Ambulance delays and people spending hours, dying, waiting to be seen, in the news again today.
People are living more fragmented, solitary lives. The rise in people living alone has soared in the UK, as around the world, since the middle of the last century and particularly since the 1990s and has more than doubled since the 1970s. 30% of over 65s live alone, the second highest group after 45-6 year olds.
Insufficient care in the community means people can't be discharged from hospital, which means no free beds in hospitals, which means A&E fills up because there is nowhere to send people, which means ambulances can't empty & respond to new emergencies and people die.
It's not just that families don't look after extended family members as much, people are living longer, with more complex needs. The main problem is a "stretched and shrinking" workforce, whether that is going in to people's homes or the workforce in care homes. Low pay, low status and challenging conditions. Astonishingly, only 30% of social care providers are partly digitised. That means patients or residents details are managed by pen and paper or are being carried around in people's heads. Christopher Wren might have been able to build St Paul's like that, but I am sure you would much rather your relative's details were being efficiently managed and shared. Personally, I keep an updated list of my parents medication because I know how chaotic the system is.
Things are supposed to be a bit better in Scotland, but not by much.
We don't value carers, partly because things that really are valuable to humans - nature, care, clean air, unpolluted water, pesticide free food for all, meaningful human connection, spirituality are things we don't, as a society, actually prioritise, certainly not as a society that is "managed" by government. Government priorities are elsewhere and seem to be focused around money, control, minimum standards and maximum compliance.
It is a contradiction that Tories, who are supposed to be about less state intervention actually crack down more on society - but then they are also famously "tough on crime". That is because protestors get in the way of money-making and government. And to Tories, riff-raff - anyone, through fortune or design not like them - are or are near enough criminals and ought to feel the boot of the law. Suella Braverman was just a bit too explicitly Nazi-like about it and lost her job, ultimately for trying to boss the police about, but it was a long time coming.
The people who make the decisions on things like care in the community are not at the sharp end, giving or receiving care. As with so much, it comes down to a failure of imagination, a lack of empathy. So often people don't want to have empathy because they would have to face unpleasant truths and it would make their decisions more difficult. Years ago, a local councillor, who is still in office, made my concern about how dangerous it was for my children to cycle to school into a press opportunity and turned up at my house with an entourage for photos. Later, while he was still there, I pointed out that it wasn't just primary age children and bikes who can't manage our streets, because they are designed for drivers now. It is also parents, often still mothers with prams or elderly people who struggle to cross roads in our town because of the quantity of traffic and the way it is managed. He said he had no children. I said I was sure I could find him a mum willing to go with him and her toddler or two to show him just how hard that could be. He looked terrified. I don't remember if he literally backed off very hurriedly but that was certainly the effect. I now wish I'd suggested doing it with a baby in a pram, a toddler, a doddery grandparent and a dog.
Most decision makers just don't want to experience the difficult truths of people's lives. They just want to decide about them.
In another policy contradiction, this Tory government prioritised reducing migration over improving social care. Tory voters can just pay for private care. But what kind of country wants to "stop foreigners" more than it wants to help elderly people?
