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See below for Jacqui Smith's answers to your questions.

This week's Have your say debate centres on the Victoria Climbie inquiry.

What do you think should be done to restore the public's confidence in child protection services? Do you think another case like Victoria Climbie could happen again? Or do you have a view on the way the Climbie Inquiry is working?

Have your say and join the online debate by clicking here

All the responses will be posted here

Health minister Jacqui Smith has answered questions from visitors to www.community-care.co.uk and readers of Community Care magazine. Questions are grouped in different subject areas.

Pay, morale, recruitment and retention

Question: Is the government going to put more resources into social work? If salaries are not increased, social workers will leave to join the private sector. Kathleen Webberley

Answer from Jacqui Smith: We increased spending on social services by 6.2% this year. This is well above inflation. As you know, pay for individual staff is decided by their employer - we do not set pay levels for social workers or social care workers.

Q: When will the government substantially increase pay for social workers to recompense for years of effective pay restraint, and to reward in a way that reflects the nature of the work and helps to retain staff? Tony Raybould

A: As I said in answer to the question by Kathleen Webberley, we have increased resources for social services. But we don't control social workers' pay - which is decided by employers. We can only encourage employers to have effective recruitment and retention policies that look at all the issues, including pay.

Currently the starting salaries for social workers, teachers and nurses are on average the same which is an important start in our bid to recruit more people into the profession.

Q: The problems in retaining staff in social care are well documented. Is there a role for performance related pay? Anonymous

A: Again, pay is an issue for individual employers. But I personally think that innovative schemes, such as paying more to duty teams working out of hours or promoting more flexible working patterns, definitely have a major role to play not only in retaining staff, but in recruiting them.

Q: With the current shortage of qualified social workers, why isn't more being done by the government to encourage/demand local authorities to retain the experienced qualified staff they already have? I am a senior social work practitioner working in child care, there is no option within my department for me to reduce my hours or to work flexitime, which, in accordance with the government's work-life-balance guidance policy is essential in the recruitment and retention of staff, and is line with good staff care policies and a healthy productive workforce.

Many of my colleagues and myself have all suffered from stress and paperwork orientated high caseloads, particularly with the introduction of the new doh core assessment requirements. This career is not just about money, although it helps, it's about commitment and dedication, and all the retention payments in the world cannot make up for the feeling of being valued, supported and cared for within the workplace. There seems so much government energy and public sympathy being focused on the shortages and work pressures of teachers and nurses, but little media coverage of the desperate shortage and work pressures of social workers.

In light of the recent tragedies involving children, why isn't the government looking into the disparity that exists within local authority social services departments in relation to working pay and conditions to retain existing experienced staff, instead of just focusing its attention on the recruitment and training of new social workers? Carol Groves

A: We are encouraging councils to look at the best ways of retaining their staff. The social work recruitment campaign, which the Secretary of State for Health launched on 19 October, is not just about recruiting new staff. Its wider aim is to improve the image of people who work in social care. I appreciate that social work staff feel very much under attack by the media, and so one of the purposes of the campaign is to raise the level of public and media awareness about the brilliant work that social workers do.

I entirely agree with the point you make that retaining social workers is not just about money, but is also about flexible working practices and people feeling valued. I hope that, on a national level, the campaign will help with this. But on a local level, it has to be up to the individual employer. We are encouraging employers to have good human resources policies - the report 'Care to stay' by the Local Government Association shows that acting on these can be very effective in retaining and recruiting staff. So does 'People need people', a report by the Joint Review Inspectorate that shows that councils which have good human resources policies tend to have good outcomes for service users, too. But in the end, it is about individual employers making a conscious decision to invest in their staff.

