Care and support - a community responsibility?

Any new settlement on long-term care and support must address the apportionment of responsibility for its delivery as well as its funding. With the state's capacity limited and family input likely to decline, the wider community must expect to play a growing role. This offers an opportunity to end social care's marginalisation, argues David Brindle.

Key points

• Social care has become isolated from mainstream society and its recipients are cut off from their neighbourhoods and from each other.
• Care and support need to be reintegrated with, and owned by, the wider community, and the voice of service users must be amplified and heard.
• A comprehensive information and advice service provided by local authorities would help knit together a system that has become fissured and inequitable.
• Demographic and societal changes mean there will be a growing shortfall of family carers and an imperative to promote care and support from the community.
• The government espouses the principle of rights in return for responsibilities, and seeks to foster community empowerment, but is not clear enough about the implications for adult care and support.
• Difficult questions about family and community responsibilities are being ducked and the issues risk being overshadowed by a focus on personalisation of services.
• Initiatives to build social capital in communities and encourage volunteering can make an important contribution, but are unlikely to deliver large-scale solutions.
• Consideration needs to be given to a new form of social contract, making explicit the relative responsibilities of the state, family and community and offering incentives to deliver care and support.