PUBLIC SERVICES TAKE CENTRE STAGE IN NEW TERM

As New Labour wins a mandate for another term, many are left
wondering what the new administration has up its sleeve for social
and public services. Linda Steele takes a look at who the potential
winners and losers might be in the plethora of promised and
forthcoming legislation in the fields of mental health, learning
difficulties and adoption.

Public services have finally made it to centre stage in a
general election. Schools, hospitals, transport, crime and welfare
through work will be key for Prime Minister Tony Blair’
newly-elected government. But what do the coming months hold for
social care?
First, the ever closer integration of social care and health –
known to some as the health takeover – will continue apace. Care
trusts got the go-ahead in the Health and Social Care Act just
before the election. “We’re worried that local, democratic control,
provided by social services and local government, is not
sufficiently valued by this government,” said Unison’s social
services officer, Owen Davies. “Joined-up services are a good thing
but our concern is that care
trusts could become the normal or preferred model of
provision.”
Julian Le Grand, social policy professor at the London School of
Economics, thinks the writing is on the wall. “Will we see child
care go to education and care of the elderly go to the NHS [in care
trusts]? Yes, we will,” he said. “It’s fairly clear that the day of
the generic social worker is over.

“But that’s further down the line. More immediately, the
newly-appointed ministers – or reappointed, in the case of health
secretary Alan Milburn – will get together with the whips to decide
what will make it into the Queen’s Speech on June 20.
This will be the moment when the government sets the tone for the
kind of administration it wants to be. Competition to get bills in
will be immense – where it’s not a foregone conclusion.
The widely applauded learning difficulties white paper, Valuing
People, could be an early victim. Mencap will be campaigning hard
to get learning difficulties onto the agenda. Richard Kramer, the
charity’s head of campaigns, says they will be “seeking an
effective framework for decision-making for adults who do not have
the capacity to communicate their wishes themselves….[and]
the introduction of a new ‘abuse of trust’ law to outlaw sexual
relationships between care staff and those they are caring
for.”
As in 1997, New Labour’s first session of parliament is likely to
be a long one – 18 months – with between 12 and 18 bills. It will
be a showpiece session, so anything that’s not a top priority could
wait till November 2002.
There’s a chance that the reform of the Mental Health Act 1983
could be delayed, but campaigners are fairly optimistic that a bill
(which is probably already being drafted) will appear in November.
Although one expert has voiced concern that the plans for detention
of those “dangerous people” with antisocial personality disorders
could go ahead separately from the wider reform, this seems
unlikely. Uncoupling personality disorders and generic mental
health services, brought together in the white paper Reforming the
Mental Health Act, would require much reworking, administration and
extra legislation.
But the bill, however and whenever it appears, will not get through
unchallenged by lobbyists. “There’s no legal right to an assessment
and services. This legislation is a fantastic opportunity to
introduce that,” says Mind’s campaigns manager, Sue Brown. And the
personality disorder proposals and plans for compulsory treatment
in the community will be opposed. But the bill is unlikely to be
the government’s biggest hurdle in mental health.
New Labour has acknowledged that services must be expanded and
improved dramatically – currently around one person in three with a
serious mental health problem doesn’t get help when they seek it.
Andrew McCulloch, head of policy for the mental health charity the
Sainsbury Centre, says: “The Sainsbury Centre estimates that 8,000
new staff will be needed in mental health services alone to
implement modernisation plans. And, without a radical skill mix and
working smarter, it’s hard to see where people will come from,
given staff shortages.”

In fact, implementation across the board will create
difficulties for second-term New Labour. Crippling staff shortages
exist in social care, and elsewhere in the public sector. Without
another look at salaries and an overt commitment to valuing workers
and the public service ethos, it’s hard to see this huge problem
melting away.