Q: If you were employed as a social worker, morale was low and you did not know whom you would be working for i.e. health, education or police (in the child protection team) in a year's time, what would you do? Len O'Connor

A: I think that I, like anyone else, would be a bit anxious about the changes. But I would welcome anything that would let me provide a better service for children and families - and I think that working more closely with health, education and the police will help to do that. I would want to make sure my voice was heard before all the decisions were taken, and that I took every opportunity to have some input into what the changes would be and how they would be implemented. It's very important that people, like you, who work on the front-line get a big say, because you are the people who know best what service users want and need. And, if I was a team leader, I would want to look at ways of improving morale, perhaps by having a look at innovative schemes that other councils have used to retain staff and seeing if they would work locally.

I really hope that you stay and are part of the changes.

National service framework for children

Q: Will the 'NSF for children' promote the integration of community based child health services with social and education services to ensure seamlessness and single case management for those children that are vulnerable especially for children with disabilities? If it doesn't how will the government ensure that services do breakdown professional boundaries and pool resources? The flexibilities of the partnership legislation allow for joint investment plans and pooled budgets, but how can this be managed effectively whilst children's services sit in separate organisations e.g.: PCT's, secondary trusts, education, social services, environment and leisure, Connexions, youth offending teams etc.? Carol Baker-Longshaw

A: The NSF will set out to tackle inequalities, raise standards and reduce unacceptable variations by setting clear national standards and targets. It will provide a coherent and integrated approach to services for vulnerable children. We want to build on existing health and social services programmes - such as the Quality Protects programme and SEN Programme of Action - to develop an integrated approach to supporting vulnerable children, especially disabled children. Most disabled children who use social services also have health and education needs. Disabled children who need the support of social services, health and education services should receive these through an integrated system.

Adoption

Q: Can you confirm that the government will take very seriously the repeated questions asked in the debate in the House on 29th October that adoption by unmarried couples should be included in the Adoption and Children Bill? Mary Lane

A: Yes. Alan Milburn indicated in the House of Commons he welcomed debate on this issue, and that we would consider carefully the evidence heard at the Special Standing Committee. Under the existing Adoption Act 1976 single people may adopt (regardless of sexual orientation), but only married couples may adopt jointly. It is open for one unmarried partner to adopt a child and the other to obtain parental responsibility by applying for a residence order in respect of the child. The Adoption and Children Bill makes no change in this area. We believe that these proposals as they stand are broadly right, but by sending the Bill to a Special Standing Committee we are providing the opportunity to hear a wide range of evidence from stakeholders in the field, and for there to be further debate on this, and other, issues."

Q: What is being done about revising the court process in relation to adoption and the new standards? Many of the delays in placing children are clearly to do with court decisions. The reasons vary, but often relate to courts losing sight of the child's timescale, and by emphasising the need to be fair to birth parents. Alan Jones

A: I agree that children's needs should be at the centre of adoption. Our white paper 'Adoption: a new approach' recognised that delays do sometimes occur in the courts and set out a range of measures to improve the situation.

By the end of the year, we plan to extend the private law jurisdiction of district judges dealing with cases under the Children Act 1989, which will increase the numbers of judges available to deal with disputes over contact or residence with a child.

This will also free up judges to deal with public law and adoption work. And from November 1 specialist adoption centres at county court and high court level came into force across the country to help reduce delay and improve services.

We plan to consult on ways to encourage and improve inter-agency communication and co-operation later this year. We want to encourage consistent recording of information relating to timescales for children and adoption cases, with a view to setting target timescales for children's cases next year.

Smacking

Q: Does the government's reluctance to afford children the protection from assault enjoyed by adults stem from old adages like "you have to be cruel to be kind", "spare the rod and spoil the child" and hypocrisy such as "this hurts me more than you"? Ian Johnston, Director, British Association of Social Workers

A: There are many areas of social policy where legislation acts as a point of good practice and principle in regards to the treatment of children. The Children Act is one of these. In the case of the Children Act the legislation provides an expectation that society will treat its children with care and respect.

