It was the worst of times but, alas, not the best of times. Launching a green paper on social care into a political and economic and fiscal tornado couldn’t have been worse timed – but how essential has it been to bring out these issues fully into the open? Publication gives clear sense, purpose and direction to the issues and will help us all give them a higher profile with the public and, not least, our workforce.
The fundamental principle that directors of adult services will be taking into the forthcoming, complicated negotiations over the care and support green paper is pretty simple. We have to look at the complex inter-relationships it discusses between structure, budget streams, family responsibilities and the duties of central and local government, and ask: ‘What do they mean for the people who are using these services? How will their lives improve by adopting any of these particular options on offer?’
If that sounds easy, believe me, it isn’t. Beneath and within the green paper’s rather well-written pages there lie suggestions which, if fully taken up, could lead to substantial structural changes in the relations between all those factors. And where you get structural changes you will get the usual, initial self-defensive mechanisms springing into action. Alongside those comes the usual fierce horse-trading that goes on whenever changes of this magnitude are envisaged.
Those with long memories might remember the Griffiths Report in the late 1980s which foreshadowed the transfer of community care responsibilities to local government from the Department of Social Security. While those with shorter, fresher ones can dredge up their files marked `splitting social services into adults and children’s services’ and recall the mantra politicians urged civil servants and local authority managers to repeat almost every time they met earlier in this decade: ‘Forget about structure: concentrate on outcomes.’
We might hear faint echoes of that advice repeated during the consultation stages of this green paper. It could get louder afterwards, when the electoral dust has settled, and when politicians have the time to devote themselves to medium- and long-term thinking, rather than the short-termism that electoral considerations necessarily and inevitably demand.
The Association of Directors of Adult Social Services will have to look closely and reflectively at those parts of the green paper that ask questions about how funds for adult services are to be raised – and what proportions each from individual, family, local authority and state. They will then have to look carefully at the proposed and possible mechanisms through which it should be spent. Individuals and their needs should be the pivot around which all these other legitimate, but competing, interests will have to be balanced.
Those will be the hard questions: few organisations yet will be prepared to make any firm decisions around them.
Too many implications that have knock-on effects on other parts of our services and local economies have to be teased out. Snap judgements, in this context, would be nothing but hostages to fortune.
But there are less controversial areas where we will be able to move ahead irrespective of the outcomes of the consultation process. Personalisation will proceed apace. Providing personalised services, getting on with improvements in the advice and support we provide users and carers and enhancing our preventative services are far from being a problem for the issues raised in the green paper – they are germane to the social care transformation agenda.
As, indeed, is a deeper integration between our social care and health services. Integration needs to be taken a considerable step beyond co-location (which is essential as well). This involves looking at the barriers that prevent true professional integration.
Maybe that will be a task for the social work taskforce, which is looking at some of the major workforce issues facing social care. Members are looking at the idea of a Royal College of Social Work, and the green paper has suggested creating a social care equivalent of the National Institute for Clinical Excellence. These ideas are more than straws in the wind and, if anything comes from them, then social work and social care might well be poised to fulfil some of the ambitions its founding mothers and fathers had for it. They are certainly ones that the Social Care Institute for Excellence could think about building on in its own future planning.
Alongside the green paper, don’t forget that the Department for Work and Pensions published an equally important strategy for ageing which set the detail of Shaping the future of care together into a broader social and cultural context.
Here we saw a deliberate attempt to bring older people into the tent marked `inclusion’. The DWP paper is as brave and as far-sighted a document as the green paper and should be read not as an afterthought to it, but as an equal, complementary document.
No, we couldn’t have launched either in worse economic, fiscal or political circumstances. But, in a way, that’s what makes them almost more important. The fact that they have been launched at all in such times bestows on them the right amount of urgency that the topics merit.
Jenny Owen is president of the Association of Directors of Adult Social Services
