The valuing of social care.

Yesterday evening along with over 500 guests I attended the Welsh Care Awards in the City Hall, Cardiff. I was in Cardiff because that was where the Five Nations Care Forum had been meeting for a day. This is a Forum which brings together care representatives’ bodies from the United Kingdom and Ireland twice a year to share issues of mutual concern and priority. Clearly the cost-of-living crisis, the energy and fuel crisis, and the huge workforce shortage were issues which all the five nations shared. Because I was in Cardiff I was invited to present an Award at the Welsh Care Home Awards. It was a real honour to do so.

The evening was amazing not least because it was the first time that the Awards had been held since the trauma faced by the care sector in Wales during the pandemic. It was so good to hear such amazing stories of professionalism, integrity and sacrifice; to hear first-hand from the First Minister of Wales, Mark Drakeford, of the value and priority placed upon social care by the Welsh Government, and to be part of such an emotional evening graced not least by amazing musical contributions from Sir Bryn Terfel and Wynne Davies, the event’s compere.

Throughout the evening as I sat there listening to stories of great professionalism, about nurses and carers, about domestic and catering staff, about managers and supervisors, one word kept being used time and time again. That word ‘value’ – that these were people who we needed to value as an intrinsic part of society in Wales and that they deserved all the value that was being shown to them during the event and by the Welsh Government and wider Welsh society.

The dictionary describes ‘value’ as the regard that something is held to deserve, its importance and worth. It also states that value has a sense of moral or ethical character. Indeed, the root of the word in Old French has connotations of strength and worthiness.

I reflected on whether we really value social care and the workforce that represents that world? Or is our sense of societal value transitory and illusory. I reflected on whether one of the reasons so many feel a sense of lack of value is that in general terms if society is being honest, it does not value care in essence. Three brief thoughts.

I have heard from colleagues across the UK this week about the sense that social care services and supports, whether delivered in a care home or in a community setting through homecare and supported housing, is most certainly not valued. Otherwise, it is stated we would not be faced with the degree of ‘crisis’ that clearly is the current reality. People talked in their own part of the United Kingdom about social care being seen as the ‘Cinderella’ service, as the after-thought, the last to be considered when budgets are allocated and priorities are determined. There was also a sad consistency in that there was a feeling that social care continually was only seen of value in terms of what it could do for the NHS, to alleviate its pressures and strains, not least in terms of delayed discharge. Yet at the same time there is clearly a failure across the UK despite the policy reality and political rhetoric to both work as an integrated health and care system and to treat each part with the respect, professionalism and regard it is due. It is very much an acute NHS wagging the political dog which barks at social care – and then wonders why the system is not working or responding. As so many people in the world of social care know only too well – if we are every going to solve the crisis of a failing health system it is going to have to involve getting social care providers and organisations around the table – not continually treating them as a problem or issue to be sorted rather than as the solution and answer. The prioritisation of the NHS in the whole system shows little valuing of social care or those who work in that sector.

There is a second way in which this week I was reminded of value and that is the way in which a government or political leadership bestows priority and value upon one economic sector compared to another. It was a delight to hear from the Welsh Government Deputy Minister of the way in which social care in Wales, the role of providers and services, was seen as a core part of their foundation economy model. That is based on work of some age now which argued that social care rather than being seen as a drain and deficit, as a cost and charge, should rather be seen through the lens of contribution and capacity, as an enabler of community and a fosterer of citizenship. The very fact that services and supports exist do not just enable individuals to be personally supported but free family and others to remain economically active and contributive. The latter observation is so critical in a society and at a time which needs all those fit and able to work to be economically contributive and which has a population deficit. Social care is a driver for innovation and entrepreneurship. And yes, I have before lamented about the lack of priority in the Scottish Government’s fiscal strategies in relation to social care – in fact barely a mention and that which does exist sees the sector as a cost not as a driver for economic innovation and contribution. If we were truly to value social care, we would start to recognise the real economic benefit to be achieved by proper investment and prioritisation, not just for those directly impacted but by the wider community. This is perhaps especially the case when we think of community benefit – so many care homes for instance not only employ those who live in the local community, but they buy their food, source their support in terms of maintenance and repair, utilise community assets such as leisure and artists, and so much more. Care providers are a massive contributor to community wealth building, to community benefit and to community cohesion and maintenance. Yet this is so often ignored or overlooked.

Lastly, and perhaps the most visible issue last night was the extent to which society is paying but lip service to the contribution and role of social c are workers in our communities. Yes of course we clapped for carers (albeit begrudgingly) but can we honestly hand on heart say that as individuals and as a collective we consider the contribution of a care to be just as important and valid as that of a teacher, a train driver, a banker or a IT analyst? Because in truth the way we answer that question will evidence what we consider to be the essential requirements of a community built on valuing contribution. Some might say it is false to try to create a hierarchy or equivalence – and in an utopian ideal reality I would agree – but the fact that we pay what we pay, resource allocate what we allocate, fail to meet unmet need for tens of thousands who require care and support, are seeing care organisations going to the wall and collapsing every day – those facts speak to a valuing of social care which is wholly absent and negative. Part of the way you value anyone, or any sector is the extent to which you reward and remunerate those who work in that sector – I have said it before and repeat here that there is a perverse upside-downness of societal value and priority when social care, especially the care of adults and older people, comes into play.

Valuing in applause and sentiment, in word and rhetoric is easy, valuing in reality and reward, in recognition and regard is so much harder.

The American poet Christine Kysely perhaps sums it up well:

What is a person’s value?

What is their worth?

Can it be based solely

On what is found in their empty purse?


Can that one missing emptiness…

Take away a person’s pride?

Can it belittle,

The entire worth of their life?


Is there some value,

In the light in their eyes?

Is there some value

for the past loves of their life?


Is there some value

In the all the books that they’ve read?

The knowledge imparted

The words that they’ve said?


Do they get credit

For the beauty they’ve seen,

Painter of paintings,

Dreamer of dreams,

Taker of photographs

Creator of life,

Mother of children,

Lover of life.


Lover of wisdom, of knowledge, of men,

Friend to all people, both dark-skinned and light,

Lover of humans,

Meets all with delight.

Lover of all things,

Both known and unseen,

Champion of causes, of persons, ideals,

Believes in the future, values every meal.


Is there some value,

To someone who really loves life,

Whose laughter fills each and every day,

In spite of their ongoing strife?


To someone who looks to the heavens,

Always amazed,

Someone who has pondered the moon,

And watched it go through its phase.


To someone who has held the earth in their hands,

Who has felt the sun on their face,

Who is raising their own children,

Who puts on a brave face.


What is the value,

Of one who has financially hit a wall,

Who has often sat here and pondered,

And tried to make sense of it all.


What is my Value?

What is my Worth?

Will I be valued solely,

By what is contained in my purse?


(c) Copyright 2010 by Christine A Kysely,


Donald Macaskill