Q: How can the minister justify the government's recent refusal to make such a principled decision in respect of outlawing the physical chastisement of children? Nikki Bradley, Adoption manager

Q: I was very disappointed by the government's decision not to ban smacking children in England while they managed to do so in Scotland. How do you justify this? Liz Hill

A: We are committed to improving safeguards for children to protect them from harm, violence and abuse and to improve their life chances. The 'common sense' approach we recently set out in response to the difficult and sensitive issue of the physical punishment of children was informed by our consultation on this issue. We received a large number of responses which revealed that this was a subject about which people have deeply held and strong opinions.

We need to balance the needs of children with the reality of the difficulties of parenting. And recent developments in the law answered some of the key concerns that led to the consultation exercise in the first place.

We do not believe any further changes to the law would either be enforceable nor have widespread public support. We will however be keeping the use of the 'reasonable chastisement' defence under review to ensure that the Human Rights Act 1998 serves to provide children with adequate safeguards from violence that should not be capable of being justified as reasonable chastisement.

We have put forward proposals which meet the needs of parents and children in England and Wales, and under devolution the Scottish Executive is free to put forward their own proposals.

Domiciliary care

Q: I would be most interested to know what plans there are to help self-funding older people who wish to remain in their own homes, but who need a high level of care, which agencies choose to call nursing care. Packages of this nature cost vulnerable people huge amounts of money (day care around £1,000 per week for nine hours a day, sometimes with only 10 minutes in the hour hands on.) There appears to be no ombudsman to protect their interests, and no help other than attendance allowance. Since they are self-funding, they are not open to social workers, and since they are at home, they are not entitled to nursing costs being reimbursed, as with those going in care homes. Anonymous

A: By introducing free nursing care, we have ended the anomaly of people having to pay for the care they receive from a registered nurse in a nursing home, care that would be provided free through the NHS in any other setting - either in residential care or at home.

Anyone can have access to NHS community nursing services in their own home through a district nurse, regardless of their means. People may choose, if they wish, to pay privately for care that they receive in their own home.

Currently, anyone who receives social care, which is not provided by or contracted out by the local council, and who is unsatisfied with the service provided, should contact the Department of Trade and Industry.

In recent years, the domiciliary care sector has grown in both size and variety. More and more individuals are choosing care at home rather than away, and more external agencies have been set up to help people meet their needs. We want to help people to remain independent for as long as possible and recognise that the domiciliary health care sector has an important part to play in doing this, but we need to ensure that the services these people experience are of a proper standard.

We are currently consulting on the regulatory framework and national minimum standards for personal home care services.

The regulations and standards fall into three main areas - information about an agency, conduct of domiciliary care agencies and registered persons. Information about an agency regulations and standards stipulate what information agencies are required to provide in their service user's guide. This should include the aims and objectives of the agency and the nature of the service it provides. The conduct of domiciliary care agencies covers arrangements for the provision of care. For example, agencies must consult users about their care and take account of their wishes and feelings, religious persuasion, racial origin and cultural and linguistic background. The final area - registered persons - places a duty on domiciliary agency to ensure that the people delivering care and managing the agency are fit to do so.

Day care

Q: Please can you tell me if the government/councils intend to stop the disabled having to pay a "day care charge" to attend day centres around England? Frank Colley

A: We consulted recently on draft guidance to be issued to local councils on charging policies for day care and other non-residential social services and we will be publishing this soon. Councils have had power to levy charges for these services since at least the beginning of the modern welfare state in 1948. The power has always been discretionary, meaning that there is no compulsion on councils to levy charges.

Nursing care

Q: Is it right that very soon people like my mother who has to pay £700 a week for nursing care and who had to sell her house to pay for this, will now be able to pay less or none at all? Would like to know when this is to come into force or is it now? Annette McCarthy

A: From October 2001, NHS nursing care became free in all settings. This ended the previously unfair system where people in nursing homes may have paid for their nursing costs. We also acted to both ease the burden of residential care costs and since April 2001 have introduced a number of measures including the 12-week property disregard and deferred payments.

Deferred payments give people an option to meet care home costs without selling their family home. It also takes further pressure off people who in the past had to leave their home and sell it at the same time.

