A recent review of Peter Limbrick’s new book made me think about some of the anxieties many of us are now feeling about the slow bleeding out of publicly-funded healthcare, and what it might mean for the future of professions like physiotherapy.
A full review of the book, titled Caring activism: a 21st century concept of care. A proposal for citizens to join together to support vulnerable children, teenagers, adults and elderly people, can be read here, but what particularly struck me were these two opening paragraphs;
Peter Limbrick’s Caring Activism argues the case for what he calls ‘a new concept of care I am proposing for vulnerable people in this 21st Century’ (13). Limbrick identifies that some countries are experiencing reductions in funds for public services while numbers of vulnerable people continue to rise. In the United Kingdom, a ‘dramatic reduction in support available’ from public agencies means that increasing numbers of vulnerable people are falling through the safety nets. He points, in particular, to teenagers in care homes, elderly people living at home and refugees.
Limbrick suggests that a potential response to this lies, not in further burdens on overstretched statutory agencies, but in the power of a concerned citizenry. He envisages what he calls caring activism, ‘a concept relying on citizens holding particular beliefs about rights and responsibilities and about the sort of world they want to create for this and future generations’ (35).
Many of our patients are as vulnerable as those highlighted in the book, and so it probably follows that many of the points made about the need for caring activism are as valid in the Stroke Unit, per se, as they are in the care home.
So I’m interested in Librick’s argument that the statutory agencies can’t be asked to do more, and that we need other ‘agencies’ to step up. (Here I’m assuming that ‘statutory agencies includes profession’s like physiotherapy).
My reading of this is that he sees a much bigger role for non-traditional providers of healthcare in the coming years, and a much broader umbrella of services offering what used to be much more centralised. As always, the primary driver of change appears to be economics, and the perception that our historically-established model of orthodox healthcare is becoming increasingly unaffordable.
Caring activism could be a good thing then, because it might make care more affordable to vulnerable populations (people in long-term pain, infirm elderly, people with long-term disabilities, etc.). By the same token, it might rely on registered professionals to ‘share’ their competencies with others and diminish their social capital.
Following on from the post thread over the last week or so, it waits to be seen, therefore, whether physiotherapists will see the emergence of democratising processes like caring activism as a good or bad thing: an opportunity or a threat.