Tomorrow is St Valentine’s Day and this year it will be markedly different for all of us. Doubtless Hallmark et al will still be much used though I suspect it will be as a result of mainly online card orders; there will be expensive Take Away Valentine dinners and no doubt the florists will still make needed revenue from exorbitant costly red roses. But for many Valentine’s Day will simply not be the same. For thousands it will be a day of emptiness and sadness, regret and remembrance.

This time last year the Guardian newspaper carried a story entitled ‘Love in the time of coronavirus. ’ It described the attempts of the crew of the Diamond Princess cruise ship to make Valentine’s Day as normal as they could for the thousands of passengers who were quarantined on the vessel as it sat off the Japanese coast. You might remember the story of how one by one crew and passengers were struck down by this new virus which had swept China and was beginning to affect many countries across the globe. By Friday 14^th last year 218 passengers and crew had shown positive results among just over 700 who had been tested. As the journalist commented: ‘The ship’s once carefree community, who until two weeks ago were making calls at ports across the far east, is now host to the biggest single cluster of coronavirus cases outside China – and by some margin.’

A year on and such instances seem almost unexceptional if not sadly routine as 2.7 million people have succumbed to this deadly virus with millions more having been infected.

This last year has witnessed such a degree of loss that it can almost be hard to contemplate. Indeed I came across a story this week which seemed to encapsulate the way in which our normal has become abnormal; but also the way in which folks are trying to hold onto something familiar and trusted when all the usual markers of life seem to be swept away.

Deborah De La Flor has been a florist in America’s Florida coast for over 40 years. She has never experienced a February like this one. “At a time when someone is sending you an ‘I love you’ card, someone is sending an ‘I loved you’ card,” said De La Flor,

As America’s Covid death toll sits near 460,000, florists are in equal measure creating wreaths and bouquets in a strange synchronicity of love lost and love held.

At about the same time last year I was meeting with colleagues in my role as chair of the working group creating Scotland’s National Bereavement Charter. Few of us could have expected that the very way we grieve and deal with loss as a society in Scotland would be changed out of all reckoning in the months ahead. Traditional means of remembering and celebrating the lives of loved ones have been altered beyond familiarity; we have lost ritual and the rhythm of farewells, and despite strenuous efforts a sense of the functional and mechanical has crept into moments of departing. I fear we are in danger of losing the comforting power and the necessity of mourning. This past week I attended a funeral and the restriction on numbers, the inability to be with people afterwards, to share memory and laughter, to hug and console, makes the whole experience of funerals during lockdown so hard for people.

Today in this weekly blog I want to reflect on two issues, the first is that of care home visiting, the second the wider implications of loss during the pandemic.

At the start of the pandemic care homes closed their doors in order to save lives and protect residents. Many managed through great professionalism and dedication to do just that. But the virus which we even then called the ‘novel’ coronavirus was so new and different that despite all efforts it got in and destroyed with horrendous harm. Throughout all the early weeks and months as numbers increased and we experienced the full impact of the first wave the doors of care homes remained closed to family and loved ones except sadly at end of life. Then over the months small steps were taken to open up, first outdoors and then indoor visiting, the latter only really starting with testing machines sent to care homes in mid-December. Some homes were confident in going further than the guidance, others were more reticent and concerned. Caution and protection were the bywords, but it became increasingly clear to many that so much avoidable harm was being done by the desire to protect at all costs as deterioration and decline, loss of motivation and connection became so evident.

Throughout these months many families and relatives have experienced anguish and heartache being separated from their loved ones. Others have been too frightened to even contemplate going into the care home. They have lost moments of togetherness that will never be re-captured. Care home staff and managers have struggled with the stress and strain of trying to do the right thing for all amidst growing pressures of demand.

All those involved in the tragedy of coronavirus in care homes share one desire – a safe restoration of life and contact as it used to be as soon as possible. Before the virus I could count on one hand instances of dispute and disagreement over family contact. Today the key relationship between family and care home staff is much more fragile than anyone would ever want. I have never met anyone who deliberately and consciously for no reason wants to keep people apart in our care homes; rather the best care homes have always recognised the role of family as not a ‘visitor’ but as a part of their community.

So as has been reported in the media many have been working hard to try to change all this despite the fact that we are in the midst of a second wave and living with a strain which is much less easy to control, manage and supress. Doing nothing has and is not an option. Moving forward ending contact should only be in exceptional circumstances never the norm. People must be safely brought together so that we end what has been a nightmare for so many. How we do that is what is so critical at this time given that we cannot simply go back to the way we were.

