Is health taking over social care again?

Health seems to be taking over social care again, says James Churchill (pictured), who is about to retire as chief executive of the Association for Real Change. Vern Pitt reports on his fears for the learning disability sector

James Churchill, the soon-to-be former chief executive of the Association for Real Change (ARC), is feeling rather sad. This is not because of his impending retirement from the role he has held for 22 years at the umbrella body for learning disability providers. Instead, he is sad about the state of services for the client group.

“What I’ve noticed is how health seems to be taking over social care again,” he sighs. “Escaping from the clutches of the NHS and people who tell you that you’re ill and they need to guide what you do has been one of the major achievements of learning disabilities over the past 20-30 years.”

Although Churchill is pleased the government wants to provide seamless care, he fears medical models will again dominate. He says the Care Quality Commission is a prime example, and questions its ability to regulate both sectors.

Churchill is equally frank about health secretary Andrew Lansley whose NHS White Paper includes plans for two health bodies, the National Institute for Health and Clinical Excellence and Monitor, to assume social care functions. “Mr Lansley obviously has some grand plan but I’m not sure everyone has bought into what he is putting forward.”

Churchill is no stranger to being outspoken. In 2002, he described the diploma in social work exam as “utterly failing to ask crucial questions”. In 2007 he questioned local authorities’ ability to take on the commissioning and funding of learning disability services from the NHS and implement the then government’s Valuing People Now strategy. “It won’t be Valuing People Now it will be Valuing People Never,” he said.

This year he described the rise in the use of private learning disability hospitals as “institutionalisation through the back door”.

He says those fighting for better lives for people with learning disabilities should be vocal but that this has its difficulties. “There is always a reticence about speaking for people with learning disabilities and there is a growing move towards people with learning disabilities speaking for themselves,” he says. “But then you have the double dilemma of who the government will take notice of.”

Churchill’s passion for his subject isn’t surprising given how long he has worked in the sector, but he didn’t always intend to end up in it. He studied theology and intended to be a priest before becoming an agnostic and a teacher. He moved into working at learning disability campaign group United Response before being elected as treasurer of what was then the Association of Residential Communities for the Retarded (ARCR), when he was absent from a board meeting. He became the ARCR’s first full time chief executive in 1998; the name was shorted to ARC soon after.

Speaking out has become important as councils prepare to make cuts. Churchill says it’s a worrying time for learning disability services, which he characterises as expensive and vulnerable when axes swing.

A supporter of Valuing People Now, he is concerned that the government looks set to dismantle its delivery team. “The implementation will become the responsibility of those for whom it is not a priority,” he says.

Yet he remains hopeful that more people with learning disabilities will be able to access personal budgets in future. “It is possible that the financial crisis will finally mean the local authorities will give up trying to control everything and everyone and give people the money they need and let them live their own lives,” he says.

However, recounting a story illustrating the limits of personal budgets, he shows the limits of his optimism. “One young graduate did a placement at a local authority and they asked her to stay on and write a guide to what people could not spend their personal budget on,” Churchill says with an exasperated laugh.

About the Association for Real Change

The Association for Real Change represents organisations that provide education, employment and home, day and residential care services for people with learning disabilities. Besides offering advice, information and training services to members, ARC has representatives on learning disability partnership boards and lobbies government on behalf of providers. It is also member of the Learning Disability Coalition, which campaigns on the sector’s behalf.

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