Dr Simon Duffy gave this talk to lecturers, practitioners and students in social work at Kingston University, London. He explores the underlying causes of the severe crisis in social care and suggest what we can do about it.

1. Why Social Care is Failing
Dr Simon Duffy, Centre for Welfare Reform

2. Pruitt-Igoe

3. 1. Social Care has emerged out of the system of institutions and the Poor Law. It
has not yet shaken off the legacy of its problematic past.
2. The system is now in a profound system-wide crisis, accelerated by austerity.
It is breaching human rights and increasing rates of death and abuse.
3. The law and systems of advocacy has been wholly inadequate to defend the
right to social care for individuals or society as a whole.
4. The system (commissioning, care management & regulation) is struggling to
overcome the damage caused by the ‘purchaser/provider split’.
5. Genuine innovation is counter-cultural and it (a) promotes citizenship
(b) strengthens family and (c) enables community cooperation.
6. We need a new system of social care to combine universal, non-means-tested
entitlements with local systems to prevent need and strengthen inclusion.
7. Change will require new strategies and a leadership which can heal the
fractured nature of the social care community.

4. 1. Social Care

5. What’s wrong with Hayley?
Absolutely nothing.

12. 2. Crisis

16. The Committee is seriously concerned about the
disproportionate adverse impact that austerity measures,
introduced since 2010, are having on the enjoyment of
economic, social and cultural rights by disadvantaged and
marginalised individuals and groups. The Committee is
concerned that the State party has not undertaken a
comprehensive assessment of the cumulative impact of such
measures on the realisation of economic, social and cultural
rights, in a way that is recognised by civil society and national
independent monitoring mechanisms (art. 2, para. 1).
UN Committee on Economic, Social and Cultural Rights:
Concluding observations on the sixth periodic report of
the United Kingdom of Great Britain and Northern Ireland
24 June 2016
UN declares UK Government fails to respect human rights

17. …there is reliable evidence that the threshold of grave or
systematic violations of the rights of persons with
disabilities has been met in the State party… The core
elements of the rights to independent living and being
included in the community, an adequate standard of living and
social protection and their right to employment have been
affected… freedom of choice and control over their daily
activities restricted, the extra cost of disability has been set
aside and income protection has been curtailed as a result of
benefit cuts, while the expected policy goal of achieving
decent and stable employment is far from being attained
UN Committee on the Rights of Persons with Disabilities:
Inquiry concerning the United Kingdom of Great Britain and
Northern Ireland carried out by the Committee under article 6 of
the Optional Protocol to the Convention
6th October 2016
UN declares UK Government fails to respect disability rights

18. http://bit.ly/counting-cuts

20. In total, across England as a
whole, the WCA disability
reassessment process during
this period was associated with
an additional 590 suicides
(95% CI 220 to 950), 279,000
additional cases of self-
reported mental health
problems (95% CI
57,000 to 500,000) and the
prescribing of an additional
725,000 antidepressant items
(95% CI 406 000 to 1 045 000).
Barr B, et al. J Epidemiol
Community Health 2015;0:1–7.
doi:10.1136/jech-2015-206209

22. • The battle for citizenship and
lives of meaning goes on.
• Margaret had lived life blighted
by institutional abuse from an
early age.
• She left Lennox Castle Hospital
20 years ago and uses an
Individual Service Fund
managed by Inclusion Glasgow.
• Over time her service evolved
into a wonderful form of shared
living and family life.
• But today Glasgow Social
Services are planning to move
Margaret from her home into a
Nursing Home.

23. 3. Advocacy

25. • Little independent research
• Charities and advocacy groups
co-opted or muted
• Regulation kills innovation
• Many MPs have shares in
residential and private healthcare
Where are our defences?
http://bit.ly/care-crisis

28. Public policy is designed to promote stigma

30. 4. System

33. Have direct payments hit their peak?

36. …confused responsibility & liability

37. 5. Innovation

40. Citizenship is practical and inclusive

44. http://bit.ly/peer-power

49. 6. Reform

57. 7. Change

58. Unite
Connect
Organise

62. www.cforwr.org
@citizen_network
@CforWR
@simonjduffy
fb.me/centreforwelfarereform
fb.me/citizennetwork
e simon@centreforwelfarereform.org
www.citizen-network.org