Institutional investors must put the values back in the value of care for older generations, or we all suffer
As a Doctor working with older patients during the pandemic, Rachel Melsom believes the Silver Linings Competition could be part of a necessary renaissance in the care sector.
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Some of you will have listened to the 2020 series of The Reith lectures: How We get What We Value – given by Mark Carney, the former Governor of the Bank of England.
The lectures are particularly pertinent in relation to the desired outcomes from our Silver Linings competition, which challenges how we currently perceive, treat, care for and finance our increasingly older population, and how we generate and ascribe ‘value’ to them as individuals and to their well being.
We are seeking to close the gap between value and values with new and innovative projects that benefit all stakeholders.
In the first lecture ‘From Moral to Market Sentiments’, Carney details that the concept of ‘value’ has recently become defined more narrowly in economic and financial theory – and less with our ‘values’ (principles or standards of behaviour). Values include our judgements of what is important in life such as fairness, responsibility, sustainability, solidarity, dynamism, resilience and humility. Carney highlights what I think we all subconsciously know: that societies’ values have become equated with financial value, and financial value has come to be considered worth more than human values.
Carney notes at the end of his first lecture, that: “there is a mismatch between value derived and value paid (in relation to care workers, front line health workers and educators) and that gap needs to be closed”. This is only one of many gaps. There is no disputing the intrinsic value of health and well being to society and the economy to enable them both to function. The global pandemic continues to wreak havoc with the economic position of every country. Every element of the global economy and every individual has been affected to a greater or lesser degree.
Over 1 million people rallied to help the UK’s National Health Service (NHS) during lockdown, which was a wonderful example of civil society acting and assisting in a time of need. The sad fact though is that this included providing assistance to older generations that they had required for years, but that we as individuals, corporates, investors and governments had simply chosen not to focus on. We have lost the balance between purpose and profit.
Covid-19 has raised the public’s awareness of the vulnerability of our older population: where and how they are cared for, by whom, on what basis, and at what financial cost? Many people have been shocked to learn of the low value we have ascribed to their well being – reflected clearly in the (frequently less than) minimum wages that their carers are paid, the lack of Personal Protective Equipment (PPE) available in care homes, and the enforced isolation required to protect our older citizens. All of these factors have contributed to the increased mortality of this vulnerable and frail section of society. Government cuts in budgets for social care and the fact the weekly government contributions to old age care regularly do not cover the real costs of a care home when this is needed, and decreasing allowances per individual in residential care, are facts we are familiar with.
Business owners and financial organisations reducing costs in residential care homes (which inevitably means reducing physical care provision) has become standard. In many instances this has resulted in terrible outcomes for the most vulnerable in our society. There has never been an acceptable excuse offered for neglect of our older population, but there is always a cause. Sadly this has tended to be financial – making ends meet for small businesses and /or generating a required magnitude of financial returns for larger businesses to be appealing to investors. Beneficiaries looking to secure their wellbeing in retirement via a pension may unwittingly be investing themselves in a poor quality care industry.
But increasingly, long term investors such as pension funds are supplementing their measures of financial returns with metrics that are better at expressing purpose and values. There are many contributors on this topic, all actively seeking consensus, and attitudes to measuring the ‘S’ (Social, and some now say ‘Stakeholder’) element of ESG and to make it integral to how we ascribe value to investment. These include greater focus on human rights, equality, diversity and inclusion. Covid-19 has made us focus on how to factor in health and well-being as a measurable and key contributor to ‘social’ impact – for both individuals and society in general.
Spending time currently during the Covid-19 crisis as an NHS doctor working with older patients, I am aware how extensive and varied their individual needs can be, how fiercely independent many are and wish to remain, and what the multi-factorial inputs are to enable them to not only have the basics required for life (food, warmth, shelter) but to also live full and varied lives to the maximum of their ability.
We will (hopefully) all be old at some point. We need to harness and embrace the knowledge out there across finance, social care, health care, policy, technology, design, architecture, sustainability and more to find better solutions together.
Working collaboratively is the route to finding and delivering multi stakeholder benefit, as outlined in the ‘partnerships’ called for in number 17 of the United Nations Sustainable Development Goals (SDGs).
Now is the time to ‘join the dots’ and create a virtuous circle between the financial value and societal values that both pension funds and their beneficiaries seek
The Silver Linings competition is an opportunity to rethink how we value our older generations and their care, and find sustainable routes to invest in it via collaborative ideas that deliver for all.
As Mark Carney said in another of his Reith Lectures, From Covid Crisis to Renaissance, in response to a question:
‘What do we do to invest more effectively in care, knowing that this issue is only going to increase, and given the demographics? It requires a rethink. These are easy questions to ask, but hard to answer, but we should take the opportunity to do so.’
Join us in trying to seize this opportunity by entering the Silver Linings Competition!
Dr Rachel Melsom, MBBS, BSc, one of the creators of the Silver Linings Competition, is a Director, Medical Matrix Consulting and a practising Physician.