Care in Rural Areas
Pembrokeshire is a rural county. One of many across Wales. Delivering services of any kind presents problems. Settlements are scattered, services are constrained by distance, low population levels result in school closures and diminishing public services, young people leave to find work, older people retire here to benefit from the beauty of the countryside and the peaceful way of life.
Individual need is much the same, wherever it occurs. Human beings need shelter, food, health, purpose, contact with others, wherever they live, however old they are, whatever their age or gender or circumstances. Needs tend to merge one into another. Health suffers if diet is poor and housing is inadequate. Health suffers if friends don’t call round and you don’t go out much, it’s easy to slide slowly out of contact and difficult to stop it happening.
We use the term ‘Care’ to cover our response – the paid carers sent by the agency who ‘do’ three visits a day, twenty minutes each, get us up, change our incontinence pads, make a quick sandwich. The private carer who lives in or who calls twice a week and does whatever needs doing. It covers the nurse in hospital and the mum or dad, brother or sister, supporting the learning disabled, the physically handicapped, the accident victim – wherever people live, in cites, in towns, in villages, in remote farmhouses, people need care and some of them receive it.
The Covid Crisis has made some points for us- local communities were able to reach people more quickly than the official public services and were able to respond to a wide variety of needs. People were asked ‘What do you need?’ and their needs were met – food, shopping, dog walking, prescription fetched, someone to talk to. Their actual needs, met. When local government caught up, some Councils joined in, helped, facilitated and supported. Some tried to take over, to micro manage , to ’round things up’ on a ‘one size fits all and is easier to deliver’ basis, but local community groups had already begun to demonstrate that one size doesn’t fit anyone and that individual need is best responded to on an individual basis.
Solva Care has been running for five years now. We set up to support the elderly in our community, to help them stay in their own homes . Our project had already taught us what the Covid crisis is making evident – that Care needs to focus on the individual, that it needs to include and involve not ‘be done’ to someone. Care is best delivered by and in the local community with a thorough understanding of local circumstance and directly responsive to individual need. We learned early on in our project that older people can offer care as well as receive it and that care is not the prerogative of the elderly- younger people, children, single parents, out of work people – all need and can give, care. Real care is bottom up, not top down, co-operative not competitive – the division between Health Care and Social Care, militates against the delivery of any care.
What we need to do now is change the system – maybe start by depoliticising care ? Stop Politicians using it to win votes?
- work together to keep what has worked well, –
- devise a system which supports and encourages community based projects,
- one which is flexible and centred on the individual
- establish a clear, fair system which is easy to understand and which is easy to access.
- value carers, pay them a decent slary, give them training and job security
- ring fence funding at national level and allow flexibility for adjustment to local circumstance.
Much easier to to agree that an enquiry will be set up and that they will report back and meanwhile we will carry on as we used to because we all know how it worked ???