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Voluntary sector ponders green paper fault lines

Posted: 12 May 2005 | Subscribe Online


To make self-determination for adult users of social services a reality, the adult services green paper is depending on the voluntary sector to play a crucial role.

Although leadership will remain with local government, voluntary sector representatives are expected to sit on the new strategic commissioning partnerships that will plan adult services over the long term.

The sector's role in provision will have to expand, not only to meet the expected explosion in demand but because of the government's call for a shift to preventive services.

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Its experience in advocacy will be crucial in empowering users to shape their own services through individualised budgets. And its ability to reach people untouched by mainstream services will be vital on promoting social inclusion.

Although the green paper has received a warm reception in the sector, concerns have been raised.
A coalition of voluntary organisations has written to NHS chief Nigel Crisp warning that changes in priority areas for section 64 grants to charities for 2006-7 conflicted with the green paper's vision. In practice, the group argued, it would curb innovation and lead to a funding shift from social care to health, and away from preventive services in particular.

The green paper's plan for the voluntary sector also feeds into a wider debate over the fault-lines between the sector's service planning and provision on the one hand and campaigning and advocacy on the other.

Shortly after the green paper's publication, Stephen Ladyman, then community care minister, went to the heart of the matter at a King's Fund briefing: "Where the voluntary sector gets a seat at the strategic planning board, it can't come out and criticise the plan. I want to hear from the voluntary sector whether this is a role it welcomes or whether you want to be lobbyists."

Stephen Lowe, policy officer at Age Concern, says: "That's a problem for the voluntary sector, which has roles as service providers, client representatives and campaigners."

His solution is local protocols allowing the sector to combine planning and provider roles with campaigning and advocacy.

Nick Aldridge, head of policy at the Association of Chief Executives of Voluntary Organisations, rejects any contradiction between service planning and campaigning. "Our members want a seat at the table so the experience they've gained advocating for users is reflected in services."

But a more pertinent question may be whether the voluntary sector will get a meaningful seat at all.

Although Ladyman had emphasised there would be duties on councils and primary care trusts to sit on strategic commissioning boards, there will be no such duty on the voluntary sector.

This mirrors the approach taken in the Children Act 2004.

Caroline Abrahams, head of policy at children's charity NCH, says the sector has been frozen out of some children's trusts and strategic partnerships in certain areas. She says she understands the rationale behind this, in terms of protecting the sector's independence, but adds: "It leads to the impression that we are a second-order partner." She believes the mixed picture reflects "individual attitudes in local authorities".

But one problem facing councils is identifying the voluntary sector. Des Kelly, director of not-for-profit provider coalition the National Care Forum, says: "How do you engage with a service sector that's so fragmented and made up of small providers?"

John Dixon, co-chair of the disabilities committee of the Association of Directors of Social Services, says it is unrealistic to expect smaller organisations to become involved in strategic planning.

He says: "There's not too much difficulty bringing on board representatives of the larger organisations like Age Concern. What's more difficult is engaging the smaller organisations that are too fragmented and too numerous to have a seat on a local authority board."

Yet these organisations, particularly those from ethnic minority and other potentially excluded communities, are crucial to the green paper's socially inclusive aims.

Dixon says councils must engage with such organisations through local forums and "learn to speak the language" of the community sector.

But perhaps the biggest fault-line between councils and not-for-profit organisations concerns local authority commissioning.

A key assumption in the green paper is that many services fail to meet need and promote dependence. Councils and charities agree that underfunding of social care is a cause of this, particularly as this stops councils investing in preventive services. But for many in the voluntary sector poor council commissioning practices are also to blame.

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Aldridge says: "The vision will not be deliverable without significant change to local authority contracts. We are looking at long-term goals. But more than 90 per cent of our members are on one-year contracts."

Although the private sector has the security of long-term arrangements, he adds, many voluntary organisations are on short-term contracts that give them no chance to invest in training and infrastructure.

Nick Danagher, executive director of the National Centre for Independent Living, says user-led organisations face a similar problem. "Most user-led direct payment support services are on contracts of about three years and are constantly retendered by local authorities, which militates against long-term planning."

Kelly says councils should tender on the basis of quality not cost and create a market for the specialist, personalised services that only the voluntary sector can provide.

Dixon agrees many councils must change, and suggests different commissioning arrangements for smaller bodies to promote community development organisations. "Smaller organisations are not going to be able to gear up to competitive tendering in the same way as larger ones. But we can improve commissioning."

Pressure to change should come from the Commission for Social Care Inspection, which is to use its judgements on providers to assess councils' commissioning performance.

But some are pessimistic about the possibility of change. James Churchill, chief executive of learning difficulties charity the Association for Real Change, says: "I see precious few good signs."

There are more positive aspects to the relationship between local government and the voluntary sector on this issue. Several charities have signed up to a joint lobbying strategy with the ADSS and the Local Government Association through the Inter Agency Group (IAG).

Dixon paints a picture of constructive engagement. "The charities are bringing their perspectives to the table, some of them quite critical of the way the system works."

Yet the IAG is focused on lobbying government on common points of interest, such as funding, and not on influencing practice locally.

But Dixon adds this could be a useful byproduct of the group. "By bringing people together we are hoping that we will also influence attitudes on the ground."

In-depth green paper analysis

Starting next week Community Care will be running a series of in-depth articles giving expert analysis on the adult green paper, the problems that it poses and the solutions which will help to shape the future of adult social care. And we want you, our readers, to contribute to the debate and play your part in deciding what the future of adult social care should be. Our website, www.communitycare.co.uk, is mounting a green paper campaign in tandem with our series, including an online chat forum for all our readers to air their views on some of the most important issues in social care. We will compile your views into a report to be discussed at our green paper conference, Power to the People, in London on 27 June.  Our expert analysis series comprises:

  • Role of service users - 19 May.
  • Role of professionals - 26 May.
  • Leadership and the adult social services director - 2 June.
  • Refocusing on prevention - 9 June.
  • Performance management - 16 June.
  • Strategic commissioning - 23 June.

 



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