On the record

The last four years have seen the social care landscape change
drastically under a plethera of New Labour initiatives. Here,
Jonathan Pearce maps out these new initiatives, while Bill Jordan
analyses the success of the government’s social policy
programme.

“Community care is in tatters,” said the Labour manifesto at the
last election. So when Tony Blair came to power on that sunny
Mayday bank holiday back in 1997 bringing to an end 18 years of
Conservative rule, he promised a vision of national renewal, to
build a “country with drive, purpose and energy”.

Four years on, on the verge of another general election, it is
time to assess Labour’s record. In terms of social services and
community care, specific manifesto commitments were thin on the
ground in 1997. All Labour were prepared to give was a list: local
authorities would be free to develop a mix of public and private
care; a Royal Commission on long-term care; a long-term care
charter; an independent inspection and regulation service for
residential homes and domiciliary care; and a focus on older
people’s community care needs.

But change has come thick and fast as the government set out its
stall early on. It claimed a vision of tackling social exclusion
and poverty, and reformed public services. Over-arching strategies,
joined-up government and performance management would be key themes
in the New Labour administration. The Social Exclusion Unit was set
up in December 1997 and in less than a year had reported on
neighbourhood renewal, truancy and school exclusion, and rough
sleeping.

The report on neighbourhood renewal in particular was a classic
example of the government trying to grasp the big picture. It
became a national strategy and finally a national strategy action
plan in 2001.

Other big-picture, agenda-setting initiatives included
Supporting People – the policy and funding framework that
will bring together care, health and housing in providing support
services to people in supported and sheltered housing in 2003.

Similarly, Quality Protects in 1998 promised to transform
children’s services with a three-year strategy to define government
objectives for local authorities, including helping children in
care beyond the age of 16, improving educational achievement and
reducing the number of moves while in care. Later, legislation on
care leavers was passed.

The introduction of the Children’s Fund aimed at preventive
services for five- to 13-year-olds was part of a child poverty
strategy complemented by the creation of the Children and Young
Persons Unit.

The NHS Plan was published in summer 2000 after a hectic four
months of planning. At its launch health secretary Alan Milburn
spoke enthusiastically of joined-up services – common goals and
budgets with new care trusts delivering both health and social
care.

Based on the plan, the model of care trusts contained in this
year’s Health and Social Care Bill was an extension of the agenda
for social services which had been set in 1997 and 1998 – the
integration of health and social care and the slow steady deletion
of the term “social services” from the policy lexicon.

In 1998, plans were announced for pooled budgets for health and
social services, lead commissioners and integrated provision. These
were soon followed by the Modernising Social Services
white paper, promising independence, protection of vulnerable
people and higher standards.

It proposed the General Social Care Council in England – the
social work regulation and registration body – and parallel bodies
for Scotland Wales and Northern Ireland.

By the end of 1999 performance indicators and standards were
measuring social services departments’ performance. The Best Value
regime replaced compulsory competitive tendering in local
government, compelling social services to scrutinise all the
services they provide.

Care and carers had been mentioned in the manifesto. The
National Carer’s Strategy in 1998 gave £140 million to local
authorities to support the six million carers who supply informal
care. The Carers and Disabled Children Act 2000 allowed them to be
assessed and receive services in their own right.

In general disabled people also benefited, although many were
disappointed the government did not go further. The Disability
Rights Commission was set up, anti-discrimination measures were
extended and the Special Educational Needs and Disability Act
became law this year, allowing children with special educational
needs to attend mainstream schools.

Another manifesto commitment was long-term care. The Royal
Commission on Long-Term Care was tasked with solving a problem at
the heart of the welfare state, namely, where does social care end
and health care begin?

Boldly, the commission recommended long-term care should be
free. But last year the government chose the minority report – that
nursing would be free, but personal care would be means-tested. As
a concession, for the first three months of admission to
residential and nursing home care, the value of a person’s home
will be disregarded from the means-testing rules.

As a result of devolution, the Scottish Parliament is taking a
different approach.

Care homes also came under the spotlight. Work began on
standards in 1999, published this year and due to come into force
in April 2002. They cover choice of accommodation, health and
personal care, social activities, complaints, staffing and
management.

