OPINION: Angels: flying and falling

“The closest thing to being cared for is to care for someone else.” Carson McCullers.

There has been much spoken and written about in recent months about the nature of the above. In reality, by the time we read and hear about these issues, it is inevitably in connection with a lack of care rather than that of care itself.

The term ‘carer’, it seems to me, is far too widely applied, is frequently misunderstood and is wide open to misinterpretation. We have also come to expect God-like qualities upon those whom the title is bestowed or as been appropriated.

In our own borough, we have heard how the police, social services and the council failed in their duty of care to the girls in the grooming case. The residents of North Staffordshire are being bombarded with revelations about failures in care at their local NHS Trust. Heywood’s Father Paul Daly has asked for a more caring culture to be at the heart of plans to deal with Rochdale’s homelessness crisis.

The concept of care as a legal duty sprung from the unlikely case of a snail in a bottle of lemonade in 1932. (Donahue versus Stevenson) In Lord Atkin’s famous judgement in the House of Lords, it was established that “…The rule that you are to love your neighbour becomes in law, you must not injure your neighbour; and the lawyer's question, ‘who is my neighbour’? receives a restricted reply. You must take reasonable care to avoid acts or omissions which you can reasonably foresee would be likely to injure your neighbour. Who, then, in law, is my neighbour? The answer seems to be – persons who are so closely and directly affected by my act that I ought reasonably to have them in contemplation as being so affected when I am directing my mind to the acts or omissions which are called in question…”

Has the term ‘carer’ been too widely applied to make it have any universally understood meaning? Is a carer merely someone who is receipt of Carers Allowance or who is said to be a member of a so-called ‘caring profession’? Perhaps something more required - if so, what? Can the capacity for caring be weighed or measured? Can we detect it if we put someone in an MR scanner and look at their innermost workings?
We should remember that carers are first of all people just as much as their client/customers/’service-users or patients are. If we can accept that, then perhaps we can also accept that they are not always operating at 100% capacity and may even have a bad day at the office now and then?

In my experience, when care fails it tends to stem from a systemic or organisational failure. Far too much is expected of far too few by far too many. The nurses of North Staffordshire seemed to be spending far too much of their time trying to hit government targets and filling in too many care-audit forms than they were looking after patients. A recipe for disaster that was not long coming.

We used to talk about nurses having a ‘sense of vocation’ as if they had received some sort of divine call to enter the profession. Most nurses I know chose it as a job because they wanted a career in public service that would offer reasonably secure employment as well as pay the bills. They get quite embarrassed when they hear of themselves described as ‘angels’ because they know they are just mortals engaged in a particular craft in order to put the loaf on the table.

Yes, I know that there are a few genuine bad apples out there who should not be doing the job but many more seem to be failing because of increasing demands placed on them by government targets, increased public expectation or simply, as in the case or the homeless, a massively increasing caseload to deal with at the same time as the need to manage a reduced budget.

We should be careful how we treat our carers. If we describe them as ‘angels’ and put them up on pedestals, why should we be so surprised when one of them falls off every now and then?