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We have a dream
Reframing the social care conversation

It’s not easy to find an article on social care in the national press that doesn’t contain the word ‘crisis’ or ‘breaking point’. While the attention on the issues is welcome, is this stance helping, or are we just desensitising the general public? Neil Crowther shares his thoughts on this and why it’s so important we craft our messages in the best way.

“We all want to live in the place we call home with the people and things that we love, in communities where we look out for one another, doing the things that matter to us. That’s the #socialcarefuture we seek.”

Martin Luther King never gave an ‘I have a problem’ speech. Painting a vivid picture with his words, King passionately set out his dream of a different, better world where, ‘one day right there in Alabama little black boys and black girls will be able to join hands with little white boys and white girls as sisters and brothers.’ King appealed directly to the ‘American dream’, invoking shared values and hoping that ‘this nation will rise up, live out the true meaning of its creed: “We hold these truths to be self-evident, that all men are created equal.”’ Emotionally heavy, while factually light, his vision remains a touchstone for gauging political commitment to, and progress on, racial equality in the USA and around the world. King framed the debate.

Why this is important

Framing is, in a nutshell, about drawing the pictures in our audience’s heads of the world we hope to bring about, speaking to and igniting values to motivate people to support and pursue this world, and giving a clear sense of the path – the solutions – that will take us there, so that people are left with a sense of opportunity and possibility. It is about setting the terms of the debate.

Where we fail to present a story, people rely on the existing pictures in their heads, meaning that no matter how many facts or great ideas we give people, our messages often fail to take root. If we neglect to consider people’s emotional brain – the values and moral intuitions which powerfully guide our receptiveness to new ideas and arguments – we either miss opportunities to enlist people’s support, or worse, direct them away from our goals by igniting unsupportive values. If we fail to leave people with a sense of hope and possibility, we create a sense of fatalism: in the absence of clear answers, over time any sense that ‘something must be done’ subsides and is replaced with an abiding sense that ‘nothing can be done’.

Organisations and social movements are beginning to employ these insights into our cognition and psychology in the pursuit of social change. LGBT+ campaigners have successfully shifted the frame from demanding ‘civil rights to same sex partnerships’, which invoked difference and ‘othering’, to ‘equal marriage’, with messages and imagery rooted in shared values of love, commitment, family and belonging.

In the UK, the Joseph Rowntree Foundation is striving to circumvent negative attitudes to social security by reframing poverty itself, describing it as ‘restricting and restraining’ people and positioning benefits as a solution that ‘unlocks’ people from these constraints, with their messages rooted in the values of compassion and justice.

Where are we now

Those of us involved in #socialcarefuture have a dream. Unfortunately, our new research into how the story of social care is presently being told by campaigners for change, how it is reported by the print media and how it is understood by the public presents instead a bit of a nightmare.

Social care is uniformly talked about as ‘in crisis’, so much so that ‘tackling the social care crisis’ has become the de facto policy goal. The story is one of money – public or private – with social care a question of meeting a growing and unaffordable financial cost.

To individuals and their families, the cost is described as ‘catastrophic’, threatening their home and savings. Very large sums of money are proposed to solve this crisis, but frequently characterised as insufficient or unattainable.

Rather than looking at it in terms of people’s lives, social care is spoken about as a ‘sector’, depicted and seen to be both under pressure and dangerous and, through its failings and lack of money, a cause of unsustainable pressure on councils and the NHS. Those requiring support are positioned as both the cause and the victim of these pressures, with the ageing population a ‘timebomb’. Working age adults do not feature in the current story of social care, save their presence in an overall reference to ‘the vulnerable’.

Social care is seen as an end in itself, ‘looking after’ people ‘who cannot look after themselves’ through life and limb care, rather than as transporting people from one life situation to a better one, or as aiding their life chances. The story of social care is often a footnote to that of the NHS, with ‘patients’ now being the single most common group descriptor of those using or seeking its support. National government is the only ‘active agent’ in these stories, with funding the only issue to be addressed. Those requiring or using support are never depicted as having agency.

Does this framing work?

Some will argue that crisis messaging has helped elevate social care up the public and political agenda. Social care is certainly enjoying a new level of political salience, featuring prominently in the Conservative Party leadership contest and with progressive proposals for funding via general taxation emerging from all sides of the political spectrum.

Prime Minister Boris Johnson, speaking on day one of his Premiership pledged to ‘end the social care crisis once and for all’. It is however worth noting that in Johnson’s promise to ‘protect you or your parents or grandparents from the fear of having to sell your home to pay for the costs of care’ the Prime Minister echoed the words of his predecessor, Tony Blair during his speech to the Labour Party Conference in 1997.

Moreover, by focusing on property wealth and security, this message – when allied to the overall story of social care being told, reported and heard by the public – seems likely to be directing people away from those shared, outward-looking values needed to build support for paying more taxes, especially when overlaid with the social and economic anxieties of Brexit.
The persistence of crisis messaging, allied to the non-appearance of government proposals for reform does however appear to have fostered fatalism among the public.

Despite the current high profile of social care, in June of this year, Just Group reported, ‘For years we found around two-thirds of over-45s expressed interest in the debate [on social care funding] but that dropped this year to just over half, while those saying they are not interested has almost trebled to 17%.’ Similarly, the issue has dropped off Ipsos Mori’s Issues Index (which measures month by month the priorities of the British public), having featured regularly in the latter months of 2018.

Absent of a forward-looking vision of what social care is and does, the crisis message also risks becoming a self-fulfilling prophecy. As Julia Unwin has argued about housing, ‘If you talk about housing in terms of desperation and need, then you can’t be surprised if it becomes an emergency service.’ While the Care Act 2014 offered a vision and legislative framework for wellbeing, with personalised, community-based care and support being the means to those ends, the debate around funding frames care as a safety-net for the most vulnerable, offering only life and limb personal care.

The shortfall in spending on social care is inarguably a major cause of its current ills and the lack of progress by governments since 1997 to achieve consensus on long-term funding of care is itself a result of failing to find a way to build public support for change. But rows over the funding of social care have sidelined the crucial question of what care and support should do for us and how it needs to work.

This is why the primary focus of #socialcarefuture’s work is on shifting thinking about what social care should and can be and do in the future. If and when the funding tap is turned back on, we want to make sure any new resources are invested in ways which unlock the abundant resources and power to make change that already exist among individuals, families and communities.

What must be done

In May of this year, 80 participants in the #socialcarefuture movement, including self-advocates and directors of adult social services, people from disabled people’s organisations and from service providers, parent-led organisations and academics met in Manchester to begin drafting our shared dream for the future.

We now need to do lots more deep listening to understand how the public thinks and feels about social care, to understand the values that will motivate them to support change, or which may stand in the way, to craft and test our messages and to support people to begin telling our story.

We’re making good progress in drawing together the financial and practical support we need to put this project into action, covering the costs of expert advice, research and project management and plan to start work this autumn. We want our dream to become reality, and writing and telling our story lies at the heart of how we plan to achieve this. If you share our dream and would like to support us or be involved, please get in touch.

Neil Crowther is a member of #socialcarefuture. Email: socialcarefuture@gmail.com Twitter: @socfuture. Listen to Neil’s podcast for more, the report ‘Talking about a brighter #socialcarefuture’ will be available October. 

What are your thoughts on the crisis messaging in the media? Do you feel it’s a help or do you think we need to reframe the debate? Share your thoughts in the comments below.

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