The standards will be implemented by the National Care Standards
Commission. From 2002, local authority inspection and regulation
units will transfer to the NCSC, which will also regulate care
homes, children’s homes, domiciliary care agencies, adoption and
fostering agencies, as well as private and voluntary hospitals.

Usually, wherever standards were published, a strategy could be
found close by.

The National Learning Disability Strategy launched in 1999
resulted in a white paper this year, while the Mental Health
Strategy of 1998 led to a green paper, white paper and proposed
reform of the Mental Health Act at the end of last year. The
government wants to see 24-hour services, assertive outreach teams,
better treatment and more staff.

The underpinning of the strategy by the modernisation of the
care programme approach in 1999 contains much of Labour’s health
and social care philosophy – integration of health authorities and
social services, two levels of CPA service and crisis planning.

Mental health was also subject to another government creation –
the national service framework, comprising aims, standards,
milestones and timetables. Older people’s services also received an
NSF this year.

Another innovation was the creation of the role of tsar to lead
change or reform. Older people got Professor Ian Philp, mental
health got Professor Louis Appleby. Keith Hellawell and Louise
Casey represent drugs and homelessness respectively.

There was no national service framework for asylum seekers, and
they didn’t get a tsar either. The Immigration and Asylum Act 1999
created the National Asylum Support Service and the universally
condemned voucher scheme. The accommodation and support of
asylum-seekers transferred from local authorities to Nass in April
2000, but by the Labour Party conference in September, campaigners
had won a government concession to review the voucher scheme. The
Home Office promised to act quickly, but recently announced the
review would be delayed until after the election.

Social work itself was not forgotten. The Social Care Institute
for Excellence will be established this year and aims to develop a
knowledge bank of research-based good practice.

Adoption is also set for change – the first major review in 25
years. The government wants an increase in adoption from local
authority care, more national standards and a national adoption
register.

There was other progress on adoption with the enactment of the
Adoption (Intercountry Aspects) Act 1999 which promised new
safeguards for children adopted from abroad. Key sections of the
act were only brought into force this year following the Kilshaws’
internet twins fiasco.

As with many areas of social care, strategies are in place.
Indeed, local government is drowning in plans, consultations,
reviews and targets which it must address. But the full impact
remains to be seen. As the government might say, much has been
rolled out, but not everything is online. An early election helps
to avoid potentially trickier questions that arise through
implementation. Ask the asylum seekers about that.

Could do much better

How successful has New Labour’s social policy programme been?
The problem of assessing it is that Tony Blair’s government
combined grandiose claims of a new dawn: “Rediscovering a true
national purpose” and becoming “a model of a 21st century developed
nation” with very modest specific targets. In short, the rhetorical
victories have outnumbered the material achievements.

New Labour aimed to change the moral and political culture
around welfare issues; to reform the tax-benefit system; and to
improve the performance of public services. The flagship programme
was directed at unemployment and the most striking successes have
been in reductions of young claimants (around 70 per cent), and
increased labour-market participation by lone parents (about 30 per
cent). This reflects the resources ploughed into the New Deals and
into improving incentives through the Working Families Tax Credit
scheme.

But has the government, as ministers boast, simultaneously
delivered a blow against the twin evils left by 18 years of
Conservative rule – poverty and social exclusion? New Labour was
keen to redefine social justice in such a way that this claim could
be upheld. The objective was to move from a welfare state “that
primarily provides passive support to one that provides active
support to help people become more independent”.

This justified holding down benefit rates, putting pressure on
claimants to take short-term, low-paid jobs, and emphasising their
“responsibilities” because “work is the only reliable route out of
poverty”.There is no question that this strategy has been
politically successful. Labour’s pre-election research had shown
that taxpayers were willing to pay more to support “deserving”
groups – pensioners, disabled people and their carers, “hardworking
families with children” – but not lone parents and those claiming
unemployment benefits.

The doubt is whether this strategy has delivered social
inclusion for those now in employment or “security” for those still
outside. Statistics on continuing inequalities, and the evidence
from disadvantaged districts, suggest that it has not.

This is hardly surprising. On the one hand, the kinds of jobs
created – primarily in service work, not least in social care – do
not provide “ladders of opportunity”. More often, they trap workers
in exploited, insecure positions, on poverty wages. Furthermore,
they arise in more affluent areas, away from pockets of
deprivation. There is no question of them becoming members of the
communities in which they work, because housing costs there are too
high. In other words, their employment still leaves them excluded
on several dimensions.