As has been reported in the media and noted by the First Minister, and in all likelihood next week, new guidelines for the restoration of meaningful contact will be published. They have been developed in wide consultation and partnership with family representatives, care home providers and Government clinicians and advisors. They are about working together to restore. What is important about them is that they are a steppingstone to something closer to normality. They are incremental in their nature but their outcome is clear and definite – the restoration of meaningful contact.

But in order for them to mean anything I am convinced that we need to make this journey together, supporting one another, assuring when there is anxiety, reducing fear, motivating through example and reducing the risk of creating rejection. In my experience the process of helping an individual whether staff or family member overcome fear will be one which requires us all to listen to the views of others, work through our shared intent, and together move forward. It is a time for individual conversation to address the needs of each person recognising that a care home is a community of multiple voices, it is not a time for blanket decisions and policies that forget the needs of each unique individual.

So as I sit here on the day before Valentine’s Day I think and know that this is our singular most important gift of love this year – to restore meaningful contact between families and residents in our care homes. I know I and many others will commit all energies over the coming days and weeks to enable that to happen. In so doing we will address fear, reduce anxiety and manage emotion. In so doing we will hopefully listen more and talk less.

I reflected above about how this has been a year of crippling loss and that is not only for the thousands who have died of coronavirus, but the thousands left without loved ones who have died from other conditions. It has been a harrowing and hard year with so many of us unable to grieve and say farewell in the way we have been used to or the way that has comforted us in the past.

I have written before about the need for a national day of mourning and I accept that we still have a way to go before such a formal national moment to remember can take place. But in all my work around bereavement and grief I increasingly feel that we need to come together – virtually and physically – to show one another the solidarity of our loving, remembering what has happened and is still happening. Maybe this becomes especially acute at this time of year not just because there are thousands who will be spending their first Valentine’s Day without the touch of the person they loved, but because we are coming close to the first-year anniversary of this pandemic.

Marie Curie have recently launched a #DayofReflection for the 23^rd March 2021. They want it to become an annual day which will give us all ‘time to pause and think about this unprecedented loss we’re facing, and support each other through grief in the years to come.’ On the Day they want to hold a national minute of reflection at 12pm as well as other events and supports. You can find information at https://www.mariecurie.org.uk/get-involved/day-of-reflection.

Such markers and events will not be for everyone but I think collectively we do need to do something as we try to deal with the pain and hurt of the last year.

There are too many who will never be able to re-capture the lost contact and touch which this virus has prevented them from experiencing; there are too many who have died alone with only the love of stranger to console and hold them. We cannot re-write that story but what we can do is to support one another, make the change that needs to be made and be determined to be there to comfort and hold up hurt.

In Finnish there is a concept called “sielunmaisema” – which literally means “soul-landscape” or “soul-scene”; it denotes a particular place that a person carries deep in the heart and returns to often in their memory. I think we all need to create such a space or place, external or internal, where we can cradle the moments of memory of those we have loved and lost, of those we are separated from. We need such a place as a society for I fear we will rush beyond remembrance to recovery without thought for the pain hurting at the centre of our community. But we also need to nurture that space for our own mourning and grief, and that for many might not be for a person, but for a dream, a role, a relationship, which the passage of time and the cruel reality of the last year has taken from us.

Valentine’s Day 2021 will be different, for most of us, it will be virtual, but I hope it will also be a time when if we need to we can take space to mourn, if we want to we can commit to action, and that we may all discover our own sielunmaisema. I end with words of a favourite Finnish poet Helvi Hämäläinen

For one day I’ve the right to mourn,
for one day I’ll shut the windows of the sky,
I’ll dismiss the blue,
I’ll raise a black sun to mark my mourning.
For one day I’ll wilt the flowers,
for one day I’ll silence the birds.

I’ve the right to mourn one day, I’ve the right to mourn.

Donald Macaskill

I used to live in West Lothian and over the years walked across much of the countryside. Occasionally I would come across a marker stone commemorating events which had taken place in isolated and yet hidden parts of the landscape. Similar markers exist across much of central and lowland Scotland. These are memorials to a turbulent period of Scottish history, the time of the Covenanters.

