In my darkest hours, I wonder if social work is the only profession to train workers to believe things and do things that will never be possible in practice. Despite recent changes to the education system, we still take some of the most radical and principled people we can find and encourage them to reflect on topics such as anti-discriminatory practice and a social model of disability.
We then unleash them into a workplace where none of this is possible and sometimes does not seem valued by employers.
Bewilderingly, we are then surprised when new recruits either aren’t very good at some of the bureaucratic tasks that care management entails, or don’t find them fulfilling, or both. Often, people get disillusioned, go off sick or leave, and we never seem to anticipate that this might happen – even though it seems to me almost inevitable.
Of course, all this is a caricature (and a broad one at that), but the fact that it seems a recognisable caricature suggests it has some validity. As one social work manager said to me, “care managers today are accountants, photocopiers and gatekeepers”, and this seems very different to what many people came into social work to do. As another pointed out, “current care management is very good on the ‘management’ part of the equation, but whatever happened to the ‘care’?”
So why, given all this concern about losing the care aspects of the job, is there such opposition to new ways of working such as direct payments and individual budgets? Where these have been slow to develop, a key factor has been the personal and professional suspicions of social care staff, who sometimes do not fully understand these policies, do not agree with them or find them threatening.
Even now, there are probably still people who don’t know about direct payments because the staff working with them have never told them about this option, and this is a serious problem a decade on from the Direct Payments Act 1996.
However, it seems all the more unfortunate given that direct payments and individual budgets are one of the best ways of helping workers get back to the underlying values that brought so many into the profession in the first place.
At a recent direct payments learning network, participants said that they came into social work wanting to help others, make a positive difference and support people to live as normal a life as possible.
They wanted to work in a preventive way within the system while also challenging it. They wanted to promote independence, advocate on behalf of users and use their statutory position to mobilise services and resources on people’s behalf. These aspirations were felt to be difficult in the current system, with insufficient resources and eligibility criteria focused primarily on those in crisis.
Yet this is exactly what direct payments and individual budgets are about – and the time seems right for a major reassessment of the social work role.
In the future, those who are able and want to should be freed up from the current system to plan and design their own support with their families and support networks around them.
The role of social workers could then be to focus on those with the most complex needs, without support or in difficult family situations – a return to pre-care management social work skills and values.
Social workers are good at working alongside people facing major and potentially traumatic changes in their life, they are good at putting the individual in a wider context and they should have the right skills to help people articulate how they want their lives to be and how this could best be achieved. They are not good at care management (as currently conceived), and we probably shouldn’t really expect them to be.
Dr Jon Glasby is head of health and social care and a reader at the Health Services Management Centre, University of Birmingham. He is also a board member of the Social Care Institute for Excellence
Why are we surprised when social workers aren’t very good at some of the bureaucratic tasks that care management entails?