Creating Space for Citizens in Social Care

Review of Caring Activism: a 21st Century Concept of Care

Author: Peter Limbrick

Reviewed by: Simon Duffy

Peter Limbrick has a long and distinguished career promoting innovative and respectful ways of organising support to vulnerable people. In this book he sets out an idea which he thinks could transform care in the 21st century.

I was very lucky to catch Peter Limbrick, the author of Caring Activism, at Glasgow’s CitizenFest: We Are One a fantastic event created by partners of Citizen Network. Peter shared some poetry and the essence of the idea of Caring Activism, in a Zen thought:

“My left hand has a thorn; my right hand takes it out.”

In other words, we must think of help and being helped as one essential element of the human condition. The challenge is to remember that We Are One. One day we may be able to give help, one day we may need help, but we are one people who can only flourish in our interdependence.

Peter has already had a long a distinguished career as an innovator and thought-leader. He was responsible for developing the Team Around the Child (TAC) concept and practical systems of supports for families, like The One Hundred Hours project. His colleague Hilton Davis, who edited the book, also developed the concept of The Family Partnership Model. There are obvious close resemblances between this work and the work of several Fellows of the Centre, for example:

• Pippa Murray’s work on family leadership (Murray, 2010; 2011)
• Clare Hyde and Clare Jones’ work on women-centred work (Duffy & Hyde, 2011)
• John O’Brien and Beth Mount’s work on person-centredness (O’Brien & Mount, 2015)

However the concept of Caring Activism is a connected, but rather new idea. Limbrick is not marketing a model, he has not developed a new business or a social enterprise, instead he is offering a concept - a good idea - that he hopes others might take up.

At its simplest Caring Activism has two principles:

1. No vulnerable person is knowingly left without support
2. No citizen wanting to help tries to do so on their own

These seem simple propositions, but they disguise decades of experience and wisdom. The book argues that we citizens should start to act from “common decency” and be more confident about taking care of each other. He explains why this citizen action is necessary and important and he also proposes a series of disciplines that would make this kind of everyday citizenship workable. In particular he proposes:

1. People choose to come forward to help, but focus on a specific neighbourhood or issue
2. People don’t work alone, but in teams which put the authority of the person who is being helped at their centre
3. Forums could be formed to bring together such teams, spot problems and create solutions
4. The whole approach needs to avoid professionalisation and idea of people as being staff or volunteers
5. Caring Activism creates power horizontally - through collective action, partnership and negotiation - power with, not power over
6. There is potentially an advocacy role for Caring Activists, but working directly with people should not be trumped by campaigning

The book is easy to read and persuasive, and it raises multiple interesting issues. Here I want to explore two aspects that were particularly striking to me:

• How does Caring Activism relate to existing notions of power and care and what does it offer that other competing ideas do not?
• Given the scale of ambition of Caring Activism how best might it be realised in the real world?

Current debates about care are often quite peculiar. The dominant explicit view in public policy is that social care is some kind of ‘industry’ that needs to be funded and regulated and which is best delivered by highly trained professionals. In an age of privatisation this mindset has been very helpful to those who want to exploit every human activity for profit; but often even advocates on the Left can fall into the trap of accepting an exhaustively professionalised model of care. This discourse stands in stark contrast with the reality in the UK:

• Social care has been targeted for cuts by control Government
• Most needs for social care go unmet
• Means-testing is vicious - effectively a tax on disability
• Social care staff are paid appallingly low wages
• Levels of care are often dangerously unsafe
• There are significant levels of abuse
• Centralised state regulation does not work

Without a doubt the privatisation of social care has increased all these problems. Charities cannot speak out about the severity of harm. Private companies can squeeze profits and then collapse their companies when profits are no longer available. However it is not clear that returning social care back to an old-fashioned form of nationalised industry, policed by a Whitehall bureaucracy, will solve all the problems in social care.

One reason we should reject the social care industry model is that most social care is not provided by paid staff. Most social care, about 500% more, is provided by families. The voices and interests of these families goes almost entirely unrecognised; in fact you would think from the newspapers that the main problem families face is having to sell off their home to pay for dementia care. Most families would be lucky to have that problem.

Families needs go largely unrecognised and unsupported. Too often lack of support is combined with a patronising approach from professionals which leads to many families rejecting or avoiding professional assistance. Not everyone - there are excellent professionals out there - but there is a tendency to simply take family care for granted:

• Family carers, not always, but more often women, receive negligible financial support
• Assessments for social care needs will often just assume people are coping
• Families are often seen as failing those in their care, but the needs of the whole family are often ignored by services or professionals

In a sense the real privatisation of social care is not the take-over of public services by profiteering investors (many who are directly or indirectly involved in politics). The real privatisation of social care is that we simply choose to ignore the needs of those we can’t see, those who don’t qualify for help or those who are trapped in the wrong or inadequate services. The problems people face are have been turned into private problems - none of our business - and if those problems spill over into public view we then expect public services to sweep in and take over.