In the numerous religious disputes of the 17^th century thousands of Scots signed what was known as the National Covenant, in which they pledged to resist changes imposed by King Charles on the Scottish Kirk, and these disputes eventually led to violence and rebellion. After the 1660 Restoration of the monarchy, the Covenanters lost control and dominance, becoming a persecuted minority. During what was known as ‘The Killing Time’ hundreds died in a period from 1679 to 1688. Under severe persecution thousands gathered to worship in their own way out of sight, hidden in conventicles in the Scottish countryside. Attendance was very risky and a serious offence, and preaching at these locations was punishable by death. The memorials bear witness to their determination to resist and to re-shape a new way of being faithful.

All this came to my mind this past week when I read the Feeley Review or to give it its proper title the Independent Review of Adult Social Care in Scotland. The Review was published on Wednesday and has been broadly welcomed. I have read it a few times now and whilst a lot of commentary has been made on its central and core recommendation of creating a National Care Service there are some parts which, I would contend, are equally significant, but which have received less observation. One such is the idea of a social ‘covenant.’

The Report says:

‘One key factor in the realisation of [the aims of the report]… is the need for mutual commitment by citizens, representative bodies, providers, civic Scotland, and national government to set aside self-interest and each work together for the common good. Trust is not currently in plentiful supply in social care support and so we believe that there is a need for an explicit social covenant to which all parties would sign up. This will be particularly important if we want to achieve our aspiration for everyone in Scotland to get the social care support they need to live their lives as they choose and to be active citizens.

In their 2014 report, the World Economic Forum describes a social covenant as a vehicle for giving effect to a common set of values and beliefs:

• The dignity of the human person, whatever their race, gender, background or beliefs;
• The importance of a common good that transcends individual interests; and
• The need for stewardship – a concern not just for ourselves but for posterity.

Together, these offer a powerful, unifying ideal: valued individuals, committed to one another, and respectful of future generations. Fostering these values, which we believe would serve Scotland well as guiding principles for improving social care support, is both a personal and a collective challenge. We must do more than just talk about them; we must bring them into public life and use them to guide decision-making.’

I think the above summarises both the vision and aspiration, the integrity and ethos of this hugely significant landmark report. I personally consider that the time is absolutely right for all of us to rally round the idea of a new national covenant – one of and for social care.

The concept of covenant is an ancient and rich one. Perhaps its oldest use is in religious communities, not least the Judaeo-Christian tradition and scriptures. There it is used as a description of the agreement between God and the ancient Israelites, in which God promised to protect them if they kept his law and were faithful. The everlasting visual sign of this Promise was in the form of a rainbow.

But covenant also carries overtones of law and finance. The word is used today to describe an agreement or promise to provide or do something, or the reverse. It is a legal and defined agreement. In finance and banking it is used as a formal agreement to pay a fixed amount of money regularly especially to a charity.

But in essence both the ancient and modern use of the word carries a depth which goes way beyond the concept of a contract or a formal agreement which can often be based on self-interest. It carries with it a sense of relationship and promise, fulfilment and commitment, solidarity and intent. It is this element I want to focus on in what follows. Much has been written about social covenants and the way they are evident in many societies, but Jonathan Sacks summarises the essence well when he writes:

Social contract creates a state; social covenant creates a society.

The vision painted of a new social covenant in the Feeley Review is one that many of us have been waiting to see articulated for a long time. It is one which puts the autonomy and priority of those who use care and support front and centre. It is one which seeks to embed structures and models, processes and frameworks within a robust human rights perspective. It is one where the direction, the focus, the energy is centred on the citizen. It is one where care and support are not seen as a self-perpetuating means to their own end, but the tool, vehicle and energy by which individuals are able to be part of their own communities and play their full role as citizens.

There will be time elsewhere to go into the detail – because after all that is usually where we find the devil – but for now I think there is an urgency to gather round and to commit collectively to the need not only to reform and change a system which lies in many parts corrupt and broken, but to take the vision, share it, build upon it and implement it.

It has been said that a people without a vision perish. Perhaps we have not literally perished over the past decades in social care, but we have at best stood still, unable to move from principle into practice, from vision into reality. We have allowed aspiration to die and wither away, frozen by the fear of risk and change. The time for day dreaming is well and truly over. The pain of the pandemic has left us with the necessity to heal and bind up, to reform and re-design, there is an urgency to come together and to seek collective agreement and commitment. The three essential characteristics of such a new invigorated social covenant noted above are a good starting point for such a movement.

