Escaping the social care doom loop

A ‘doom loop’ is a negative belief cycle, where a series of beliefs, actions, and reactions work to reinforce negative beliefs and unwanted behaviours.

I believe social care is caught in a doom loop, and the mission of those of us who want a better future needs to be to break free of it. The following two graphs are from new polling, focused on satisfaction with the NHS, by the Health Foundation.

Given only a minority of those polled will have direct experience of engaging with social care, the perceptions and attitudes will largely derive from either word of mouth, or quite likely, from media consumption.

Media coverage of social care is overwhelmingly negative – of a ‘broken system’, which fails to support ‘our most vulnerable’, from which workers are fleeing to stack shelves in Aldi, and which is bringing ‘our NHS’ to its knees. The coverage largely reflects the messaging of the sector, think tanks and campaigning charities. Against this backdrop the government ‘delayed’ (read: dropped) its plan to ‘fix social care’, while Labour have said that social care will not feature prominently in its bid to win the 2024 General Election (and indeed, it does not feature at all in today’s 5 ‘missions’ announced by Keir Starmer). My bet is that the deepening pessimism on display in the Health Foundation polling could be tracked against that intensifying media and sector narrative, and that if you were to ask people why they held these views, they would cite those stories.

What’s the problem with that, people ask? Surely this proves that the narrative is shaping public opinion and building awareness? Well, yes, but the things is, that’s the problem. As Thomas Coombes said recently, in the past, campaigners have gone by the maxim ‘sunlight disinfects’: by pointing at what’s wrong, and conveying its harm and urgency, you foster the public and political will for change. But we are in an age of multiple crises, all competing for attention and action, where despair can all too easily suffocate hope. Coombes reminds us that in fact ‘sunlight grows’: that we need to be putting equal effort into pointing towards what’s strong, and how it can become the norm. It’s why Social Care Future has invested in developing an optimistic story of the social care future we can build and promoted ‘glimpses of the future in the present’. In its absence, pessimism breeds fatalism, and the doom loop gets worse.

While I will rarely ever celebrate Boris Johnson, it is worth noting I think that the closest we have been in recent times to social care funding reform is under his premiership. I think that was in no small part because of the rhetorical optimism he managed to strike at the 2019 election, with a battery of 3 word, action and outcome oriented slogans. We will, he said, ‘get Brexit done’ deliver ‘full fibre broadband’, secure an ‘oven ready deal’ and ‘fix social care’ (with a plan we have prepared). Of course we can debate his record and the detail of that social care plan, but had Covid-19, the war in Ukraine, an energy and cost of living crisis and politics not intervened, there seems every chance his message of optimism would have carried those modest reforms over the line, because he made it sound possible.

And for all those who say ‘we are merely representing the reality of our members and supporters’ or ‘we have a duty to speak truth to power’, well perhaps, but you are just failing all of them if the way you then translate that into your campaigns and communications makes matters worse. Your role is to campaign and communicate in a way that marshalls support for the change that improves the lives of people who draw on or work in social care. If in the way you go about that you either don’t have any positive impact on that outcome, or make things worse, you are failing them.

I’ve quoted Raymond Williams’ “to be be truly radical is to make hope possible rather than despair convincing” numerous times. But I can’t think of a more important time to practice it. If we want to see the fortunes of social care change radically in our lifetime, that’s our challenge. If we fail to break free of the doom loop, the only way is down.