Resisting the assault on care

Martin Sime argues that the voluntary sector can play a major role in resisting cuts which affect the most vulnerable, but that the left must take a more thoughtful look at the issues faced at the margins of the state.

Will voluntary organisations be in the vanguard of those resisting the cuts? And what, exactly will they be fighting for? There is surely fertile ground here for anti-cuts campaigners to recruit people and organisations that work to support some of our most vulnerable and marginalised citizens. Many think that the voluntary sector ought to have a natural affinity with the trade union and labour movement and a mutual antipathy to rapacious bankers and duplicitous politicians.The voluntary sector has been uniquely affected by the recession and imminent cuts in public expenditure will have a profound impact on their work. Their meagre resources are diminishing at precisely the same moment as demand is growing. Across the world there are queues outside homeless shelters; record numbers are seeking help from the Citizens Advice network and many services are stretched beyond their limit. This perfect storm is made complete by falls in donated and earned income including government contracts, whilst facing the same escalating costs as everyone else.

The Big Society is now widely understood to be a fig leaf for cuts

If such an army could be won to the cause of resistance they would bring a formidable scale and reach which compliments the more formally organised battalions of the labour movement. The voluntary sector includes the millions who volunteer on a regular basis as well as a paid workforce which is now not far off the size of the NHS. The purpose of this article is to explore this proposition and to place the contemporary voluntary sector in a political and socio-economic context. My focus is Scotland, but the domestic themes here have a wider resonance – the salience of non-profits, NGOs and wider civil society has risen around the world in the last 20 years and their role in campaigning and civil resistance is much debated.
Of course we are grappling with diversity and pluralism here. In Scotland alone there are some 50,000 voluntary organisations, each with their own management committee and volunteers. Three new charities are registered every working day and the combined annual income of the sector is estimated at £4.5 billion. The vast majority are small and volunteer-led but there is now a cohort of service-providing groups, some of whom have substantial operations mostly in the field of care services under contract to local government.v The challenges faced by this service providing model have been well rehearsed. Can you bite the hand that feeds, or will the traditional campaigning role be forced to take a back seat? As far back as 1993, a report to the Home Office (The Centris Report), suggested splitting the sector into two: tax breaks (and muzzles) for the service providers and no state funding at all for advocacy groups. A recent visitor from Sweden characterised their social welfare groups as having moved from “voice to service” and “from watchdog to lapdog”.
The recent fashion for social enterprise has also had an impact. A creeping managerialism and talk of business plans and contracting strategies have replaced the values and ethos focus of traditional charities. Of course a degree of professionalism is necessary in order to run any operation of scale, but the notion of being agents of change has morphed into the sector being suppliers to government. The growing third sector workforce, too have noticed the change. Competitive tendering run by local government has simply eroded pay and conditions for what is now an army of care workers. It’s become a race to the bottom with zero hours contracts, no pension, minimum wages and frequent TUPE transfers to other providers. The sector has become what many feared – the cheap (and dispensable) alternative to public sector delivery. The irony here is that this has been done by local government, which now boasts an army of “commissioning officers” with thick rule books and a detailed knowledge of European procurement procedures. Yes, these are the same Councils who promote a “living wage”, final salary pensions and no compulsory redundancy policies for their own staff. Despite the rhetoric, there is no parity of esteem here. No matter how necessary the service, the work of many voluntary organisations has a second class status imposed by municipal authority.

Trade unions have been quick to recognise the voluntary sector as a fertile recruiting ground but this too has proved problematic. Labour disputes and poor employment practices are now all too familiar in the voluntary sector, but the rights of workers have been difficult to assert within a culture of well-meaning benevolence that characterises the volunteer Boards which lead many organisations. Also, if the money isn’t there then there is not much else that can be done: there are no profit margins to shave or governments to shake down. But trade union recruiters in the voluntary sector have also found it difficult to reconcile their traditional public sector mentality with the interests of their newly recruited voluntary sector members. Manifestos which oppose contracting-out look hostile to voluntary sector interests. No-redundancy agreements with Government simply export job losses to voluntary organisations. A two tier workforce is now emerging between those directly and indirectly employed by the state.

