‘More Empty Promises on Health and Social Care Let Disabled People Down Again’

Did I hold my breath, awaiting Keir Starmer’s announcements about his proposed changes to save the NHS and reform social care? Excuse me while I nod off, as the New Year mercilessly pushes on through a world that seems caught in another wave of profound multiple crises.

As wildfires rage, daring to encroach into the homes of the most rich and famous, while many in the UK reel with the shock of extremely low temperatures – and, personally for me, flood risks – there are also the horrors that humanity inflicts directly upon itself. From the ceaseless slaughter in Gaza and conflict in Sudan, to a second Trump presidency and the destruction of women’s rights. It’s hard to stay hopeful.

I can’t bear to deeply investigate the latest tragedy regarding the grooming gangs scandal, whereby big-mouthed men use survivors, as always, to further their own profile. I say this, too, as a victim of childhood abuse, who was not listened to once.

At the bottom of these horrors, we find those pushed into new depths of vulnerability and terror – children, the elderly and, with intersectionality, the disabled.

Right now, you don’t want to be in this tribe.

In my every day, I realise I have some ‘privilege’ which has been won by those who came before me. But we suffer under yet more waffle from politicians with scarcely a difference between them. I’m not sure if socialism manages to glimmer at all, as we’re weighed down by growing models of oligarchy and, in simpler terms, those looking for the best profit margin.

I’ve protected my mental health by not delving too deeply into the detail of Starmer’s proposals, but I know from the opinions of many I trust, that they amount to little more than another Starmer Charmer offensive.

Behind the headlines, there’s the mind-melting reality of the private health industry pushing its slimy fingers into our NHS and social care systems to offer answers to the lack of provision that feature in headlines regularly. What I see floating on the surface is the same old turd – private equity companies are welcomed in, for profit over care provision.

As others have noted, this doesn’t quite mean pulling a credit card out as you queue in A&E or using your wages to quicken the wait for your social care assessment. But it does remain rooted in the privatisation of a public service (already paid for by us), to make profits for shareholders.

Would this mean my elderly family member could still have a cooked lunch and not merely a microwave job? Does it mean my newly-disabled friend would have to continue sitting in urine-soaked incontinence pads because they’ve just had their care package reduced?

Do I really need to keep saying that this is where the personal is the political? I’ve been uttering it since the 1980s, when I was fighting Thatcher’s privatisation of so many assets and national services the country once had.

These thoughts take me back to when I used domiciliary care and ‘Meals on Wheels’. My husband at the time gave me much of the support I needed, but when he went to work, I could neither take myself to the toilet nor prepare food. Looking back, it’s easy to recall it with a smiling nostalgia. I lived in the East End of London, and lively, mumsy-type women would bustle in holding a foil container with a handwritten description of the contents. ‘shep pie’, ‘pork cass’, and, if, like me, you didn’t eat meat, there would be a ‘mac cheese’.

Meals on Wheels did not help with personal care. If you were lucky, that came separately from the home help service run by the local council. I met many lovely individuals doing these runs. Working humans who had not been bullied into the ground, as others thought merely about cost and profit – as they do now.

Have things improved? And what is coming next?

Not much, it seems, to take us out of our gloom. I turn to my online community of disabled activists and campaigners, friends and allies, who are on the frontline where the painful fallout of decisions really does mean there’s shit that hits the fan. There is an obscure comfort to see that many of us feel the same way, that sense of a community fighting together yet again.

But the tropes remain too familiar and we’re all so tired.

Governments come and governments go, but still disabled people across many societies, all spectrums and impairment groups, are crushed by further empty promises – words that go on and on without making much difference. The words of my friends and allies are an echo of what’s gone before and what is likely to come again:

‘How aggressive the world is now’

‘The wildfires… how would disabled people get out alive… these seem far away issues in a far away land but, trust me, they’ll come our way pretty quickly’

‘The world turning even more right-wing when Trump comes into power in a few weeks’

Then, the close-up and personal; the daily drag of being a disabled person within these oppressive structures:

‘Inability to get social care that I can afford’

‘[As always] dealing with the Department of Wasters And Plebs’ (DWP)

‘Paying for care [is an] absolute nightmare [because authorities] never increase [funds to match] the minimum wage’

‘Exhausting bureaucracy, for the basic means to live’

‘Lack of awareness [of] what we go through every day… from work to benefits to everyday reactions to us’

‘Fear of… decisions being made about priorities in… the ever-crumbling NHS… that admits it is struggling to always provide a safe service’

‘[The reality that we have a] Labour Government that prioritises assisted dying over assisted living’

I thank my friends for trusting me to share these powerful thoughts. I’m saddened they are not new to me, and while we have fought for years – literally years – throughout our lives, those that still live, any positive change has always begun with us, yet moves at glacial speed because of those who work against us.

In some ways, I wonder if there’s any point caring what Starmer and his Cabinet have to say. So far, it doesn’t seem that different to the Tory way, and it appears that the so-called radical changes to save the NHS are little more than the dressing-up of more policies to bring in privatisation.

Dr Julia Grace Patterson, chief executive of Every Doctor UK, sums it up her latest newsletter: “Privatisation introduces a motive to the NHS which simply should not exist when delivering public healthcare – a motive to create a profit. If we want to get the NHS back on track, that motivation, and the shareholders driving it, need to be removed.”

I agree. There will always be something sick in the heart of a society that pushes personal profit over greater community good. We, the disabled, in all our intersectionality and wherever we are, remain the lowest of the low.

Yet, I cling to defiance as I have done all my life. Behind headlines and proclamations, silently and together, we work and reason with the unreasonable – sometimes shout – to get our voices heard above the usual, clichéd (inaccessible) institutions.

Penny Pepper is an award-winning author, poet and disabled activist