My personal housing conflict
There is a growing debate around housing to do with tenants and their health. The medical and social care needs that people have are linked very closely with having a decent, secure, affordable home.
Home can mean very different things for people who need help. A lot of this is reflected in the kind of help they need. I won't try and describe all the different ways that health and housing overlap. From needing a few adaptations to make an otherwise ordinary home accessible, right up to full nursing care, matching people to accommodation can be a complicated process.
For me and my wife, we live in a two-bedroomed council bungalow which has had a fair amount of money spent on it so that it meets her needs. She has Secondary Progressive Multiple Sclerosis and has fairly high care needs – an electric wheelchair, and using a hoist for all 'transfers'. Transfers refers to moving from one position to another. For most of us, we can stand up and sit down, moving between chairs, without any help. For some physical disabilities, this isn't possible, and people must be lifted in a sturdy sling from armchair to wheelchair, and from wheelchair to bed or commode or shower chair.
Even though we are fortunate enough to get some help for a few hours during the week, a lot of my time is taken up being Mrs G's full-time carer. Sometimes this means just being on call all the time – making drinks and meals, turning her over to avoid pressure area problems, running errands, sorting out the paperwork involved in being an employer for her carers and acting as a confidant and morale officer. In a lot of ways these roles are typical of any marriage, but, leaving aside the playing of any sympathy violins, as a carer it often isn't a balanced division of labour.
For this reason we're entitled to up to six weeks of respite care each year. During this time, Mrs G goes into a respite centre run by our local council. This was a difficult thing to get used to. Firstly, as a carer it's easy to think that you're supposed to be superhuman, and be able to care 24/7, 52 weeks of the year without help or a break. This conceit can be dangerous, as carers need a break too. Keeping going might seem noble but overworking in something as intensive as caring can lead to carer fatigue or breakdown and nobody wants that.
As a result of central government cuts to our local authority budgets, our respite centre is being shut down. There's no clear alternative that's been offered yet. At a time when our notion of 'home' already feels precarious after the bedroom tax, the prospect of having our quality-of-life-saving respite taken away almost doesn't bear thinking about.
On the one hand, a lack of suitable replacement respite provision would lead to the risk of a breakdown in my ability to care or Mrs G's chance to get away from me for a bit. The thing about our council-run respite centre is that it's more than just a place. The staff have become great friends to my wife and she to them. Whatever the professional boundaries that are supposed to exist, Mrs G's plain-talking style and previous experience as a high-level manager for Social Services mean that as well as being 'looked after' while she's away, she performs an informal mentoring role to a lot of the staff at the same time.
It's a true conflict of interests, though. The respite centre is being shut down not just to save the ongoing costs of providing the service, but also so that the site can be used to build supported housing. This should provide homes for people who need somewhere to live permanently, but who need a bit of help to live independent lives. These are the split outcomes of 'social care cuts'. Councils everywhere are having to ration what they provide, choosing between different groups of people in need.
It's frustating for us that we're one of these groups, and as a big fan of supported housing, when it's done properly, it feels selfish to complain about the possible breakdown of my own caring relationship when other people might benefit from our trusted, personal respite being taken away... but for right now, it feels like there's no guarantee that the proposed supported housing that will replace our respite won't just become “Starter Homes”.
This would be another, different conflict of interests, once more pitching different sorts of people in housing need against each other. As the fallout from previous cuts, the budget and the autumn statement begin to take shape, we can only hope that the costs of the things we're giving up are worth their price.