In early February, the Education Secretary Damian Hinds declared that every child must have access to key foundations in areas such as sport, public performance and volunteering to build character and resilience.
His cabinet colleague Matt Hancock, recognising in December that volunteers had been supporting patients in the NHS since its creation in 1948, said he wanted “volunteering to be the norm across every NHS hospital, with volunteers given the tools they need to fit seamlessly into the organisations they are giving up their time to support, so that the public and clinicians can work side by side to deliver the best possible care to patients.” This coincided with the publication of the King’s Fund report on The Role of Volunteers in the NHS: views from the front line commissioned by Royal Voluntary Service (whose work now extends well beyond trolleys, shops and cafes) and Helpforce. In the days following the King’s Fund report, the Guardian ran a piece on How an army of volunteers could help win the fight for the NHS.
The Daily Mail launched its campaign (backed by no less than by J K Rowling, Claudia Winkleman and Sir Cliff Richard) to get people to sign up and by 16 December a total of 23,655 readers had done so, pledging a combined total of 1,344,132 hours in help and support. When published, the NHS Long Term Plan confirmed expectations on the role of volunteers and the doubling of the current workforce of around 78,000.
Clearly volunteering is back in political fashion. For schools it is part of the wholesome must-dos. For health it is part of survival. Has David Cameron’s elusive Big Society come back to stay or haunt?
In our continuing age of political-led austerity, it is not surprising that some reaction has been somewhat cynical – A volunteer army is no substitute for the doctors and nurses the NHS needs was one response. The King’s Fund report itself, whilst recognising that the overwhelming majority of frontline staff agree that volunteering in hospitals adds value for patients, staff as well as the volunteers themselves and that staff enjoy working with them, highlighted the lack of clarity regarding role boundaries. A tricky one perhaps, as much of integrated care and working in the community for instance, is about reducing those boundaries.
The commentator Mary Dejevsky echoed a King’s Fund concern about the need for training noting how poor training can already be for paid staff in the NHS. She cited her own experience in outpatients at a London teaching hospital concluding that “it is not more members of staff (paid or unpaid) that are needed, but fewer – properly managed and trained”. I expect we can all think of examples of that.
Dejevsky goes on to cite an example of an Expert Patient scheme that fizzled when it became mainstream and professional staff didn’t value it – another concern raised by the King’s Fund report. Her most strident objection is reserved for the role of volunteering for young people. With older people, the richness of their life experience, she argues , gives weight to their contribution to helping people confront the reality of their situations, the care they need and to navigate “the labyrinthine system”. The suspicion is that with younger people what they have to offer in volunteering are things which are substitutes for jobs that should be part of the paid workforce. I suspect she would not have much time for Damian Hinds putting the hairs of resilience on the chests of the snowflake generation.
No doubt the debate on this will be ongoing – the need to avoid exploitation of volunteers and using volunteers as a cover for poor provision needs to be set against the value that volunteers can bring and the vast resoruce deficits that the NHS faces.
Volunteering goes to the very heart of beliefs about what service is about, what our responsibilities to ourselves and others may be, what the meaning of a national health service in a modern context should entail. The struggle for resources is never-ending, austerity or post austerity. It is simply foolish to think that under current circumstances (or perhaps any) the state can provide all. But what we need to be talking about is more than just volunteering. Volunteering is part and parcel of the wider assets we and communities bring to the overall collective of resources. That collective also includes the 7 million people in the UK that could be classed as “carers” which itself includes the 1.5m (and 50,000 children and young people) caring for someone with mental health problems. An estimated 75% of the 800,000 people with dementia live at home mostly supported by unpaid carers. Assets include our capacity to prevent ill health and to self-manage our conditions and our own digital competence and equipment. It includes the relationships that enable people to go about their daily lives. All the things that work against the crippling effects of isolation.
Assets are inextricably bound up with the themes of empowering people and empowering communities set out in the Five Year Forward View and the ambitions for engagement and co-production. Whether the powers that be fully appreciate what an unleashed beast full engagement and co-production might be in our currently fractured and challenged democracy, is a moot point. If volunteering is a key part of that engagement and co-production and a part of developing the capacity and resilience of whole communities it takes us into a completely different sphere whose future may not be so easily predicted from the tea leaves in the RVS teapot.
Photos: Penguins made from recycled bottles by The Cracking Art Group along the bank of the River Vltava, Prague