The ALLIANCE proposes a rights based approach to the reform of adult social care in Scotland.
“Where, after all, do universal human rights begin? In small places, close to home – so close and so small that they cannot be seen on any maps of the world. Yet they are the world of the individual person; the neighborhood he lives in; the school or college he attends; the factory, farm, or office where he works. Such are the places where every man, woman, and child seeks equal justice, equal opportunity, equal dignity without discrimination. Unless these rights have meaning there, they have little meaning anywhere. Without concerted citizen action to uphold them close to home, we shall look in vain for progress in the larger world.” Eleanor Roosevelt
It’s hard to escape the doom and gloom surrounding the current state of health and social care. Every day the media seems to carry a fresh story about NHS funding crises, the impending threat of Brexit, and repeated obstacles encountered by those trying to access – and deliver – services.
Several initiatives have been created in Scotland aimed at finding solutions to these problems. We have a raft of laws and policies to guide us, a growing body of evidence about what works (and doesn’t), and a strong and capable cadre of people and organisations beavering away in different places and sectors. However, while there are some examples of good practice and small scale improvements to existing models of care, the transformational change that is so desperately needed still hasn’t quite happened.
The Scottish Government and COSLA (Confederation of Scottish Local Authorities) recently circulated a discussion paper, in which central and local government have come together to propose a national leadership programme to support adult social care reform. As the ALLIANCE’s response indicates, we believe that radical and profound change for the better can be achieved if we embed a strong equalities and human rights based framework within the system.
Human rights provides a common language and unifying philosophy with which to address key issues and opportunities across the current system in a joined up and cross-sectoral way. A rights based approach can be embedded at all stages – policy development, service design, delivery, and assessment – and helps put the ‘human’ back into our systems and processes. Because rights are universal, they belong to everyone; this means we can focus on the workforce AND people who access services.
There’s also a strong business case for taking a rights based approach, particularly for highly politicised issues like social care. It can help overcome concerns about fairness and transparency, support difficult decision making and help balance competing interests and risks.
The inspirational words above, by former First Lady Eleanor Roosevelt, serve to remind us that human rights are not just lofty ambitions or confined to the world of courts and lawyers. They are about the “small places, close to home”‘. And where better to realise our rights than within support and services, to ensure they put us at the centre, help us exercise choice and control, and live as equal, active and independent citizens?