In truth there has always been ambivalence about the role of voluntary organisations in public life. The left promoted not-for-profit delivery as an alternative to privatisation, for example in the housing association movement, whilst the right saw voluntary sector service delivery as a way of breaking up the power of a monolithic state. Patronised on both sides but for diametrically opposing purposes, voluntary organisations have exploited successive governments of all persuasions to promote their interests, fund their particular causes and create the most positive operating and fiscal environment for the sector of any developed country. However, politicians who see the sector as a potential instrument through which to achieve their objectives are almost always disappointed. (The Big Society is now widely understood to be a fig leaf for cuts.) Such ambitions often flounder on an inability to orchestrate diverse and often competing interests or to curb the remarkably steady inflow of new causes and movements. It seems that society, that much derided concept that Thatcher claimed did not exist, is alive and kicking in the environment movement, the work of groups like Positive Action in Housing and, of course in the many disability and single interest groups where self help and mutualism are the founding principles for collective action.

If such an army could be won to the cause of resistance they would bring a formidable scale and reach which compliments the more formally organised battalions of the labour movement. The voluntary sector includes the millions who volunteer on a regular basis as well as a paid workforce which is now not far off the size of the NHS.

In any case the old battles to protect the public sector (perhaps because they will protect the vulnerable) have surely had their day. A big challenge is coming to all of these producer interests and to top down delivery on an industrial scale, including the voluntary sector and the state itself. Health and care is where it will be most sharply felt. Public expenditure cuts may have sharpened the debate about the sustainability of public services, but it was already widely known that the NHS could not be sustained in the longer term without radical surgery. The challenge of demography, and in particular the growing population of older people, could not be addressed with the current array of services, no matter how much Barnett-driven funding became available. On current projections for example, every school leaver would be needed to work in the care industry by 2030. What’s more, there has been a growing appreciation that the current service model is outmoded. Statutory delivery, whether internal or through a third party, is fundamentally at odds with the policy objective of personal control and empowerment. Simply put, a new paradigm where people make choices about their own needs, in the context of their own families, networks and support systems offers a much better prospect than the current top down approach. In theory at least, this promotes the state to the role of enabler rather than provider and puts the citizen at the heart of what will be a revolution in the care industry.

Gone are the big contracts where the words “person -centred” meant the opposite; gone are the armies of underpaid workers shuffling from one big provider to the next. In their place, people will make their own decisions to meet their own circumstances and I do not doubt that many will be informal, irregular and based around their immediate circle of neighbours and those nearest and dearest to them. Early experiments suggest, encouragingly, that their choices will be less institutional and thus less expensive. Hospital beds will be closed because people really do prefer to live their last few months at home, with the right support. It seems that fewer people will choose residential or nursing home care too – the days of institutional solutions look numbered. We may yet end up with a state-enabled bigger society.

It would be a big mistake for the left to resist this change in defence of some combination of public sector/public service workforce interest. More-of-the-same won’t work because it doesn’t work for those who matter most, the people who depend on support to live as much of an ordinary life as their circumstances allow. Resistance to cuts can’t become resistance to a change which is better aligned to current expectations and circumstances. Of course many people will want to mobilise to resist the reactionary policies of the Coalition Government and those who work in voluntary organisations will be well represented. But the epicentre of such an uprising ought to be the people at the sharp end of the £18bn cuts to welfare rather than the providers of services to them. Voluntary organisations can be useful conduits in such circumstances since they have unparalleled reach and are largely trusted in a way that public and private institutions are not. But they can be no more than that.

There is at least a theoretical narrative that connects the Scottish traditions of self help and mutual aid to the current conjuncture. People helping themselves and each other is how our mining villages survived in the 1920s and how our most remote rural and island areas are rebuilding and renewing their communities today. The left need a reappraisal of the role of the state in 21st century life as well as a deeper understanding of the varied roles and interests of voluntary organisations and the people who work and volunteer for them.

Martin Sime is Chief Executive of the Scottish Council for Voluntary Organisations but is writing in a personal capacity

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