Reader, I have discovered a long-lost – but sadly unfinished – version of Charles Dickens’ A Christmas Carol. It focuses (anachronistically, I know) on adult social care.
In it, a mean-spirited character – he’s still called Scrooge – really doesn’t like social care. He doesn’t see the value it brings to people. He’s dismissive of the arguments that it enhances people’s wellbeing and makes us a better society in which to live. He distrusts the evidence that it supports economic growth. He’ll occasionally give it some money to help stave off problems in the health service (though he’s a bit curmudgeonly about that, too, thinking it a ‘bottomless pit’). But he never gives more than he thinks is strictly necessary and it’s always a one-off donation, never the long-term regular income that social care needs.
All this changes one night when Scrooge is visited by three ghosts. The first ghost shows Scrooge that he’s always been dismissive of social care. He’s never really understood it or known many people who drew on it. He doesn’t think that he himself will ever need it. This Scrooge had his chance in 1948 to give it the same love, and money, as the health service but didn’t.
Scrooge isn’t convinced though. He doesn’t think the ghost fully understands fiscal responsibility.
The second ghost shows Scrooge social care as it is now. It takes him to the home of an elderly woman who is left isolated and in pain because her needs aren’t thought high enough to qualify for support, to the home of a younger disabled man who gets some support but not enough to allow him to live the independent life he wants and he visits a home care worker who is stressed, exhausted and poor because she’s overworked and underpaid.
Still Scrooge isn’t convinced. He thinks that the ghost should reconsider the potential for cost savings and service efficiencies. The third ghost terrifies Scrooge by showing him the future of social care if he continues on this path. Reader, I can’t fully describe to you what the ghost shows Scrooge because it is too scary. But it involves people being left cold and alone because there are not enough workers, ‘for sale’ signs on care businesses and thousands of people selling their homes to pay for their care. It is, in truth, perilously close to what the second ghost has shown him.
Unfortunately, we don’t know for sure how Dickens intended this version of A Christmas Carol to end. However, from the author’s handwritten notes, we suspect that Dickens didn’t necessarily plan the heartwarming about-turn that Scrooge makes in the famous, published novel.
Instead, it seems he intended a surprise reveal about the identity of Scrooge himself. Some believe that Dickens planned to unmask Scrooge as the leader of a semi-secret fiscal cult, thousands of people strong and operating at the heart of Government, which has had malign influence over social care policy for decades.
Others see the villain being revealed as the social care sector itself, so indecisive that it can’t decide what it really wants or unite to help bring it about – a sort of social care version of Hamlet.
But still others believe Dickens had something more philosophical in mind, with Scrooge revealed as, well, us. In this version, the public knows little about social care, prefers not to think about ageing and disability and prefers its money to be spent on shiny new hospitals. As a result, there is little pressure on politicians to bring about real and lasting reform in social care. In this last version, Dickens is holding up a mirror to our society and forcing us to face a reality we don’t like.
Which version is the real one? Perhaps all three. But the moral of the published version of Scrooge is that – in the right circumstances – attitudes (and policies) can change. And that, as Dickens knew, is a thought to get us through the cold, winter nights.
Happy Christmas.