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The plethora of social inclusion policies are at risk of ignoring the most marginalised people, who often need the high-quality support that can be provided only by social services, writes Anna Coote.

As Labour settles into its second term in government, its social and economic policies are assuming a distinctive shape. Blair's government wants a kind of welfare capitalism that benefits "the many not the few" and eliminates social exclusion and child poverty. It aims to stop people depending on benefits and get them into paid employment, and to put new life into the poorest neighbourhoods.

An avalanche of initiatives has been unloaded - driven by performance indicators and targets. There are targets to increase jobs for disabled people, lone parents, ethnic minorities and the over-50s, to increase the number of pupils winning grades above C in their GCSE exams, and to improve social housing.

It would be churlish to doubt that the government wants to break the cycle of deprivation and improve the lives of those who are worst off. But how much will all this really help people who are least able to help themselves - the most vulnerable members of society? What about people with severe disabilities or mental illness? Refugees? Children who have been abused by their parents? Ex-prisoners? Teenage mothers? Those who are homeless or addicted to drugs or alcohol? For one thing, they tend to be the most difficult to shoehorn into the labour market. They lack qualifications, or can't get them, or don't appeal to employers, or can't handle a work environment - often through no fault of their own and for reasons that cannot easily be overcome. Furthermore, there are many in these categories who occupy pockets of disadvantage in relatively well-off neighbourhoods, or who live just beyond the areas that qualify for regeneration. Not only are they unable to share the fruits of renewal, but their sense of exclusion may be heightened as they compare their fortunes with their neighbours.

But even those who live inside regeneration zones are at risk of losing out. Local strategic partnerships, which are being set up to oversee the neighbourhood renewal strategy, are supposed to involve local people. Strenuous efforts have to be made to involve hard-to-reach groups who will need considerable support if they are to play a full part in any consultation or planning process. Not surprisingly, then, they tend to remain on the margins.

The government's vision of area-based regeneration is about empowering local communities to help themselves and cracking down on anti-social behaviour. Regeneration schemes are supposed to stimulate local economies and promote a new kind of community leader - the "social entrepreneur". They are expected to introduce neighbourhood management and street wardens. Vulnerable individuals may be unable or unwilling to take part in developing new enterprises, or to put themselves forward as leaders. The danger is that they will find themselves up against managers and wardens who want to keep things running smoothly for the majority of residents and prevent a minority of "misfits" from spoiling the party.

Building strong communities, especially in poor neighbourhoods, is a respectable objective for the government. But strong communities can themselves be, or become, exclusive. People who are disturbed, ill, frail, who don't speak English, or misuse drugs or alcohol, or lack social skills, may be unwelcome among neighbours who are only slightly better off themselves.

Society's most vulnerable members need sustained, high-quality social care and support. Not entrepreneurs or managers or wardens, but social services. In the rush to realise new ideas about social exclusion, it is hazardous to forget the importance of tried and tested professional skills. At present, the government appears to undervalue the social worker as much as it idealises the social entrepreneur. There have been no dramatic injections of cash for social workers. Indeed, they are often obliged to abandon all but the urgent cases because of financial constraints. That means they cannot provide the kind of lower-level support that prevents people from slipping into crisis. Many regeneration schemes are put at risk because those who should benefit are inadequately supported. Social services may need to be modernised but they also need serious investment - and much more thoughtful integration with the neighbourhood renewal strategy.

Anna Coote is director of public health, the King's Fund.