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If social care still has a distinctive voice at the highest levels of policy-making, there is evidence this week that it is not being listened to. For people who use services, the experience of being marginalised is nothing new. But for those covered by mental health and mental capacity legislation, it appears the government is either ignorant of some of the most important principles established by the service user movement or is deliberately undermining them.

For a start, the concept of advocacy is distorted in the Mental Capacity Bill. The Bill proposes "independent consultees", supposedly "a form of advocate". But they are no such thing. An advocate's role is not to determine an individual's best interests, but to represent that individual's views and wishes. They are not mediators but representatives.


Meanwhile, the draft Mental Health Bill for England and Wales has disappointed service users and social care professionals at every turn. It threatens to poison the relationship between them. Again, the government is either utterly ignorant of the nature and importance of those relationships, or is deliberately undermining them. Even the relationship between service users and carers could be threatened by the effective house arrest of people under compulsory treatment, which would have to be policed by their carers.

All these developments have one thing in common: the principle of user-led services, of starting with an individual's needs and wishes and building services around them, is being jettisoned in favour of speed, reducing costs, and controlling behaviour.

The huge strides made in establishing new values in social care over the past decade are forgotten. Any idea that closer ties between agencies could encourage the NHS to align itself more with those values is belied by moves such as practice-based commissioning, in which mental health services in particular could suffer because GPs, unlike primary care trusts, do not have to consult with service users.


Social care professionals are only the leaders in service user empowerment because the user movement has fought battle after battle, and is still fighting. Now the government seems intent on snatching back the spoils of those battles, and setting back by years the relationship between those who deliver services and those who need them, to the detriment of everyone.

The relocation of the National Institute for Mental Health in England from the Department of Health to the Social Care Institute for Excellence provides a ray of hope. Scie is intent on moving social care values forward, with the experience of service users at its centre.

It may be too late for the move to influence the Mental Health Bill. Scie must act decisively, strongly - and fast.