A blog entry by Patrick Hall

Sue Yeandle and I were invited to attend the Centre of excellence in research on ageing in care kick-off conference. Not the catchiest of titles, so it was handily shortened to CoE AgeCare Conference at the University of Jyväskylä. ‘Jyväskylä’ doesn’t roll off the English tongue very easily. Nor do many Finnish words and names, but I had managed to master ‘Kiitos’ (thanks) and ‘Hei’ (hello) by the time I landed in Helsinki last Saturday, master linguist that I am. The propeller plane ride to Jyväskylä was a little cramped for me, but I landed safely, greeted by -2 temperature and plenty of snow. Sunday was equally cold, but revealed a blue sky and a gorgeous, bright sun. Hotel staff told me there was a Sauna and we could take a dip in the lake afterwards. I politely declined. Sue and I had split our time so we could attend all the discussion streams: Care Needs and Inequalities, Agency and Self-Determination of Older People and Diversification of Care Work.

A highlight, for me, was Professor Teppo Kröger on ‘Care Poverty’. He is developing this concept as an alternative to ‘unmet need’: a measure of how many people are receiving no care, or inadequate care when they are experiencing functional problems associated with ‘Activities of Daily Living’ (bathing, dressing, going to the toilet etc.) and ‘Instrumental Activities of Daily Living’ (shopping, household management etc.). The discussion centred on the importance of developing a concept that could capture 1) the amount of people living in without care to the extent it is ‘unacceptable’, in a similar vein to economic poverty 2) social capital and participation and 3) the extent to which individually determined outcomes (the type of life a person wants to live) are achieved. What stuck me is that this concept could be extremely useful in describing the relative success of national care regimes in the UK. Watch this space!

In terms of national comparison, it was also interesting to note the differences between attendees in the crossover in long-term care and disability studies: another topic of discussion. The central concepts of disability studies: the social model of disability, independent living, personalisation and others are deeply engrained in the thinking of UK social care, while there is some suspicion of these concepts in the Nordic countries (that they are associated with marketisation and inequality). For some attendees, this suspicion signified a ‘paternalistic’ approach commonplace in the Nordic countries. While it is tempting to caricature the Nordic models as heavy-handed statist models with little regard for the rights of older people, and the ‘Anglo-Saxon’ model as driven only by unbridled and uncaring markets, both characterisations are grossly oversimplified.

Attendees at the CoE AgeCare event in Jyväskylä

One of the things we have to remember in comparative work is that things change: marketised systems can adapt to their failings, learning from others, and so can state-based systems. In fact, this is the purpose of comparative work, to understand the nuance of various interacting phenomena at a particular juncture. This is why simply lifting policy solutions from one country to another with a completely different set of institutions, norms, expectations and cultures doesn’t often work.

This doesn’t mean that countries cannot learn from each other. If Scandinavian politicians seek to introduce marketisation, there is plenty to learn from the history of social care in the UK since the Community Care reforms in the 1990’s. If a new government in the UK wanted to introduce a larger role for the state, there is plenty we can learn from the years of policy iteration around northern Europe. It struck me that both the Nordic countries and the ‘Anglo-Saxons’ could both learn a great deal from service types attempting to maximize social capital in Australia. Next stop Sydney!

We can’t rely on caricatures; we have to do the hard work of listening and learning. The week was a good reminder to put aside my prejudices and listen as I embark on fieldwork for our comparison of the four UK nations.

Patrick Hall

Patrick Hall is a Research Associate, working in the Sustainable Care programme. Read more about his work by clicking the link below

Comparing UK Care Systems

 

Prospects, development and differentiation in the four UK nations