The diminishing influence of social care in the Department of
Health has been described as a “decimation” by one of
the sector’s leaders – and she did not exaggerate.
Andrea Rowe, chief executive of Skills for Care, is right to point
out that this puts a tremendous responsibility on organisations
such as hers to speak up for social care as its future is debated.
As the sector goes through its biggest upheaval in more than 30
years and as social services departments are gradually consigned to
history, what will their legacy be? Much will depend on Rowe and
her colleagues, including the Association of Directors of Social
Services, and the extent to which they can strengthen the still
small voice of social care in the DH itself.
The department’s permanent secretary, Sir Nigel Crisp,
appears to have conceded the point by setting up a social care
forum to make sure that the sector is heard by the government. The
forum should be pivotal, given the exodus of expertise since the
closure of the Social Services Inspectorate and the removal of
children’s social care to the Department for Education and
Skills. If it fulfils its purpose, the forum will have a vital role
in shaping the government’s view of social care in
preparation for the forthcoming joint health and social care white
It is a big “if”. The white paper takes up where the
adult social care green paper left off, but the green paper was
about much more than social care: it was about local government.
The integration agenda has gone beyond the ambition of five or more
years ago to bring health and social care into partnership. That is
a one-dimensional view of the problem, when the green paper’s
achievement was precisely to see it in the round, as involving
broader considerations of prevention, well-being and independence
which would draw on a range of council services in addition to
social care, including housing, transport, leisure and community
No doubt the Local Government Association will use its place on the
social care forum to lobby for a broader approach. But the health
service’s failure, through primary care trusts, to tackle
prevention with greater vigour does not inspire confidence that its
masters in the DH will do better.