As national director for social care at the Department of Health, Kathryn Hudson is guardian of the department’s credibility among the sector’s professionals.
But, despite the publication of the adult green paper in March and the promise of a white paper on health and social care, that credibility is now in question.
Skills for Care chief executive Andrea Rowe has claimed the DH’s social care knowledge has been “decimated” and it is increasingly reliant on the sector’s national bodies to develop policy.
In its Forward Plan 2005-6, the DH placed developing better relationships with and knowledge of social care as a key objectives for 2005-6, with no equivalent goal for the NHS.
And a stakeholder survey published by the DH found most local government leaders felt the department failed to understand their needs or interests.
Hudson’s arrival, just over a year ago, followed the departure of children’s services to the Department for Education and Skills – and with it much social care knowledge – the abolition of the Social Services Inspectorate and a 38 per cent cut in the DH’s size.
This was reflected in her three key objectives: improving links between the DH and the sector, boosting understanding of the purpose of social care and social work, and social care “proofing” policy in the DH and elsewhere.
Despite perceptions, Hudson is adamant there has been progress and links with the sector have improved. She cites the social care forum, convened by permanent secretary Sir Nigel Crisp, which held its first meeting in July, and the planned secondment of a civil servant to the Association of Directors of Social Services.
Far from an indictment of her failure to improve links with the sector in the past, the forward plan’s objectives are an extension to the work she has been doing already, Hudson says.
And she interprets Rowe’s claim about the DH’s reliance on social care’s national bodies as testament to the department’s openness.
“We can’t write good policy unless we take account of what it’s like to be out there doing the job,” she says. “We’ve moved a long way, especially in developing the green paper.”
By this she means the long consultation that helped develop a consensus within social care behind the paper’s aims, despite disagreement over the means to deliver them.
It is a development that has her personal stamp, she says, adding: “I believe you achieve change through building consensus.”
One sign of a shift in the DH is on funding. Although the green paper initially said it would be cost-neutral – to cries of disbelief from the sector – there has been a subtle shift since.
Care services minister Liam Byrne has often spoken of building a case to argue for more resources for social care in the 2007 spending review.
And the DH has built links with Sir Derek Wanless’s review for the King’s Fund on demand for older people’s social care, which is expected to call for more investment.
Hudson says: “We look forward to seeing its outcomes. We are in no way committing ourselves to accepting them.”
But it is clear that things are not perfect.
The British Association of Social Workers says it has yet to have a meeting with Hudson since her appointment.
Director Ian Johnston says: “We used to have regular meetings with the DH before the restructure. The departure of the inspectorate and children’s services has made life slightly more difficult for us.”
Rowe feels Hudson is one of too few voices fighting social care’s corner, along with DH’s care services director Anthony Sheehan and his staff, the team behind the green paper. Rowe says: “I think she’s doing a good job. But it’s just a drop in the ocean.”
Hudson attributes renewed concerns in the sector about the DH to two things: fears that social care will be marginalised in the white paper, and the disappointment that comes when the department does not meet the sector’s increased expectations.
She says: “Within social care people are saying ‘we’re going to get taken over by health’. It’s almost as if we hadn’t written the green paper.”
She says Sheehan’s team will be involved in writing the white paper to give it a social care focus, and that it will be fully informed by the consultation on the green paper.
She adds: “People did not have high expectations of what the DH was doing when I came in. We have [now] shown we can write good policy that demonstrates leadership. But you raise expectations. Now when things go wrong people say ‘I thought they were supposed to be much better now’.”
Hudson says her ability to social care-proof government policies is limited. “It’s a challenge when you consider there’s only one of me. There’s no way I can social care-proof policy across central government.”
But she has been trying to ensure that social care is taken into consideration as policies are drafted, rather than as an afterthought.
With no managerial responsibilities, her job is all about influence and persuasion, which she describes as “good social work skills”.
But her broad-ranging role means she is not up to speed on the details of policy handled by Sheehan’s team and others.
She cannot comment on the continuing review of the national minimum standards, the development of a national continuing care framework, the merger of the Commission for Social Care Inspection and the Healthcare Commission, or the DH’s social care efficiency programme. Of each she says: “I am aware of what’s going on in general, but cannot comment on the details.”
Hudson is perhaps most passionate about her mission to define the distinctive roles of social care and, particularly, social work.
She cites work being done by the General Social Care Council to develop an English equivalent of the 21st Century Review of Social Work in Scotland to bring greater clarity to the role of social workers.
She says: “There are people in this country who need long-term social work services who do not get them because of the way services are provided today. We haven’t really made sure that social work skills are available when needed.”
Much of this is down to the commonly cited problem of social workers spending too much time on assessments and rationing services, rather than empowering people.
Without pre-empting the GSCC’s conclusions, she suggests the future may be one of fewer practitioners working in local authorities and more in the voluntary and independent sectors.
Hudson’s ability to influence policymakers will be more crucial in her second year than in her first, bearing in mind the number of ongoing initiatives, such as Wanless, the white paper, a review of the whole social care workforce and the next stage of the GSCC’s registration programme.
However, her message to social care is assured: “You will have to judge us on our results.”
“You need a lot of good social work skills like influence and persuasion.”
“I really enjoyed working with Stephen Ladyman who was committed to social care. Liam Byrne is particularly enthusiastic in his first job as a minister. He’s also been emphasising the values of respect and dignity, which i think are fundamental.”
“You will hear a lot of social workers talk a lot about the time they spend on assessments and putting together packages of care. They will say ‘I’m not using what I was trained to do’.”
Influencing government policy
“It’s a challenge when you consider there’s only one of me.”
Social care funding
“We are interested in the Wanless review’s work and look forward to seeing its outcomes. We are in no way committing ourselves to accepting its conclusions.”
The division between children’s and adult services.
“If I have one concern it is that we weren’t very good at working across the boundary when we had a social services department”.
Relations between the DH and social care
“If you talk to the Local Government Association and the Association of Directors of Social Services, they will say that communications are better.”