This is an early extract from a series of essays I am writing on the reform of adult social care. Comments appreciated.

Why care homes are immoral

What should we do about all the people who are living longer in the UK?

I wish to argue here that this is a moral as well as a political or economic question. I argue that the existence of residential care homes is proof of the failure of society to attend to the moral dimension of our aging population.

Being young is a social good. We recognise and give status to young people as the hope of the future. Being old is a social good in so far as one believes that life itself is a good, and that long life is a social good. Yet there is an imbalance in the value which we accord to young people, old people and those in the middle. They are not treated in our society as morally equal. Thus a person may be viewed as worthy of recognition at one stage in their life and yet discounted at another stage.

In order to decide as a society what we should do about all the people living longer we must decide what is the political, economic and moral worth of the part of the population labelled “old”. And we should decide what we mean by “old”. When, or perhaps how, being recognised as being “old” changes the status conferred on us..

What is the political worth of old people? The over 50s are more likely to vote. They are least likely to campaign, demonstrate or otherwise disrupt their representatives in office.

What is the economic worth of older people? That’s easy. Everyone knows old people are a burden, a drain on the economy. Their economic value generally increases when they can be persuaded to release the spending money locked up in their homes. As we shall see this quality is what makes them such targets for the big business which is the care home sector in the UK.

What is the moral worth of older people? In other generations and other societies this may be linked to the veneration given to people who have lived a long time, as repositories of history, wisdom, even magical powers. More recently older people in the UK were seen as worthy of respect for having fought in two world wars to preserve democracy in Europe. Now there is population pressure on scarce resources such as houses. The economic pressure to remove a person from their house and pop them into a residential care home until they die, is growing. The moral worth of older people is under threat.

Residential care homes are a phenomenon of the USA and UK. Their origins lie in the workhouses and mental asylums of the nineteenth century. These bedlams were places to hide away the socially unacceptable and to remove the old poor from the street.

Our present day residentail homes, however disguised, serve the same social purpose as the asylums: to lock up old people away from view. It has become socially acceptable to warehouse our old people.

The moral worth of a person in a social warehouse is almost nil. There are no social goods to be derived from this person, especially once they are out of sight or reach. They have no independence, little freedom of movement or association, and cannot be gainfully involved in society or in their family. They have become economically a burden, and politically, since so few continue to exercise power over their lives, or get a postal vote, they are disenfranchised. Without action and engagement these are beings outside the human condition. They are, so to speak, in the “place of exception” in Arendt’s words, a place which is not fit for a person with a moral standing and which is dehumanising. A place where the human being is commoditised into a “revenue source” in the private market or objectified into a “bed” in the public sector. Places where the maximum effort is expended not to preserve personhood but to maximise their profitability to the provider

A care home – even a well-run one – is evidence of a moral failure of a country to decide what is the worth of their citizens, beyond economics, beyond politics. What is the moral worth of an old person?