In April this year, a 12-week property disregard was introduced so that for the first three months following a person's permanent admission to residential care the value of their former home is disregarded from the means-test. This means that people keep more of their savings and provides breathing space between admission and deciding how best to meet care fees.

We are aware that where local authorities do not exercise discretion, some carers can be poorly treated and feel let down by the State. We are currently considering ways of addressing this.

Residential care

Q: Why does the government encourage and collude with local authorities in closing local authority residential provision, and in so doing pressurise social services staff to use the private sector? Judi Arnold

A: We think that local councils should be able to tailor local care provision specifically to local circumstances. The role of both the independent and public sectors will continue to be important in the provision of these services. We have an open mind on whether services should be delivered by the independent sector or directly by local councils. Decisions should be taken on the basis of what is best for users and best value. Best Value service review and Joint Reviews by the Audit Commission and the Department of Health's Social Services Inspectorate are used to ensure that the commissioning of services is undertaken fairly and that best practice is achieved.

Learning difficulties

Q: Given the emphasis on employment opportunities for people with learning disabilities in the 'Valuing People' white paper, should not the government set up a national framework for supported employment services to ensure greater clarity of objectives and uniform standards which can be monitored and benchmarked? At present there seems to be a 'postcode lottery' as to whether such services exist, who they cater for and what they do. Steve Porter, Manager, Community Resources, Royal Borough of Kensington and Chelsea

A: People with learning disabilities can make a valuable contribution to the world of work. And work, full time or part time, helps reduce social isolation. Our objective, set out in Valuing People, is to get more people with learning disabilities participating in all forms of employment, wherever possible in paid work, and to make a valued contribution to the world of work. Our overall aim is to increase the number of people with learning disabilities in employment, and to work towards their achieving parity with other disabled people in the workforce.

The Department of Health and the Department for Work and Pensions will be working together to look at the links between social care, employment and benefits, and will be establishing a working group to move policy forward in this area. We are about to commission research looking at the relationship between day centres and those local services providing advice, support and employment opportunities for people with learning disabilities. This will let us see what helps or hinders day centre clients taking part in work or work preparation activities and whether any action is necessary.

Local Learning Disability Partnership Boards, which should have been set up by the end of October, have to identify an employment champion from among their members. Boards should also produce a local employment strategy for people with learning disabilities by winter 2002/03. And they should develop local employment strategies, which should include plans for improving employment opportunities in the public sector.

Social services departments

Q: Do you think social services departments will exist in five years? If not, what will replace them? Nick Johnson

A: Local councils have social services functions set out in law and they decide how to meet these functions. As councils try to respond to their local communities in more innovative ways they are trying new models of organisation - such as bringing together housing and adult social care, or education and children's social services. I think this is good.

We've introduced flexibilities in partnership and the opportunity of new structures such as Care Trusts to respond to local councils' desire to be more relevant to local people. In five years time we expect councils to be organising their services in many different ways in partnership to focus of the needs of individuals living in their local communities.

Mental health

Q: Are you and your department doing anything to discourage MPs/ ministers/spokespeople from using mental health related terms as a form of abuse? It is a regular occurrence, most recently used by Jack Straw ('psychotic', 'psychopathic', about Osama bin Laden) and then another political player dismissing the whole shadow cabinet as 'known nutters'!

It is a cheap and easy ploy for them but costly in terms of the negativity perpetuated towards people who use mental health services or work in them. I train mental health workers and look forward to a time when students do not first have to unlearn misinformed beliefs involving a connection between mental distress and evil. Patricia Walton, Senior lecturer, Liverpool John Moores University

A: Many people who suffer from mental health problems emphasise that stigmatisation in its various forms is one of the most debilitating aspects of their illness. Fear and misunderstanding about mental health problems prevent people in need from seeking help, or cause them problems in continuing their studies and finding employment. Most people are generally caring and sympathetic, but too often they unwittingly use language which can cause offence.

We want to create a climate of public disapproval towards discrimination against those with mental health problems, in a way similar to the changes in public opinion over such issues as racism and sexism.

