Talk by Dr Simon Duffy in Adelaide to leadership of ACH Group on the leadership challenges for those working in the aged care sector. The talk explores the dangers facing older people by failing to fully protect people's dignity and by treating people as consumers, rather than as citizens. It sets out some possible strategies for organisations such as ACH to explore.

1. What are we doing here?
Talk by Dr Simon Duffy for ACH Leadership,
3 December 2014 in Adelaide

2. Words
are important

3. Origin of “Consumer” early
15c., "one who squanders
or wastes," agent noun from
consume. In economic
sense, "one who uses up
goods or articles" (opposite
of producer) from 1745.
Origin of “Care” Old
English caru (noun), carian
(verb), of Germanic origin;
related to Old High German
chara 'grief, lament',
charon 'grieve', and Old
Norse kǫr 'sickbed'.
• Is it helpful to think of ourselves as consumers?
• Can you consume care?
• Is care the kind of thing you can direct?
• Is it helpful to convert community into a market?

9. We make citizenship real by
1. Finding our sense of purpose
2. Having the freedom to pursue it
3. Having enough money to be free
4. Having a home where we belong
5. Getting help from other people
6. Making life in community
7. Finding love

10. This protects our dignity
1. Our life is seen to have meaning
2. We are not on someone else’s control
3. We can pay our way - we’re not unduly dependent
4. We have a stake in the community
5. We give others the chance to give
6. We contribute to the community
7. We are building the relationships that sustain community

16. “My life, my rights”
1. I have a right to live independently
2. My budget is my money
3. I can control it, and get good
support with decisions
4. I should know my budget and any
rules
5. My budget should be able to to be
used flexibly
6. I should be able to share what I am
learning
7. I should be supported to make a
contribution

19. These innovations were not
inspired by consumerism,
neo-liberalism or a desire
to create a ‘market’. They
were inspired by a desire
for justice, citizenship and
community.

21. One way forward…
individualise

25. Social Work
Individual Service Fund
Inclusion Glasgow
Service Coordinator
Lynn & her sister
Paid help from a neighbour
© Simon Duffy. All Rights Reserved.

28. My Money
Funding from one
or more sources
[enables integration]
€
Coordinator Admin
Insurance Fund
brokerage overheads unexpected costs
Restricted Funding
Individual Service Fund

32. People don’t shop for services they build
stronger community.

35. Some questions for
ACH going forward

36. • Can you really plan with people so they can find the
very best solution?
• Can you give people some of their own money?
• Can you keep people’s money safe for them (e.g. roll
it over to next year)?
• Can you let people use their money flexibly?
• Are you part of the same community as the citizens?
• Are you helping people contribute?

37. At their best providers are
points of wisdom. So how have
providers become ‘a problem’?

38. • Ideological rhetoric around markets?
• Vested-interest of commissioners?
• The increased detachment from community?
• Increased wage differentials and profit?
• Associational with institutional provision?

39. What roles should you play
in order to restore trust and
exercise leadership?

40. • Genuine commitment to partnership with citizens
• Rootedness and commitment to community
• A platform for peer support, family or self-advocacy
• Accountability for meaningful research based in
real outcomes
• Sharing what you’re learning

41. Christ does not call his benefactors loving or charitable. He calls them
just. The Gospel makes no distinction between the love of our
neighbour and justice. In the eyes of the Greeks also a respect for Zeus
the suppliant was the first duty of justice. We have invented the
distinction between justice and charity. It is easy to understand why.
Our notion of justice dispenses him who possesses from the obligation
of giving. If he gives, all the same, he thinks he has a right to be
pleased with himself. He thinks he has done good work. As for him who
receives, it depends on the way he interprets this notion whether he is
dispensed from all gratitude, or whether it obliges him to offer servile
thanks.
Only the absolute identification of justice and love makes the co-existence
possible of compassion and gratitude on the one hand, and
on the other, of respect for the dignity of affliction in the afflicted - a
respect felt by the sufferer himself and the others.
Simone Weil

42. Honour can exist anywhere, love can exist
anywhere, but justice can exist only among
people who found their relationships upon it.
Ursula Le Guin

43. All social values - liberty and opportunity,
income and wealth, and the bases of self-respect
- are to be distributed equally unless
an unequal distribution of any, or all, of these
values is to everyone's advantage.
John Rawls

44. There are eight degrees of charity, one higher
than the other. The highest degree, exceeded by
none, is that of the person who assists a poor Jew
by providing him with a gift or loan or by accepting
him into a business partnership or by helping him
find employment - in a word, by putting him where
he can dispense with other people's aid. With
reference to such aid, it is said, “You shall
strengthen him, be he a stranger or a settler, he
shall live with you” (Lev. 25:35), which means
strengthen him in such manner that his falling into
want is prevented. [Maimonides]

45. Maimonides’ 8 rules of giving
1. Don’t look down on people - respect them as your equal
2. Don’t deny people what they really need
3. Don’t wait until someone has to ask
4. Don’t force people to beg
5. Don’t act like you are doing them a favour
6. Don’t expose people to scorn or stigma
7. Don’t distinguish givers or receivers
8. Don’t let people fall into need and out of citizenship