Readers views on commissioning services, the value of special schools, the role of step fathers, and the state of domiciliary care
Commissioning needs CQC scrutiny
After years of reviewing pricing models and hearing that we must all make contingencies, I fear we have reduced fees to dangerously low levels. I suspect that there are hundreds of charities supplementing statutory organisations through fundraising or cross-charging.
Many local authority social services departments are not meeting actual cost. If inadequate fee levels are paid, services will decline.
Commissioners have a responsibility to purchase robust and sustainable services. If these fail, commissioners must take some responsibility. I believe that the Care Quality Commission (CQC) should have powers of inspection over local authority purchasing practices. It is often the contracted supplier that is sanctioned by the CQC but if the price is driven so low by purchasers, failure becomes inevitable.
The recent BBC Panorama programme portrayed online reverse tendering as the unacceptable face of commissioning services, being about price and not quality. Users and their families must be involved in tendering, and councils are missing a trick if they do not assess what agencies can provide as added value.
Overhead costs are not recognised; HR, training and financial administration all cost money and are an important part of providing a quality robust service.
It is time for a complete overhaul.
Let us recognise that financial constraints are real and that we need innovative solutions. This may involve strategic purchasing that identifies the financial contribution a provider might make. Charging policies need to become more standardised. We have challenges where resources cannot meet need. Let’s work together to find a long-term solution.
Patrick Wallace, chief executive, Self Unlimited
Only special schools can offer expertise
Teaching union NASUWT recently called for an end to “special needs policy”. Many mainstream schools provide outstanding experiences to young people with disabilities, but in some instances the needs of children are not matched by resources and expertise.
The pressure on teachers to deliver the curriculum can mean that children who work more slowly because of their disabilities struggle to keep up, suffer stress and low self-esteem and become isolated from their peers. This is not what inclusion was designed to achieve.
We need an acceptance that inclusive and specialist education are not entrenched opposites, but are part of a spectrum of provision. Special schools and colleges such as Treloar’s have expertise and experience in working with young people with complex physical disabilities.
Educationalists must appreciate that families make an informed, positive choice when they opt for specialist provision and we should understand and respect this and work together to make the service as seamless as possible.
Graham Jowett, Director for Education, Treloar Trust
Why stepfathers must be engaged
I was dismayed to read Natalie Valios write about stepfathers only as a risk to be managed (“Lurking in the shadows”, 9 April, www.communitycare.co.uk/111233).
Services tend to default to mothers as the parent to be engaged anyway and the article seemed to reinforce this view.
Let’s not forget that children benefit from positively engaged (step) fathers. The Department for Children, Families and Schools is urging us to Think Fathers – it may have a point.
Harvey Gallagher,Executive Director,Care Matters Partnership
Billions for war, but not for the elderly
The BBC is to be heartily congratulated for its Panorama investigation into the appalling quality of some domiciliary care.
The programme highlighted the fact that councils are auctioning off care of the elderly to the lowest bidder in the private sector, and that poorly trained staff employed by some private care agencies, whose only interest is profit, are under constant pressure to provide the minimum amount of care before moving on to the next client.
One incident featured a care worker speaking to her employer using a mobile phone with one hand while attempting to clean the private parts of an elderly gentleman with the other.
Our government spends billions on wars but is ignoring the plight of our elderly people.
Ken Mack, Wrexham
These letters are published in the 30 April issue of Community Care magazine