When New Labour came to power in 1997, one of its boasts was that
it would apply "joined-up thinking" to government. Ever the
optimist, I assumed it would eventually get around to applying this
idea to social care provision. To an extent, this has begun, with
the development of health and social services partnerships across
the country - notably in mental health and learning difficulties.
Stephen Ladyman, the minister responsible for social care, is now
proposing a green paper on the future of adult services. He wants
people to "think the unthinkable". So here are some of the points I
believe he should consider.
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The whole issue of paying for care in the community needs to be
addressed: transparent it is not, even to the professionals. The
interlocking systems of payment are overcomplicated, including as
they do the independent living fund, local social services, primary
care trusts, Supporting People and the benefits system - for
example, the severe disability premium of income support. How about
recommended or statutory rates of pay - and status - for paid
carers? And don't forget the appallingly low benefit payments to
informal carers.
Encourage people to work, by all means. But appreciate, and allow
for, the fact that many people, owing to their conditions, may not
be able to sustain regular paid employment. Many of us can be
helped and encouraged towards purposeful activity, which may
contribute towards our communities but which is not seen as
meriting payment.
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Examine how things are organised in other countries, and how the
service users feel about their provision. There must be some
research into comparative cost, transparency, level of involvement
and service user satisfaction. If there isn't, commission some. The
Scandinavian countries are often held up up as model providers of
social welfare - it would be interesting to find out if they live
up to their reputation.
Finally, don't be tempted by a "one-size-fits-all" model. Although
there are various umbrella terms to describe adults who need social
care, our needs are diverse and complex.
