Peter Beresford (Column, 2 August) raises a crucial moral and human issue in his article on lying. Does truth matter? St Augustine of Hippo noted wryly in his "Confessions" that he had met many people who wished to deceive, but none who wished to be deceived - we begin to see the hollowness of pragmatic arguments that deception is often justified.
Lack of truth screws up human relationships and it screws them up badly. In close relationships it may prove terminal, but it damages trust in many other contexts where trust is important. Of course there is a moral distinction between lying to protect one's own interests and lying to protect someone else's. But even lying to give someone else a stronger case, for example, has complex ramifications, especially when endemic.
At the institutional level, what should not occur are situations where people feel it is their moral duty to lie in order to protect the interests of their organisations, unit or cost centre and its employees and users.
This occurs when finance is tied to performance targets such as school attendance or immunisation figures. Not to lie deprives the organisation of much-needed funds - but to lie invalidates the system, undermines trust, and effectively penalises others who tell the truth. The public sector should not operate in this way.
Lorraine Harding
Department of Sociology and Social Policy
University of Leeds
Whose side are we on?
I was intrigued to read Peter Beresford's article (Column, 2 August) about social workers having to "duck and dive", operating skilfully and sometimes unconventionally in order to utilise the small spaces that are available in agencies to support clients and service users. This resonates with my own experience of some 25 years as a social worker, mainly with children and families.
It has increasingly become difficult to work in anti-oppressive ways, not least because of the move to managerialism with its focus on procedures and routines. As an example, one has only to witness much of the practice in relation to child protection and youth crime. And as a corrective to this, one must remember that radical social workers have always based their work on such values as social justice and equality. Even though social managerialism seems to have triumphed, perhaps all is not lost.
As Beresford notes, being economical with the truth often means that clients can receive the benefits and services they should receive. One must remember the old sociological question "Whose side are we on?" - and act accordingly.
Steve Rogowkski
Oldham
Guidance won't end postcode lottery
I do not advocate (News, page 4, 26 July) that councils should take a narrow resource-driven view of access to services. However, I would point out that any attempt to remove inconsistencies between authorities would founder because of the different levels of resourcing. As authorities can continue to take resources into account the suggestion that the new guidance will end the "post code lottery" is unrealistic. It is important that we explain this clearly to the public.
I welcome the publication of the draft policy guidance for consultation on fair access to care, to be followed by practice guidance. The guidance does recognise that differences between authorities do and will continue to exist. It emphasises councils' responsibility to be clear to service users about what they can expect.
The Association of Directors of Social Services shares the ambition of the guidance to have good preventive services available. But directors of social services know that these have been under threat in many areas. We would welcome reassurance that resources will in due course allow us to make a reality of that ambition.
Given that a survey earlier this year showed 85 per cent of departments predicting an overspend, I expect that some authorities will want to question the alleged "limited resource consequences" of the new guidance. Even the best performing councils will find assessments will take time and attention not available for other developments.
Moira Gibb
President
Association of Directors of Social Services
Small print obscures nursing care debate
Your account of the small print revelations of the Department of Health draft guidance on free nursing care (In Focus, 2 August) suggests something of a selective interpretation of previous policy announcements. The NHS Plan, published a year ago, stated explicitly: "In the future, the NHS will meet the costs of registered nurse time spent on providing, delegating or supervising care in any setting." To suggest that this refinement has emerged only with the small print of the draft circular obscures the debate.
The issues concerning the definition of nursing care are also not new. They arose with the publication of the NHS Plan, and in the debate that surrounded the passage of the Health and Social Care Act 2001. Of course there are problems with any definition, but even if a decision had been made to fully fund all personal care, this issue would remain. Wait for similar controversy in Scotland over what constitutes personal care, and what can be termed as living costs and housing costs.
The registered nursing care contribution (RNCC) tool is not the same thing as assessment. The draft version of the RNCC is in fact on the Department of Health website. The RNCC will only come into play following the completion of an assessment, and that assessment will be the single assessment process already announced as a key component of the national service framework for older people. The consultation draft guidance on fair access to care (News, page 4, 26 July) also restates the general principles of assessment for adult social care, and further guidance on the single assessment process is imminent.
It is vitally important that there is debate about many of the issues raised, and that the practicality of the RNCC can be evaluated.
Melanie Henwood
Independent health and social care consultant
Towcester, Northamptonshire
Pensions for ex-services personnel
I joined the Royal Navy as a 15-year-old boy seaman and left at 40 ("Wounded soldiers", 2 August) as a highly skilled and experienced petty officer seaman (submariner).
I am now employed as a social worker. While a submariner I was involved in submarine escape trials and training, requiring very rapid changes of atmospheric pressure, resulting in avascular bone necrosis of my left femoral head and acetabulum. I therefore have a 20 per cent "war" disability pension (you don't have to have been in a war to get a war pension).
Please can readers of Community Care who are in contact with ex-services personnel with any disability attributable to their service, or the widows, widowers or partners of ex-service personnel whose death is attributable to their service, suggest they contact the War Pensions Agency on 0800 169 2277, or e-mail: warpensions@gtnet.gov.uk The website is at www.dss.gov.uk/wpa/ index.htm
Peter Clements
Saltash
Cornwall
Primary therapy
I was interested to read Melissa Benn's article on the need to recognise children's emotional needs in the school setting (Perspectives, 12 July). In the Clay Cross area of north east Derbyshire we have been doing just this for the past four years with our Positive Play scheme.
The scheme is based in Clay Cross infant school. It started because the head teacher and I were aware that many of the children were failing in school and the normal behavioural policies were not effective. Clay Cross is an area of high deprivation. A substantial proportion of children in the school had low self-esteem, came from difficult family situations and were unable to cope with the complexities of the school day.
The scheme is based around individual play sessions in school with a special education care officer. These focus on allowing the children to explore their emotional needs and also giving them the skills to cope in school. It has spread to other schools in the area, covering nursery to secondary level. It has prevented exclusions, improved classroom behaviour, improved academic levels and given a more positive experience of school to many children.
It is a very cost effective scheme. The recent Ofsted inspection gave it great praise. So the future is not all bleak. There are many schools where something is being done to help the most vulnerable children.
Irenie Zelickman
Primary care liaison worker
Chesterfield
