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The fears of many in social care have been realised: the profession is losing a powerful voice as the Department of Health restructures, before the new partnerships for its future have been developed.

The DoH's current structure for social care is based on its relationship with social services departments, which looked almost solely to the DoH for policy, legislation and guidance. Social care, although provided across various agencies, was largely shaped by social services departments: by far its most powerful structures. Even as the role of voluntary and private providers increased, so did their dependence on social services departments through contracts.


In the DoH, the chief inspector of social services became the equivalent of a chief nursing officer or chief medical officer - the country's top social care professional, with the ear of ministers.

The new-look department has much to recommend it, especially its commitment to "steering not rowing". But while social care is intrinsic to the vision, its separate identity is not. The vision fits a world without social services departments, in which social care - in a far wider range of structures - will refer, particularly in children's services, to several government departments; perhaps to the DoH only in its partnerships with health. The government's full plans for children's services have not been revealed. But the Home Office and Department for Education and Skills are already at least as influential as the DoH. Meanwhile, the government's vision for adult health and social care remains fixated on the NHS.


New structures, as Community Care has argued before, are less important than the influence of social care values. The independent Commission for Social Care Inspection, the General Social Care Council and the Social Care Institute for Excellence will (though they do not yet) support social care's professional status and its influence on policy and practice. They are evidence of the government's good intentions.

Yet the new DoH lacks a voice for social care at the highest level. There is no social care professional alongside the chief nursing and chief medical officers. This must change. It deprives social care of political clout and diminishes its professional identity just when it needs both more than ever.