To whom can staff under pressure turn?

The death of government scientist Dr David Kelly has laid bare with
rare force the relationship between individual responsibility and
public policy. Suddenly trains of accountability are being revealed
and accountability has again become an issue.

All this has happened because the usually impermeable exterior of
policy decision-making has collided with the simple human image of
Dr Kelly’s lonely death in an area of conventional beauty and
calm.

This train of events is a UK expression of a broader phenomenon
that comes in the wake of accidents, wars, and disasters; of trying
to find out what really happened and what part powerholders played.

There are many resonances here for social care. This is a field
that has to address tragedy, loss, neglect, inequality and
vulnerability and which still, too often, plays its own part in
generating them all.

A long time ago, I bought a second hand push bike from an old man.
He’d been a relieving officer, the precursor of a social worker, in
the old pre-war Poor Law. He told me that when he started, his
senior told him a story from his own early days. A destitute man
went to the office for money and was refused. The next day his body
was washed up on the beach. “Always remember”, his boss said to my
acquaintance, “it’s easier to explain to your chief why you gave
money, than to the coroner why you didn’t”.

He’d always remembered this and so have I. These are difficult
times in social care: of cash limits, tight eligibility criteria
and too often of budget-led rather than needs-led services. But
ultimately the buck stops with face-to-face workers. They bear the
front-line responsibility, especially when things go wrong. This
doesn’t excuse managers and policymakers. They usually aren’t faced
with the pain and heart-searching of denying people the support
they should have. The challenge is to ensure everyone faces their
responsibilities.

Practitioners can play a key role in mediating the social care
system in the interests of service users. That’s why service users
so often distinguish between services – which can feel like another
obstacle to overcome, and service workers – who are frequently seen
as allies. The complexity of their allegiances is something social
care workers have long had to deal with. Perhaps this was also one
of the dilemmas facing Dr Kelly. More must be done to give social
care service workers the support they need to deal with the
dilemmas they face day after day in trying to do their job in
everyone’s best interests.

Yvonne Roberts is on holiday.