UKHCA vice-chair: DH ‘misleading’ over home care registration

United Kingdom Homecare Association vice-chair Bill McClimont has accused the Department of Health of disingenuousness and putting users at risk by delaying the registration of home care workers.

In a letter to health secretary Andy Burnham, written in a personal capacity, McClimont attacked the latest delay in allowing the General Social Care Council to register home care staff, which came despite “clear public safety risks” in leaving them unregulated.

However, McClimont, until recently a member of the GSCC’s governing council, also rejected the DH’s professed reason for the delay – to enable the General Social Care Council to improve its conduct function. He also warned that the continued delays “may put the entire initiative at risk of falling to expenditure cuts”.

Registration due to happen in 2007

Registration of home care staff was originally due to take place in April 2007 but had been multiply delayed before the DH announced plans in April this year to register workers from 2010 onwards, initially on a voluntary basis.

But this week, the department said it had put the process on hold to allow the GSCC to concentrate on improving its conduct function, which applies to the only currently registered groups: social workers and social work students.

The conduct system has been under the spotlight since July, when a backlog of over 200 cases was identified, prompting the suspension of GSCC chief executive Mike Wardle and a review of its conduct function by the Commission for Healthcare Regulatory Excellence.

‘Misleading and disingenuous’

However, McClimont, whose two terms on the GSCC ended in August, dismissed the DH’s reasoning as “misleading and disingenuous”.

A truer reason, he claimed, was that the department was considering alternative models of regulation to statutory registration, as evidenced by the DH-commissioned report on extending workforce regulation in healthcare, published in July.

The report, by a stakeholder group, said statutory regulation was “likely to be disproportionate” for “large volume groups of workers, such as health care support workers”.

‘Lighter touch’ proposed

It suggested a “lighter touch” model in which employers took greater responsibility for staff safety and quality, as has been piloted for health care support workers in Scotland.

In his letter to Burnham, McClimont pointed out that health care support workers and social care workers were “for all practical purposes indistinguishable”, with both primarily carrying out personal care, and lines between the two becoming increasingly blurred.

He dismissed employer-led regulation for both groups, saying it would be “totally inappropriate” to leave the multiplicity of health and social care employers with the job of excluding inappropriate staff. He said a “comprehensive statutory listing is the only workable solution”, saying establishing this for the social care workforce was “the primary reason for the GSCC’s inception”.

GSCC problems ’caused by DH dithering’

McClimont also claimed that the “temporary, administrative” problems at the GSCC had in part been caused by the DH’s failure to respond promptly to a “steadily lengthening shopping list” of requests for action by the regulator, including on extending registration.

He said: “The ‘stop-go’ dithering by DH on registering the wider workforce itself distracted time and focus [at the GSCC].”

No ‘satisfactory explanation’ for delay

McClimont added: “The department has been repeatedly delaying this essential public protection measure over the last several years. In my time with the [GSCC], it was a source of ongoing frustration that DH put off implementation, generally without any satisfactory explanation.”

In an interview with Community Care, McClimont claimed the GSCC had also requested some streamlined rules for carrying out conduct procedures “and there were many months of delay” from the DH.

DH sticks to its guns

A DH spokesperson said: “The department remains committed to regulating home care workers and to considering the case for registration of residential care workers.  That said, the GSCC’s current priority must be to ensure that it has the right systems and processes in place to carry out its existing statutory duties swiftly and effectively. 

“It is for this reason that we have concluded that further work to open a register of home care workers should be put on hold temporarily to enable the GSCC to prioritise work to strengthen its conduct function.  

Legislation not enough

“We agree that registration of home care workers has the potential to deliver public protection benefits. However, legislation alone will not deliver these – the GSCC as the social care workforce regulator must also be able to effectively enforce the rules and so we await the publication of the report from the Council of Healthcare Regulatory Excellence into operation of GSCC’s conduct function before deciding on next steps.”

The CHRE report is due out later this month.

GSCC view

In a statement made about the registration delay at its annual conference this week, GSCC chair Rosie Varley said the decision was taken both because of the “serious problems” facing the regulator and the “continuing debate” over what form care worker regulation should take.

She added: “There has been and continues to be considerable discussion as to the form that regulation should take and whether it is feasible or desirable simply to roll out the professional regulatory model for social workers to the rest of the workforce.”

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