The president of the Association of Directors of Adult Social Services, David Pearson, spoke on various BBC news programmes last week, to discuss the crisis in the NHS. On the BBC’s Breakfast show last Thursday, the GP interviewed before Pearson had used the opportunity to get a simple message across that the government had failed to train and retain enough GPs. As a result, surgeries could not cope with the demand and people were going instead in increasing numbers to A&E .
Before introducing the Adass president, the Breakfast presenter identified the cuts in social services budgets – worth £3.53bn from 2010-11 to 2014-15, net of inflation and demographic pressures, according to Adass itself – as one of the main contributing causes to the crisis in hospitals.
Cue David Pearson, who should have said: “Yes, year-on-year cuts to social care budgets mean we don’t have enough money to provide support services to older people. And yes this is contributing to hospital beds being blocked and people ending up in A& E.” He could have added that the government’s policy of providing an additional £2bn for health in 2015-16 whilst cutting social services budgets was “nonsense”, which was how Pearson responded to this policy when it was announced in George Osborne’s autumn statement in December.
However, instead of doing this on BBC Breakfast, the president gave a prepared statement littered with statistics that provided a defensive response to blocked beds. It was down to “exceptional pressures”, he said. Pearson also paid tribute to the efforts of staff, referred to innovate schemes across the country that were seeking to improve the response to these pressures, and said the government’s integration policy was welcome but that more social care resources were required. It was very measured but hardly the sort of thing that would incite outrage among viewers about the way some of the most vulnerable people in our society are being treated.
Contrast this with Royal College of Nursing general secretary Peter Carter, appearing alongside Pearson on Radio 4’s The World at One last Wednesday. He blamed the pressure on A&E on the inability to support older people in the community due to cuts resulting in the loss of over 6000 district nursing staff since 2003. Pearson’s comments on The World at One were almost word-for-word what he was to say on Breakfast the following day.
The Breakfast interview wasn’t simply a case of being over-briefed and trying to cram in too many facts. It was also not an issue that was specific to this Adass president. It was something more fundamental, it was the same reason that we have heard so little public criticism of government from Adass about the savage cuts to adults’ services over the past five years.
Behind closed doors
This was a rational, measured, but passionless defence of social services. Why – because Adass’s tactics are not to criticise government policy or ministers publicly but to work behind closed doors to influence them. The belief is that “people who shout are not listened to, their arguments are dismissed without being heard”.
But this approach has not worked for the past five years. Ministers have repeatedly made it clear that they are not listening to the lone voice of the profession around a table staked with government advisers promoting the private and not-for-profit sectors, saying families should do more and the state should do less, and asking whether we really need expensive social workers to work with older people.
While the president’s recent robust remarks on the Adass website are welcome, they are not accessible to the public. Breakfast, by contrast, is a programme watched by an estimated 1.5 million people each day, and was a perfect opportunity to cut through to the public at large.
Now is the time for a more robust leadership; let’s face it, in view of the budget settlement we have nothing to lose.
We need Adass to make more of a drama out of this crisis; we need the Adass president to get passionate and show some anger at what is happening because that will galvanise public opinion and that’s what government’s respond to in an election year.