Earlier this year we launched a national campaign, mind out for mental health, aimed at tackling the stigma and discrimination faced by people with mental health problems and at supporting their social inclusion. It is aimed at key groups such as employers, the media and young people - to help raise awareness of mental health issues and put an end to the stigma and discrimination experienced by many people with a mental health problem.

One of its key themes is that labels are for THINGS and not PEOPLE, and this is a message we are trying to get across to everyone, regardless of who they are.

Attitudes cannot be changed overnight, but this campaign should lay the foundation for a fundamental shift in how mental health is seen in this country.

Disabled people

Q: I am concerned about the lack of attention given to people with physical and sensory impairments within the Department of Health's strategic priorities. Whilst initiatives such as Welfare to Work, and the joint circulars on dual sensory Impairment and community equipment services support some piecemeal progress, these lack the overarching drive and direction afforded to older people, mental health, learning disability and children through the NSF's, white papers and QP.

What plans does the government and the Department of Health have to address this imbalance, and what assurance can be given to disabled people and the groups that represent their interests, that they have not been forgotten? Stuart Rees

A: I certainly want to reassure you that we have not forgotten about disabled people. We work with the Department for Work and Pensions on this important area. Since 1997 we have taken a number of important steps such as the establishment of the Disability Rights Commission and the passing of the Special Educational Needs Act which I think demonstrate our commitment to ensuring full inclusion in society for disabled people.

In the Department of Health many of our general initiatives have considerable relevance for disabled people. For example, our drive to improve standards and quality in the social care sector through the National Care Standards Commission and the Social Care Institute for Excellence.

As you say in your question we have a range of initiatives specifically for physically disabled and sensory impaired people. You mention a number of these and I could add others, for example our 'Modernising NHS Hearing Aids' project and work that has recently begun to review the process of identifying and registering, with social services, people who are blind or partially sighted.

But I understand the point you are making when you ask about some way of giving overarching drive and direction to this Department's work for disabled people. You mention National Service Frameworks, which are one of the Department of Health's most important policy development and planning tools. You may like to know that we have now begun work on the NSF for long term conditions. This was originally announced by Alan Milburn earlier in the year. (Our current timescale for this NSF is delivery in 2004 with implementation from 2005.)

We are currently working out the scope of this initiative. It will, as Alan Milburn said, include a focus on the needs of people with neurological disease and brain and spinal injury. However, there are many areas of treatment and care which will be generic to most, it not all, long term conditions e.g., patient and carer involvement, information, rehabilitation, pain management, care and support in the home. By including these generic issues we will be able to bring about improvements in care for about 90% of all people suffering long term conditions of any sort.

In addition, the Social Services Inspectorate are currently developing an inspection of adult disability services. There will be close links between the development and conduct of this inspection and the development of the Long Term Conditions NSF. The pilot inspection will take place in February 2002 with the rest of the inspection in the second half of that year.

Voluntary sector

Q: Have we not created more pressure for smaller charities/voluntary organisations who are often the sole provider of very valuable services e.g. KIDS" playschemes for children with special needs, with the ever increasing "tender" culture, to access funding from a wide variety of funds and initiatives? It's not particularly the provision and development of a service, but e.g. time spent submitting bids, which may not be successful, and finding more office space for extra personnel etc. which creates the headaches. A local contact says "please don't tell me about any more pots of money!" Margaret O'Brien

A: The Funding Code of Practice, published to supplement the Compact on Relations between the Government and the Voluntary Sector, recognised this issue. It states that the criteria for Government grants programmes should be made clear at the outset and that the need for extra information in application forms should be set against the principles of good regulation i.e. transparency, accountability, targeting, consistency and proportionality.

Potential applicants should be able to discuss their plans with officials prior to submitting them. These principles should ensure that the best schemes get funded and that those with little chance of success know that at an early stage in the process.

