‘We need to get social care intervening at an earlier stage’

Dropping free home care for disabled people earned the Welsh health and social services minister criticism from social work. But now, he tells Derren Hayes, he wants to raise the profession’s profile

Dr Brian Gibbons was the man held responsible last month for dropping the Welsh assembly government’s manifesto commitment of free home care for disabled people (Disability groups condemn Welsh government’s U-turn on free care, 23 February).

The decision attracted the ire of disability and older people’s campaigners who warned it would keep many disabled people in poverty and questioned the basis of the policy shift (Campaigners blame Welsh free care reversal on narrow research remit, 2 March).

It has also done nothing to quell the belief, among some in social care, that the sector is some way down the health and social services minister’s priority list.

Brian GibbonsGibbons, a GP in Blaengwynfi, West Glamorgan, took over the role in January 2005, and has spent a large part of his first year tackling hospital waiting lists, which dwarf those elsewhere in the UK. But he denies neglecting social care.

“Waiting lists and the means of how the health service responds to patient need are absolutely crucial, but to say that’s our sole concern is way off the mark.”

In fact, the minister says his government’s mission this year is to raise the profile of social care in Wales through a number of initiatives, primarily a 10-year strategy called Designed for Care, due out in draft in May.

He says: “As someone outside social care I was surprised [on taking the job] by the need for social services to establish itself as a priority in local government, and by the battles and campaigns that need to be fought to bring it to the fore.”

The number of letters he receives on social services issues – such as child protection – are “scandalously small”, making up just a handful of the 3,500 in his postbag each year.

Of the strategy, he says: “Everyone would agree Designed for Life [the health strategy published last year] has presented a fundamental review of the way health care should be delivered in Wales and I hope Designed for Care will be every bit as radical.”

A key theme will be to promote a shift in provision from crisis intervention to preventive work. In justification, Gibbons cites Sir Derek Wanless’s review of health and social care in Wales in 2003.

He says: “A key message from the Wanless report was that we are too much driven by crisis intervention. We need to get social care intervening at an earlier stage such as when a family breakdown starts to occur. The threshold for intervention is too high in Wales.”

Gibbons echoes concerns raised by Scottish ministers recently over the welfare of children whose parents misuse drugs.

“There is a tier [of service] between crisis resolution and universal services. We need to identify this cohort of children at risk and intervene. The looked-after children population in Wales continues to grow – it isn’t levelling off as it is in England – and I don’t think we really understand what’s driving that.”

The strategy will also promote more joint working between councils and the voluntary and health sectors. He also detects a “new impetus” among councils to work together.

This collaboration, he says, will  help to tackle the shortage of professionals – social worker vacancy rates in Wales were 15 per cent at the last count.

“We’ve started to turn the corner and the number of students on degree courses is going up, but this would be helped by councils working more collaboratively rather than competing against each other for a limited number of people.”

Gibbons’ ambitions for social care are clear. Now he and his ministerial colleagues must show whether they have the commitment to realise them.


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