy is bankrupt and the statue has been sequestered - by parliament! Perhaps the fence should be stormed for that reason - which in some eyes, in an added irony, would justify its installation. This is all part of the determined re-feudalisation of the country, although of course as the increasingly perverse climate-change-deniers with ministerial responsibility for Mr Benyon’s department are trying to make sure, before long there may not be much environment left for the peasants to work on. And there will be fences around the whole of Westminster, like a vast medieval castle.

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