Editorial Comment: In-house delusions

It is an inevitable consequence of this government’s preoccupation with markets in public services that they will make a greater impact on social care, just as they have on the health service. Local authorities have tended wherever possible to favour in-house services because a move to external providers may have implications for staff and involve an unaccustomed leap into the unknown. But renewed emphasis on strategic commissioning is likely to make this approach increasingly untenable.

Adoption is a case in point. A new report finds that voluntary adoption agencies are feeling marginalised by councils which sometimes ignore them as services are planned and only use them as a last resort to make placements.

Yet councils often lack the resources to do the job effectively themselves. Local authorities frequently explain their insular instincts by claiming they are cheaper, but the report suggests this may be because they are underestimating their own costs. These instincts will have to change if the ambitions for commissioning set out in the health and social care white paper are to stand a chance. Every provider will expect to compete on equal terms, whatever the difficulties.


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