Interview with Jacqui Smith, the new health minister
with responsibility for social care, by Community Care’s
news editor Janet Snell.

The phonecall came at 6pm eight days ago. “Downing Street here.
The prime minister’s on the line – can I put him through?”

Two minutes later Jacqui Smith was health minister, taking over
the brief on social care from John Hutton. She’d been expecting the
call – if you’ve heard nothing by lunchtime it means you probably
haven’t been sacked. “So I was starting to wonder ‘where do I go
from here? And when he said a promotion to health minister I was
absolutely delighted.”

Even with social care as part of the portfolio? “Very much so.
The prime minister said to me: ‘This is going to be a challenging
role Jacqui.’ But I could tell it’s something he really

So as a former junior schools minister, how does she begin to
get to grips with a brand new subject area? “I suppose my starting
point is that I taught for 11 years and I know about young people.
And then being an MP I know a fair bit about the way the social
care world impinges on my constitutents. I was also a councillor,
albeit at district level, and of course I have my experience as a
parent to draw on. But my first task is to get up to speed on the
policy areas and issues and the priorities in the department.”

John Hutton is just down the corridor and he has been generous
with his time discussing how he saw things and the probable lie of
the land in future. “But I’m also doing a bit of thinking through
for myself around what I want to do with this.”

Coming from the education department she believes she can look
at health and social care from a fresh perspective.

“And if my previous jobs have taught me anything it’s that
joined up government has to be so much more than simply a mantra
you chant in Whitehall.

“It starts with ministers and departments talking to each other
in a meaningful way. You can’t expect links and partnerships
locally unless we’re doing it nationally too. When it comes to
breaking down Berlin Walls I don’t get a sense we’re completely
there yet. But there’s some incredible work going on.”

She sees her core role as “making things work better” for the
people at the heart of the service. But she is well aware of the
scale of the task ahead. “I had my constituency surgery on
Saturday, and saw a woman whose son has severe disabilities. She’s
been struggling for as long as I’ve known her but at last her son
has got a place in supported accommodation. Fantastic. But
unfortunately his care package was removed with 10 minutes notice.
The lesson I drew from her experience was though it’s clear we have
made progress in four years, as far as users are concerned there is
still a sometimes devastating lack of co-ordination.”

So when it comes to sorting things out, will she adopt
Boateng-style abrasiveness or the Mr Nice Guy approach of John
Hutton? “It would be unhelpful for me to start this job by coming
in and criticising social workers. Ok, I’m not here to make friends
– I’m here because I want to improve services. But I don’t think
you can do that by setting up conflicts.

“I’m trying to understand the sort of pressures on social care
staff. I think they are well aware working in this field is not
about having a comfortable life, and I know nobody comes into it
unless they are really committed to improving things.”

One of her early aims is to boost the status of the profession
and promote the idea of social care as a career rather than just
another job. “I want to help make it a respected profession and I
think one way of addressing that is the reform of social work
education. People should be clear about what it is they need to be
learning so they can function in the job. I think at the moment
employers don’t feel that’s happening. And I think the three-year
qualification can help change that.”

Something else she brings from education is a passionate belief
in continuing professional development. “Being a learning
profession and an evidence based profession is a key part of
improving status and morale. That’s why Scie is such an important
step forward.”

On the issue of recruitment and retention she stresses the
importance of broadening the recruitment pool. “Traditionally to
work in social care you had to have life skills and have taken a
few knocks, so staff tended to be older. But younger people have
something to contribute too, and I think we could look at using the
gap year between school and college to draw people in. They could
work towards a qualification that would equip them for social care
or for one of the other professions. But why shouldn’t social care
be a first job?” Meanwhile at the other end of the scale she plans
to try and make more use of the untapped resource of older

“My job is to deliver better services and I’ll do everything I
can to make that happen. I’ll certainly talk up the sector when I
can. I pick up on the fact that social care feels somewhat in the
shadow of health care and all I can do about that is to be, as John
was, a champion for all the good things that are happening in
social care. But I’m not in the business of making excuses for bad

As for the debate over whether social services departments have
a future, her line is that she’s not “hung up on administrative
structures”. “I don’t see things in terms of which department a
function happens to be in. But I do think social service functions
have a key part to play. Whether that’s delivered across a care
trust, or through joint management between health and social
services or in a children’s service with input from education, or
in a new way in localities – I don’t see that’s a threat to social
work. There will always be a need for social care input and I’m
pragmatic about how it’s delivered.”

Just over a week into the job Smith says that what has impressed
her most has been the way that her new department brings together
health and social care policy “not in way that’s threatening for
social care but by recognising the contribution that both sides
have to make. All I would say to social workers is ‘be confident
about what you are doing right and about what you have to offer’.
We won’t improve anything by digging ourselves into bunkers.”



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