Page 7, 25th April 1980

25th April 1980
Page 7
Page 7, 25th April 1980 — Why we need more amateurs to care for the old folks at home

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Why we need more amateurs to care for the old folks at home

NEXT month sees National Home Help Services Week. I hope that it will put (he contribution of these invaluable workers firmly on the map.

It is unfortunate that when we think of social services departments, we think of social workers. And, however unfairly, we think of social norkers as rather well meaning people who seem to create as many problems as they solve, offering a level of service which ultimately they cannot deliver, taking a lot of stick and earning little credit.

N et social workers only form some 10% of the total staff of a social services department. Home helps are nearer 40%. they are not trained for three years at taxpayers' expense. They are certainly not well paid. Their organisers look after some 40 to 50 home helps

and are therefore responsible to some 250 clients. a level of responsibility which would appal their social work colleagues, and one for which they receive considerably less reward.

Arid they get on with it: conking, washing, shopping, cleaning, chatting and simply making those improvements to people's physical environments without which their social and emotional problems could never be solved.

Few politicians seem yet to have grasped the enormity of the problem of old age which is confronting us. The number of people over 75 increases by about 60,000 every sear. In particular, the number of old people suffering from dementia will represent a horrifying challenge to society.

Therefore it is essential that we keep as many people as possible out of institutions: not only because they are inhuman but also because they are expensive. The average cost of a hospital bed is around £200 per week, that of a local authority home for the elderls £60 per week. Community care is cheaper and more satisfactory. If it grows, the cost of care for the elderly to the community will be reduced, not increased.

Yet the personal social services budget (out of which finance for home helps, meals on wheels, etc comes) is the part of the health and social security budget which is being savaged most under the government spending cuts. There are three elements to protection for the most vulnerable members of the community: social security, the health service and the personal social services.

The first two are Government's direct responsibility, the last are run bs local government. Social security spending must increase because of higher unemployment, even if the government does cut the real value of beriefits. The health service is protected by voluble unions and strong public opinion. The personal social services are not perhaps so popular due to public blest% of social workers, and the opprobium of the cuts can be laid at the door of local government, however much they may be strapped by central government cash limits.

Whatever the reasons. the effects are clear: the Government intends a reduction in real terms of 6.7% in spending on the social services compared with last year, at a time when (here is such a rapid increase in numbers of the very old.

Even if spending were to remain static, the jam would have to be spread more thinly. As it is. 35 per cent of authorities are cutting home help and mobile meal services. This may well provide quick savings. Home helps tend not to be vociferous union members; they will go quietly. But what happens if next winter sees a sudden flood of the elderly into our hospitals at considerably more expense than if they had been looked after outside?

We must not fall into the (rap of peddling the idea that care is easy, care is cheap and that all needs can he met. We live in a real norld of limited beds, limited resources, limited machines and limited people.

"Professional" care, whether it proceeds from statutory bodies or from voluntary organisations. is different in kind from care that follows from famils ties or friendship. Professional care cannot he based on personal affection and love.

But increased spending should not he simply on more professionals. Instead we should be thinking of how to support the amateur careers, neighbours and relatives. Above all we should be looking to create a society enhanced by the responsible use of freedom, and where there is a clear, deliberate acceptance of personal responsibility for ourselves and others.

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