On the other hand, new programmes for the regeneration of poor
areas favour private sector initiatives and create little new local
employment. Schemes that are focused on the resident population,
such as the New Deal for Communities and the work of the Social
Exclusion Unit, target problems like crime, drugs, and homelessness
– issues of control and enforcement.

In the public services, New Labour’s determination to stick to
Conservative spending plans meant that the necessary long-term
investment has only just begun. Instead, the government has relied
on detailed top-down prescriptions, quality standards, targets, and
a whole range of measures aimed at “joined-up” approaches.

Nearly all New Labour’s claimed achievements in this part of its
programme are contested and involve redefinitions of goals or
manipulations of statistics. The overall picture, as in transport,
the environment and the public infrastructure generally, is of
continued neglect and dilapidation, with staff struggling to keep
faith, and to cling to future promises of Treasury benevolence.

Because of tight constraints on public sector pay, recruitment
crises have hit all these services, especially in cities such as
London, where house prices have risen sharply. It is ironic that
New Labour, so obsessed with tight immigration controls, should
last year have been forced to reverse its line on “economic
migration”, partly to allow the overseas recruitment of desperately
needed teachers, nurses, and social workers.

Finally, New Labour’s attempt to appear tough on crime and
asylum has been costly, not least because it has stirred up
populist movements and opened the door for political opportunism by
its opponents. If social justice includes a rational and tolerant
climate for debate on these issues, the government has failed in
this also.

On balance, New Labour’s record may be seen more positively if
it is judged in the light of the social legacy of the
Thatcher/Major years, rather than that of its own grandiose claims
of radicalism. As an interim, transitional programme, it has been
modestly successful. But it will need to reassess its goals and
even the direction of many of the changes it has initiated during
its second term in office.

Above all, the emphasis on opportunity as the basis for social
justice cannot be sustained if employment is taken as the only
relevant yardstick. A more embracing notion of inclusion, a broader
concept of engagement and participation, and a more generous
approach to redistribution, are all needed.

Bill Jordan is professor of social policy at Exeter and
Huddersfield Universities, and reader in social policy at North
London University. He is the author (with Charlie Jordan) of
Social Work and the Third Way: Tough Love as Social Policy
(Sage, 2000).

View of the Community Care readers’ panel

Bhaggie Patel, project leader with the Barnardo’s Phoenix
project in Bolton, which supports Asian women and children
experiencing domestic violence:

There’s a difference now. There’s much more of an interest in
social care on the ground locally. More people are going into
social care, especially from black communities, because of the
changes New Labour has bought in, such as new funding for
initiatives. People have seen there is a career to be had in social
care, in terms of providing services for their communities.

Abdul Sattar, social worker with the Family Service Unit in
Birmingham:

Since coming to power, New Labour has introduced a number of new
initiatives, for example, Quality Protects and Sure Start to
strengthen existing services for children and families. These
initiatives have been well received generally but their impact is
difficult to evaluate. Therefore it is too early to say that things
have improved a great deal under Labour during their first term in
office for social care professionals and users.

Rita McIntyre, outreach support work in mental health with the
Richmond Fellowship in Liverpool:

I would have said things had improved a year or two ago but in
recent months, I would say no. It’s all down to money – there
doesn’t seem to be the volume of money. Here in Liverpool we are
very short of psychiatrists and community psychiatric nurses – it’s
really becoming a recruitment problem and it’s all down to
money.

Simon Southworth, senior practitioner, Kent social services
substance misuse team:

I do feel things have improved under Labour. It seems that we
are no longer battling with a government that refuses to
acknowledge the needs and skills of the social care workforce. This
recognition is important as we continue to face further pressures
at work.

Julia Saunders, rehabilitation officer, RNIB visual impairment
service, Solihull:

For those of us delivering front-line services, the New Labour
government seemed to hit the nail on the head with its emphasis on
the importance of partnerships, preventive care, and joint working.
However, it has absolutely failed to address the conundrum of
ever-increasing demands on social services due to demographic
change with commensurate resourcing, which leaves us in
considerable uncertainty.

All our panel members are speaking in a personal
capacity.