We have become invisible to each other. We pay our taxes and we mind our business.

This is what Peter Limbrick wants to challenge. His model of Caring Activism does not assume that everybody will want to or should take on a caring role. But he challenges us to imagine what it would be like if just some of us did. He is proposing that there is an important space that we’ve left unoccupied, between private family life and the functioning of public services. Quite properly he recognises that family is vital and families will always play a critical role. He also recognises that we need public services and that it is quite proper that we support and maintain systems of entitlement and organised community support. However he suggests that without genuine citizen action existing in between these two spaces neither will function or flourish as they should.

One of the most interesting challenges of his proposal is that Caring Activism needs to maintain its autonomy and its integrity from the state. It is also too easy and all too typical to see well-intentioned policy-makers destroy a good idea by thinking they can ‘implement it’ ‘commission it’ or ‘scale it up’. Too often these efforts create bizarre phoney forms of citizen action, robbed of their spirit. However this does raise the question of how in practice Caring Activism might come to life.

I asked him about this at CitizenFest and he said that he was hopeful that some people might take up the idea and this is why he’d made his way to Glasgow. He also described how doctors and others in Moravia, in the Czech Republic, had started to apply the Caring Activism methodology. It struck me afterwards that many of my friends were probably working in the same space as Limbrick has identified, facing the same challenges and that perhaps there might be some attempt to learn about these approaches together:

WomenCentre is an example of an organisation which is applying some elements of the Caring Activism model (Duffy & Hyde, 2011). The organisation does not accept any artificial definition of who they must support and they seek to serve the most vulnerable women and families, whatever their needs. They also ensure that women who have learned the hard way how to escape severe poverty, mental illness, prison or other horrors, get the chance to share their learning and offer practical help to other women going through what they went though. WomenCentre seem to apply a Caring Activism Team approach.

PFG Doncaster are also people who’ve often suffered from the failures of society and had to struggle through various problems (Duffy, 2012). At the heart of their work is the discovery that people can help each other. PFG Doncaster’s members are living Caring Activism, but perhaps centred around a hub and diverse network rooted in a specific neighbourhood. Interestingly, like WomenCentre, PFG does need some small financial and practical assistance from the state in order to function - a tiny fraction of typical public services costs - but something. Citizenship is always dependent on some modest financial security - otherwise it tips into dependence and can be exploited and controlled.

I am also reminded of Acorn Sheffield, my local Acorn group. Acorn is using community organising techniques to help people protect themselves from exploitation by bad landlords and other problems. Here there is certainly a conscious balance between advocacy and practical action - when people face eviction or harassment the whole Acorn community can be mobilised to protect people.

These three examples are not precisely examples of Caring Activism in the sense that Limbrick outlines. But it is interesting that they contain many common elements and they certainly occupy the citizen space between the state and the private individual. Other models that come to mind are: KeyRing, Gig Buddies, Citizen Advocacy, Bringing Us Together, IBK Initiatives, Barrow Love Families, TAP, Starfire Cinncy, Froome Council, Avivo and there are many more…

As Limbrick suggests, now is time for system-thinking. Local authorities - even better - local neighbourhoods (if only they had some system for democratic participation) could begin to explore how to support and nurture their own citizen space - their own agora. Caring Activism would be a great idea to bring to local communities that were hoping to end the era of privatisation of human invisibility. I look forward to supporting these ideas through the Centre for Welfare Reform, Citizen Network and in my own home of Sheffield.

Caring Activism: A 21st Century Concept of Care is available to buy via the publisher Interconnections here.

References

O’Brien J & Mount B (2015) Pathfinders: people with developmental disabilities and the allies building communities that work work better for everyone. Toronto, Inclusion Press.

Duffy S & Hyde C (2011) Women at the Centre. Sheffield: Centre for Welfare Reform.

Duffy S (2012) Peer Power. Sheffield: Centre for Welfare Reform

Murray P (2010) A Fair Start. Sheffield: Centre for Welfare Reform.

Murray P (2011) Developing Family Leadership. Sheffield: Centre for Welfare Reform.

The publisher is Interconnections.

Caring Activism: A 21st Century Concept of Care © Peter Limbrick 2019.

Review: Creating Space for Citizens in Social Care © Simon Duffy 2019.

All Rights Reserved. No part of this paper may be reproduced in any form without permission from the publisher except for the quotation of brief passages in reviews.