Care leavers

Q: Given that the Children (leaving care) Act strengthens local authorities' responsibilities toward young people as they make the transition from childhood into adulthood. It has moved leaving care services (and allied local authority services) away from the old distinction between children (under 18) and adults (over 18 yrs), preferring a seamless service delivery for young people 16-21 yrs (or 24 yrs).

Sadly this is not reflected in the health provision to these young people, particularly in the area of mental health services and disability.

Are we going to see some joined up thinking being applied to health services for care leavers who require a distinct approach to their health needs in terms of engaging with services and in terms of their transition from 16 to 21 yrs of age? Mike Reay

A: You raise a very important point. The National Service Framework (NSF) for mental health (published in 1999), while focusing mainly on adult services, included a number of standards and good practice models relevant across whole populations, as well as guidance directed specifically to the needs of young people at the adolescent/adult service interface.

Examples include the need for local inter-service arrangements to be agreed covering prompt assessment of serious mental illness in young people; ensuring the safety and dignity of adolescents where exceptionally care is provided on an adult ward; and arranging effective handover of care where a young person moves to mental health care for adults.

The NSF for Mental Health specified that local arrangements (including service protocols) should be in place to ensure clarity in the handling of referrals of young people in the borderline ages (eg.16 to 21 years) to ensure that no young person's mental health needs remain unmet.

The Children's National Service Framework will have a particular focus on the transition from child to adult health and social services.

Carers

Q: When is the government going to recognise the many hours of informal care by the family by putting enough resources into personal social services so that when the carer and cared for require help it is there without question?

The media and in particular the Kilroy programme on informal caring screened this month, highlighted the difficulties experienced by many carers trying to obtain some respite from the caring obligations, and who often have no quality of life as a result of an inadequately funded PSS being unable to offer adequate help. Jennie Taylor

A: We recognise the enormous amount of work done by those who have the responsibility of caring for others. That is why we have made a commitment to give carers better information, better support and better care. We are providing an extra £100 million to this year's promoting independence grant to help local councils.

We have also provided councils with an additional £650 million this year (this includes the extra £100 million announced on 9th October) for social services, and we are planning to further increase the level of resources available next year.

We recognise that carers play a vital role in the community and are determined to see that they get the support they need. This is why we introduced the Carers' Grant, the purpose of which is to enhance provision of community care and children's services to allow carers to take a break from caring.

This grant is ring-fenced and can only be spent by local councils to give carers a break from their caring duties. The grant was first made available in 1999/2000 and will continue until 2003/2004. Over the five-year period the grant will have risen from £20 million to £100 million. This will be an important step in ensuring that the target in the NHS Plan of ensuring 75,000 more carers receive a break by 2004 is achieved.

Charging

Q: How does the government plan to ensure that charges for social care services are consistent throughout the country?

At present there remains a myriad of different charging policies between local authorities, creating an inequitable system nation-wide. Stuart Lomas

A: The draft guidance on which we consulted - and which we plan to issue shortly - does not seek to change councils' power to charge, or not, for these services. It seeks to ensure that, where councils do charge, this will be based on fairer, well designed charging policies. The guidance will ensure in particular that service users on low incomes are protected from charging and that any charges levied on disability benefits are subject to an assessment of disability costs, to ensure their reasonableness. This will lead to real improvements in the position of many users, who will cease to pay charges or pay a smaller charge.

Alcohol strategy

Q: Many local planning groups are now working to produce their own alcohol strategy in the absence of a national strategy from central government, in order not to waste valuable time and resources through the lack of a coherent approach to what the government sees as national priorities.

Will the minister please inform us when her government intends to publish its consultation document on a national alcohol strategy? Elizabeth Smith MBE, Chief Executive, Alcohol & Drug Services, Manchester

A: We believe it is important to ensure that the strategy has a broad base of support, and this has therefore meant that we have devoted time to the preparation of a consultative document which we hope will receive support from our key partners such as other Government departments, voluntary organisations and the drinks industry.

The NHS Plan said that we would be implementing the strategy by 2004. We are currently on course to achieve this target.