While the new delivery unit in the Cabinet Office may succeed in
chivvying up the civil servants in the big spending departments,
thereÕs no magic formula for delivering on the ground if staff
are demoralised and in short supply.
Another problem will be the disparities in long-term care with the
Scottish executive’s promise to introduce both free personal and
nursing care. The government is sticking to its position of
means-tested personal care in England, despite the tensions the
stance will inevitably create.
The flash point could, however, be public-private partnerships,
with public sector unions already promising to oppose further
incursions by the private sector. A report from Downing Street’s
favourite think-tank, the Institute for Public Policy Research
(IPPR) which is due out in a fortnight, is likely to suggest that
private contractors should be allowed to run many more publicly
owned services.
The recommendations may not touch directly upon social care, about
half of which is already delivered by the independent sector, but
will cover organisations that social services work closely with,
such as primary care groups.
“Blair will be told by the IPPR that privatising public services is
the key to winning a third term. But it’s a policy certain to
create a backlash from a public that wants better services – not
the costly failure privatisation will inevitable turn out to be,”
said Malcolm Wing, Unison’s head of local government.Le Grand, who
sat on the commission that drew up the report, disagrees: “it’s not
going to be an unequivocal cheerleader for the private sector –
it’ll be quite critical of PFI [private finance initiative], for
example. I think it will present a balanced view.”
But not everything will be controversial. Campaigners are happy
about the likely reintroduction of the Adoption and Children Bill,
which ran out of time before the election. Felicity Collier, chief
executive of British Agencies for Adoption and Fostering, said: “I
think adoption will have a high profile and I’m very pleased.” But,
alluding to the fact that some felt that consultation and the
drafting of the bill were rushed, she says: “There must be adequate
time for debate in the legislative programme. It’s desperately
important that we get it right.”
While Labour’s manifesto only promised consultation on extending
the role of the national children’s rights director, there is
speculation that a children’s commissioner may be announced in the
autumn. In the meantime, children’s charities will be lobbying
politicians. “The children’s commissioner is an achievable goal if
the political will is there,” says Michelle Mitchell, the NSPCC’s
parliamentary adviser.
And the ambitious pledge to end child poverty by 2010 will remain a
high priority. “One of the implications of the size of its majority
is that the government will now be able to think over a much longer
term and develop a radical programme,” says Stephen Burke, Daycare
Trust director. “But it takes a long time to turn around services.
The comprehensive spending review in 2000 promised 900 new
neighbourhood nurseries, but they won’t be visible till 2004.”And
delivery of high quality social care and other services is crucial
to New Labour this time around. Blair knows that voters will judge
his government on whether public services improve, and are seen to
improve.

Tougher regime ahead
One of the first tasks facing new home secretary David Blunkett
will be to choose between the options outlined in a sentencing
review by civil servant John Halliday. It’s likely that shorter
sentences could be divided between prison and probation, with
inmates being electronically tagged, a scheme dubbed “custody
plus”.
But there’s a feeling abroad that, whatever Blunkett goes for, it
won’t be a more lenient regime. One criminal justice expert says:
“Blunkett has put it about that he will make Straw [the previous
home secretary] look like a screaming girl’s blouse.”
Cracking down on persistent offenders will be the big target, and
as many as 9,500 extra prison places could be on the cards.
“But he will bring a background in education and there will be an
emphasis on the redemptive power of education and work,” says a
spokesperson for Nacro, the crime reduction charity. Skills
training and education will be seen as important, both in prison
and in the community.
The Youth Justice Board is likely to take over responsibility for
18-21-year-olds in jail. For the under-18s, there will be a bigger
emphasis on restorative justice and community reparation, with
young offenders atoning for their crimes through activities such as
cleaning graffiti. And there will be a greater use of intensive
supervision and surveillance programmes for young offenders. Under
these programmes, organised by youth offending teams, young
offenders have a strictly monitored timetable of activity, such as
life skills training, visiting mentors and college.
Joyce Moseley, chief executive of RPS Rainer children’s charity and
Youth Justice Board member, says the programmes were “a means of
getting appropriate help to young offenders to stop them
reoffending, giving them the potential to move on – and keeping
them out of custody”.

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