This site is intended for health professionals only

The Big Society: what does it mean to you?

Lynn Young
Primary Healthcare Adviser for the RCN

It seems the coalition government is determined to take the state out of the public sector and drive it towards a more commercial world. But are you attracted to the concept of the 'Big Society'?

The latest news on the Forest Commission, and about it not being sold off after all, is sweet music to many people; but many other areas of the nation are under scrutiny and what can be taken away from the state is probably under threat right now.

There is much to worry nurses at the moment, and all those good folk who believe passionately that a decent society, rather then a big society, does what it can to care for its sick, elderly and vulnerable people. With the welfare system being rapidly dismantled, many people, with absolute justification, are concerned about the long-term health and wellbeing of those people, who for reasons of personal incapacity are unable to work. People with long-term conditions, such as mental illness, MS and heart disease, who may be able to look after themselves with the minimum of help, have little energy to cope with going to work on top of their other daily difficulties.

It looks as if a proportion of these people are about to have their financial benefits reduced and they are frightened. Nurses, particularly those who work in the community, are often close to such people and are acutely aware of how they struggle to maintain their personal dignity as well as 'making ends meet'. Nurses may find it increasingly difficult to bear the diminishing comfort of their patients and clients.

General practice and community health services focus on the lives of people, not simply the disease. When social care provision is restricted the nurses work even harder to fill the gaps that should not be there. We know only too well that the community nursing workforce has a more reduced skill mix than that of a decade ago, while the numbers have remained almost static. It does not take huge intellect to realise that with unemployment rising and reduced state welfare, community nurses are looking at hard times.

Nurses who work in the community, along with their colleagues from other disciplines have the potential for being a terrific force for good. In areas of significant social deprivation it is probably the health visitors, school nurses, midwives and other
community nurses who offer the people who struggle with daily living the most support and hope needed to make life as good as it can be.

So, back we go to the Big Society and what it really means, once the soundbite of the day has been stripped away. For this to work, communities need to be resilient and capable of being self-supporting - with a little help.

The Big Society is a complete myth if we allow people who live in the 'sink estates' to wallow in misery and drug-fuelled conditions. We all need a little help from our friends; but where are these friends in a time of hardship and dismay?

Nurses working at the front line and in daily contact with people who struggle with ill health and relative poverty need huge support and care if they are to remain strong and resilient. It is far too easy to take our work problems home with us at the end of day and worry endlessly about the lives of others.

Strong teamwork and an authentic spirit of mutual friendship and camaraderie will help us cope with the problems that lie ahead. For a while the good times seem to be taking a back seat - but who knows for how long?l