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• Thinktank recommends new health care practitioner role

Tucked away in health secretary Alan Milburn’s speech at the annual Association of Directors of Social Services conference was a proposal that, if implemented, would probably see the traditional social worker role abolished and replaced with a new-style social care professional, writes Sally Gillen.

This new breed, which Milburn said should have "more specialised skills not just the traditional general mix of social work skills", would be better equipped to deal with the "complexity of modern social work problems".

Possible hybrid roles cited by Milburn included that of a family care worker, which would combine the "skills of the health visitor and the social worker". But initial responses to the creation of such a new role have been frosty.

Liz Timms, chairperson of the British Association of Social Workers, who attended the conference, says the general consensus among her social work colleagues is that Milburn’s grand plan would be a grand flop.

"We are not in favour of anything that fudges the differences between professions. A health visitor brings something different to a family from a social worker," she says.

At the heart of Milburn’s proposals is the desire to deliver a simpler service to users by reducing the number of agencies they come into contact with. But Timms warns that while creating hybrid roles would appear to be achieving simplicity for the service user, it is in fact likely to result in a reduced service.

She argues: "It is a good thing that families have the opportunity to get two perspectives. The key is that this should not be confusing for the service user. We have to make it clear to them that what we offer is different."

Instead of creating combined roles, she says, service users would be better benefited by improving collaboration between agencies so that the distinct elements of each is retained.

Sceptics might interpret Milburn’s desire to do away with current roles as a clear sign of a loss of faith in the concept of joint working, the language of which has dominated the social care sector for the past decade.

But Timms is certain that, while it is not without its challenges, the commitment to improving collaboration between agencies is the direction in which social workers and their colleagues in other agencies should be heading. It is, she believes, the best way of providing an efficient service.

"All I have read and all the work I have done has shown that joint working takes time. It takes time to build relationships, and there must be a recognition of that fact by everyone from the government down," says Timms.

Social worker Chris Chambers agrees. As one of around 150 social workers based at what was the country’s first fully integrated social care and NHS trust, the Somerset partnership, he knows both what the benefits of joint working are but also the problems it can present.

He too worries that this latest announcement is premature. "They (the government) haven’t given true partnership working long enough to get off the ground before saying it doesn’t work," he argues.

As a frontline mental health worker, Chambers believes that what is being proposed is unworkable. "What we are asking of people is probably bigger than what any individual can achieve. It seems like we will be asking the worker to become a sort of superworker where they will be expected to be a psuedo doctor, nurse and social worker rolled into one."

"No one person can do that."

He adds: "There is a fundamental divide within mental health between the medical model and the social model. Both have their place, but I don’t know how we can ride both horses."

The practical problems of expecting a single worker to perform so many different, and what will inevitably be at times incompatible, functions is also highlighted by Timms.

Mark Jones, chief executive of the Community Practitioners and Health Visitors Association, says: "The reason I suspect this is being advocated is that more and more health visitors are doing a lot more social work because there are not enough preventive social workers. So the work falls to health visitors by default."

But, like Timms, he is aware that combining the two roles would cause problems, arguing that while he appreciates the pressures facing social workers, "the answer is not to bolt-on social work to the health visitor role because that diminishes the public health work that we should be doing".

Instead, Jones argues that while the CPHVA is not flatly saying 'no' to Milburn’s plan, it is definitely saying it is too early.

"There isn’t yet a robust argument for the combing of two or more roles. We are a long way from that point. What we need to do first before we go down that road is build on the good examples of joint working that are around. There is a lot of good work going in Sure Start where co-located teams have been introduced."

"We should try and replicate some of these teams before introducing hybridisation overall," he adds.

But Timms is resolute. "I don’t think it will work, and I hope they think again," she says.