News

Care trusts are the government's favoured vehicle for the delivery of social care and if local authorities show any reluctance to form them, they will be imposed. That was the message from health secretary Alan Milburn to the national social services conference.

Last week's attempt by Carole Bell, the Department of Health's care trust supremo, to reassure local authorities that the trusts would not be compulsory was a disaster. Not only did her attempt appear irrelevant coming two weeks after Milburn's speech, but she went on to ignite further fears by admitting that money in care trust budgets could be moved to where areas of pressure were discovered.

The health secretary already has extensive powers under the Local Authority Social Services Act 1970 to impose whatever he wants if he decides an authority is failing. And there is no doubt that Milburn would take on any opposition. This government did the same with primary care trusts, which began life as voluntary bodies but were eventually imposed.

The government does not even need to use compulsion. There are other ways in which it can force the introduction of care trusts: it could offer inducements in the shape of further freedom and financial control to local authorities that form care trusts. It could also offer larger shares of special funds, just as the social services departments that win three stars in the new rating system have already been promised.

In this whole farrago the government has never stopped to ask whether social care service users will benefit from the development of care trusts. But this process is not about improving service delivery for them - the Health Act 1999 flexibilities did that. This is about central government taking control of local authority-run social care services. And the way they plan to control those services is via the centrally-run NHS.

The government must now admit this is its aim and stop trying to take social care into health by stealth.

See News, page 6

Social care needs men

Social care agencies must strive to reflect their communities, but it will soon be impossible since an overwhelming 92 per cent of young people studying for vocational qualifications in health and social care are girls.

The Equal Opportunities Commission (EOC) is campaigning to challenge career stereotypes. But it may be all too easy to divert girls from stereotypical career choices (thereby exacerbating the social care recruitment crisis), without boys having much desire to replace them. As we know from family roles, girls readily appreciate they have just as much right as boys to high status activities like earning money and forging careers - then they come home and do the child care and housework. It seems only women abhor a vacuum. Men abhor a vacuum cleaner.

Social care must not become a women-only occupation. Both the EOC and, more importantly, the Department of Health in its current recruitment campaign, should specifically target boys and men to promote social care as a career.

But the lack of men also highlights another truth about the recruitment crisis: advertising will not succeed unless the status of social care is higher. And this requires concerted effort on two fronts: pay and conditions, and the public image of social care. If those could be improved, we might start to resolve the gender imbalance. Even more importantly, it would acknowledge the skills and commitment of millions of women.

- See News, page 12