The following blog was the substance of an address given to the Highland Senior Citizens Network in Inverness on the 14th September.
I am just going to say a few words and will be using the title of your event Keeping it Real as the basis of some thoughts about what I think are the challenges but also the opportunities for aged care today and tomorrow.
People who know me well know that I am somewhat obsessed with dictionaries and the meaning of words or phrases – and so I looked up what ‘Keeping it real’ meant.
The phrase is described as being authentic, true to yourself. But what does it mean to be authentic and true to yourself? Those were some of the thoughts I had a few weeks ago on a visit to Skye. As some of you might know my family roots are there and I was back staying with family when I discovered that the Highland Council Archive Centre in Portree – was in the final days of an exhibition which centred on the sometimes-violent disputes between crofters and their landlords in the late 19th Century. It was a great wee exhibition which not only contained the local Court Register all the way back to the 1830s but also the relevant copy of the Napier Commission report which eventually brought about a settlement to what had been the Clearances. I had not physically seen either before – and so -partly checking to see how many distant relatives had fallen foul of the law (and there were a few) I rifled through both documents.
I discovered that a direct descendant gave one of the most moving testimonies to the Napier Commission. In it he described the injustice and maltreatment at the hands of those who sought control over him and his land. He spoke for the local people and was later described as an ‘agitator.’ As I read his moving testimony, I could almost hear the cadence and rhythm of his Gaelic voice – especially when he said that ‘It would be better for Glendale (the place) that Hamara (his township) would be a lake of water than in its present condition.’
Being authentic for him (and indeed for so many who gave emotional evidence to Napier) was about being honest and true, not fake or false, not influenced by the pressure of factor or landlords, but to speak despite threat with courage and conviction. I can only admire that sense of keeping it real. It was a speaking of truth to power. It was about being true to the innate values that were those of his people and place.
And today I feel as we gather and spend time thinking about the challenges facing social care delivery in the Highlands – I think we have also to remain true, to keep being authentic to what it is which is the essence of social care, what it is which lies at the heart of what we are as a community.
No one can deny that there are enormous pressures facing us in terms of the delivery of social care in an area like the Highlands. To some extent it has always been thus. But the last few years and months have stretched the fabric of care to almost the point of breaking. Covid was hard, emotional, and traumatic, unsettling and fracturing of relationships and trust. The energy crisis and the cost-of-living crisis we are currently living though has been for so many smaller providers of social care the last straw, the thing that has broken them. I hope the measures outlined by Westminster will properly address the gaps between funding need and resource availability. But we are also faced with ongoing challenges of how we respond to the workforce pressures that we know only too well, not helped by Brexit and backward migration policies, for it is a real struggle to recruit and retain the gifted women and men who are the lifeblood of what we do in an economy where the draws of hospitality, tourism and retail are so strong.
Someone asked me recently do I not get depressed or downtrodden by the realities of what I see and hear – and yes it would be a lie to say it is not challenging – but people like me have to be positive – because current challenge can and will be the platform for a response which will take us to a future which might be different from the one we envisaged but which will be of equal worth as long as we keep it real.
To deny the realities of financial restriction, of workforce, and geographical pressures would be dangerously naïve. But to allow them to be the end statement, to be the full stop of our dialogue, would be to give in and give up, and I do not recognise that as a characteristic of Highland authenticity and response.
Four things mark social care authenticity for me:
Firstly, for me being authentic about social care – keeping it real – is making sure we do not throw the baby out with the bath water. At times of fiscal and operational challenge it could and would be so easy to stop being adventurous and trying the new – to be innovative and to invest in the ingenuity of change and difference. The role of technology for instance has so much to offer social care provision in the Highlands – so this is the time to invest and be creative in how we use technology to help someone remain independent for as long as possible in their own place and to maintain their independence. How do we use technology for instance to give more authority and autonomy to frontline care workers, so that we respect their professionalism and skills? We may need to change our regulatory and oversight systems to enable more risk taking, less paperwork and audit for the sake of audit, and to start trusting the women and men who work at the careface.
Secondly for me being authentic and keeping social care real – means that we have to encourage and embed new models of delivering care and support at local level, not just on environmental sustainability grounds but for community cohesion and collective support. Increasingly I think we will have to ensure that we give people the tools of compassion and skill to support one another. We may in the future need to rely less on formal approaches. We need to invest in our communities so that they can become even more effective at delivering care at local level. But critically that needs a population and a people because ultimately buildings or organisations count for nothing unless you have people.
Thirdly for me keeping social care real, must be about the wider political and fiscal system owning up to the reality that social care is a profound economic driver and contributor to our economy not least for our rural and remote economy, and it is embarrassing that we have politicians and financiers who didn’t even include social care in the Ten-Year economic strategy which was recently published. It is time to value the women and men who work in and who use supports and care.
And lastly and maybe most importantly, keeping it real means that at a time of economic and operational challenge we must never lose the essence of social care – which is NOT about just about providing services and supports, not doing to and for someone, but allowing that person to flourish and grow, thrive, and achieve their full potential. Social care is not about maintenance it is about creativity, it is not about speaking for but enabling someone to discover their voice, it is never predictable and safe but always risk-filled and unchartered. Because social care is an enabler of life not existence- so we must urgently discover its power to prevent, to keep people independent and to help them enjoy being part of their local community as full citizens.
In the making of our tomorrows, we must never forget the ground on which we have built our culture and communities. My antecedent John Campbell complained to the Napier Commission that the land left to them by the greedy and corrupt factors was too peaty and so not able to grow anything – all he wanted – all the crofters of Skye for whom he spoke wanted – was land which was able to provide not riches unknown, but a living fulfilled.
Keeping it real for social care is first and foremost not about creating new models and systems, new structures, and edifices, even if we call them a National Care Service – but about doing what matters to the disabled crofter in a Skye glen; the youth struggling with mental health issues in Dingwall; the care home resident in Inverness fighting her dementia or the person living in Wick who has struggles with getting up in the morning.
And if we keep it real for them then we will have done all that we should.
Donald Macaskill