• The dignity of the human person, whatever their race, gender, background or beliefs.

The Feeley Review calls for a new social covenant where the dignity of the person becomes the cornerstone of all construction. Everything we do, say and implement needs to have the inherent inalienable dignity of a human being at its heart. Within those words is the necessity to change our systems of assessment and allocation, so that we truly listen to the needs and aspirations of those who need support in order to fulfil their lives. It necessitates an end to the iniquity of charging, the lottery of diagnosis, and the formation of equality of resourcing and priority. Dignity is about getting down on our knees to be in the chaos and hurt, the pain and distress that so many find themselves. It means the system and professional, taking off the clothes of authority and power, and re-learning the insights of empathic and affective listening and hearing. It means that we recognise the glorious diversity of individual human beings and not seek to squeeze the individuality of identity, whether race, culture, sexuality or age, into the strait-jacket of pre-planned and determined models and options. Each life grows gloriously unique, a social covenant of social care commits to feeding that growth.

Dignity presupposes a relationship. Dignity is beyond transaction and task rather it sits in the place of mutual learning and respect, it is led by the voice of the person not the sounds of the observer. Dignity is rarely seen in the duality of black and white decisions or statements but settles in the greyness and colourful vibrancy of contradiction and dialogue, of conversation and discovery. A social care system that is truly person-led needs to have flexibility, responsiveness, prevention and dynamic as core principles.

• The importance of a common good that transcends individual interests

Social care at its best is always about connection, not just the maintenance of networks and neighbourhood, but the fostering and creation of new community and new purpose. There is an inescapable public and outward dimension of social care which takes it away from the closed privacy of self-interest. So the Feeley Review is absolutely right, I believe, in asserting the case for fiscal responsibility and transparency in the expenditure of public monies. In a co-operative society true entrepreneurship and economic wellbeing is best served when individual ambition walks alongside collective and societal benefit. The covenants of old were never individual contracts defined solely to benefit self-interest, they were always about a sense of enabling individuals to flourish within a community for the betterment of all. Good effective social care and support does not foster crude individualism but enables the person to achieve their potential in and through being in relationship and community with others. If one voice is not heard then the music is silent; if one person is not present then the community is absent; if one life is not flourishing, then the tree is dying.

• The need for stewardship – a concern not just for ourselves but for posterity.

Stewardship is a concept with a not dissimilar ethical overtone to that of covenant. There is a spiritual and moral imperative to do well by what we have and receive, whether that is through the stewarding of the environment in which we live, or the stewarding of the shared resource we possess to create a better community. The Feeley Review creates a vision not only of a new system and model, but it posits the argument that when we use fiscal and human resources we have to have an intentionality of regard for others in such use. So it is that workforce training and development is so central. So it is that valuing the individual worker and manager by means of fair terms and conditions, by esteem and appropriate status is just as key to stewardship as a commitment to financial probity and transparency. Stewardship within a social covenant is a compulsion to create systems and structures not for the glorification of the moment, or for historical memory but for the inheritance of those who follow us. Short termism rarely creates that which lasts and on which those who follow us can build their own fulfilment.

Do please read the Report, catch a sense of some of its vision and aspiration. It is not all perfect – nothing ever is, but in its suggestion of creating a social covenant I think it is spot on. As people read and reflect, debate and discuss, not least in the next few weeks of political partisanship, I hope we can all find it in ourselves to gather round the need to hold to the vision that this report pulls us towards. I hope that we will have less rhetoric of defence and difference, less soapbox oratory, and more listening and hearing. That is why we need a social covenant for social care.

We cannot do nothing, so we must do something; we cannot sit still, so we must move, we cannot just be silent, so we must finally speak. The vision is there, the covenant is promised. In the glorious words of Miroslav Holub we have to open the door to our future…

The Door

Go and open the door.

Maybe outside there’s

a tree, or a wood,

a garden,

or a magic city.

 

Go and open the door.

Maybe a dog’s rummaging.

Maybe you’ll see a face,

or an eye,

or the picture

of a picture.

 

Go and open the door.

If there’s a fog

it will clear.

 

Go and open the door.

Even if there’s only

the darkness ticking,

even if there’s only

the hollow wind,

even if

nothing

is there,

go and open the door.

 

At least

there’ll be

a draught.

https://www.scottishpoetrylibrary.org.uk/poem/door/

Donald Macaskill