The post-election reshuffle has moved former junior education
minister Jacqui Smith into the health and social care hot seat.
Janet Snell asks the new minister about her plans for the
portfolio.

The phone call came at 6pm nine 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 social care brief 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,” she says.

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
values.”

So as a former junior schools minister, how does she begin to
get to grips with a brand new subject area? “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 constituents. 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.”

Hutton is just down the corridor and has been generous with his
time discussing how he sees things and the 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,” says Smith.

Coming from the former Department for Education and Employment,
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,” she says.

“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.”

Smith 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 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 the
abrasive style of former Home Office minister Paul Boateng or
Hutton’s Mr Nice Guy approach? “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,” she says.

“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 as just
another job. “I want to help make it a respected profession, and
one way of addressing that is the reform of social work education.
People should be clear about what they need to be learning. I think
at the moment employers don’t feel that’s happening. And 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 [the Social Care
Institute for Excellence] is such an important step forward.”

On 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, and 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?” At the other end of the scale, she plans to try to make more
use of the untapped resource of older people.

“My job is to deliver better services and I’ll do everything I
can to make that happen,” she says. “I’ll talk up the sector when I
can. I pick up on the fact that social care feels somewhat in the
shadow of healthcare, and all I can do about that is to be, as John
Hutton 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 practice.”

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 social service functions have a key part to
play. Whether that’s delivered across a care trust, through joint
management between health and social services, in a children’s
service with input from education or in a new way in localities, I
don’t see a threat to social work. There will always be a need for
social care input and I’m pragmatic about how it’s delivered.”

Smith says that what has impressed her most so far is the way
her new department brings together health and social care policy
“not in a way that’s threatening for social care, but by
recognising the contribution 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.”

High-flier had an early start

Jacqui Smith, the new minister of state for health and social
care, is, in the words of one Westminster insider, “the archetypal
Blair Babe – articulate and utterly loyal to the prime minister and
New Labour”, writes Bill Jacobs.

So her boss Alan Milburn can expect little trouble from his new
minister of state. And the reform of adoption procedures is set to
be pursued with vigour.

Smith’s promotion from junior education minister was widely
expected after a highly competent performance in the job.

Married to a civil engineer, Smith, 38, has two young sons and
was a teacher – as were both her parents – before being elected as
MP for Redditch in 1997.

She was head of the economic and business studies department at
Haybridge High School and a member of the National Union of
Teachers.

She started her political career early when, at the age of
seven, she tackled a local councillor over whether she and other
children should be allowed to ride their bicycles on the pavement
in her home town of Malvern. Inevitably, in view of her future
career, she won the argument.

Aged 16, she signed up with the Labour Party. Then, while at
Hertford College Oxford, where she studied politics, philosophy and
economics, she moved up the party ranks to become secretary of the
National Organisation of Labour Students.

She worked as a researcher for Labour MP Terry Davis before
going into teaching, having taken a postgraduate teaching
certificate at Worcester College of Higher Education.

She moved into local government as a Redditch borough councillor
in 1991, ending up as development chairperson. She also joined the
Labour Party’s West Midlands Regional Executive in 1996 and became
vice-chairperson of Redditch Constituency Labour Party.

She contested Mid-Worcestershire in 1992 but lost. She was then
selected to stand for the successor Redditch constituency from an
all-woman shortlist in 1995 – before such shortlists were ruled
illegal by the courts.

Within a month of winning the seat in 1997, she was making her
maiden speech in the House of Commons, vigorously defending the new
government’s decision to scrap tax relief on pensioners’ medical
insurance premiums.

—————————————————————————————-

Drugs bodies fear hard line

Organisations working with drug users are concerned that
anti-drugs policy may be about to shift towards law and order at
the expense of treatment. Sarah Wellard reports.

The confirmation that David Blunkett, the new home secretary, is
to take over policy on drugs from the Cabinet Office is causing
concern among organisations working with drug users and their
families.

Blunkett is known to take a tough line on drugs, in contrast to
the relatively liberal views of the former Cabinet enforcer, Mo
Mowlam. Commentators fear that the change may lead to greater
emphasis on law-and-order aspects of anti-drugs policy at the
expense of treatment and rehabilitation.

Hywel Sims, director of Adfam National, a charity supporting the
families and friends of drug users, is worried about a potential
hardening of policy against people who use drugs. “We would be
concerned about any attempt to demonise users,” he says. “It has a
vicious effect on families.”

Roger Howard, chief executive of Drugscope, adds: “We are
looking for reassurance that the crime agenda will not eclipse some
of the valuable health, education and prevention initiatives that
have been developed and co-ordinated across Whitehall.”

The switch of drugs policy to the Home Office reflects
ministers’ anxiety that their strategy for tackling drug abuse is
failing. There are estimated to be half a million heroin users in
the UK – a thousand-fold increase in 30 years. A survey published
last month from the London Arrest Referrals Monitoring Database
found that hard drug use among people in police custody is reaching
alarming levels, with 57 per cent admitting taking heroin and 52
per cent crack cocaine in the previous month. Sixty per cent of
users were spending at least £200 a week on their habit, with
29 per cent spending more than £500 a week.

It was also announced last week that the drugs tsar Keith
Hellawell has been asked to step down just one year into his new
three-year contract. He will take on a much-reduced role in the
Home Office of “tackling international drug trafficking on a
part-time basis”.

Hellawell was appointed with much fanfare when the Labour
government took office in 1997, but quickly fell victim to
Whitehall in-fighting. There were disputes about targets for
reducing consumption of heroin and other drugs, and clashes with
the Department of Health over treatment policy. His contract was
only renewed last summer after a personal appeal to the prime
minister.

Whether Blunkett will appoint a new anti-drugs co-ordinator to
take over from Hellawell is not yet clear. Mike Trace, Hellawell’s
deputy, is known to be highly regarded by Blunkett and is perceived
as having performed well in his role, but he is believed to be
looking to move outside government.

The Local Government Association (LGA) takes a more measured
view of the transfer to the Home Office of the lead on drugs
policy. Policy officer Noel Towe says: “I don’t think the change to
the Home Office is as significant as some make it out to be. Our
main concern is that the progress made by the Cabinet Office in
addressing departmentalism will go into reverse.”

Towe points out that the Home Office’s remit in relation to
drugs is already wider than the law and order agenda because it
houses the Drugs Prevention Advisory Service, which provides advice
and support to local drug action teams.

He also believes that Hellawell’s shift towards a broader
prevention strategy was needed to augment the individually focused,
harm-reduction approach. In April, the government announced a
£300 million package for local crime and disorder partnerships
aimed at helping communities tackle drugs and drug-related crime.
While some of this money will be spent on high-profile policing and
gadgetry such as closed circuit television, the main objective is
to build capacity in local communities to help them respond to
drugs – for example by enabling tenants’ associations to have
better control of estates.

However, critics point out that attempts to attack the supply of
drugs do little to deal with rising demand fuelled by rapidly
increasing numbers of drug users. In many parts of the country,
treatment is woefully inadequate. Heroin users referred for
methadone are having to wait as long as six months for their
prescription. And for many drug users, there is little prospect of
receiving any treatment unless they are already caught up in the
criminal justice system.

There are hopes that the National Treatment Agency, to be
launched later in the summer, will improve both the availability
and quality of treatment. Paul Hays, a chief probation officer in
south east London, is chief executive designate of the NTA and is
expected to take up his new post on 1 July. But the final remit for
the agency has yet to be agreed.

It is not yet clear, for example, whether alcohol abuse will
fall within its scope. Adfam’s Sims believes it is vital that it
does. He also wants the agency to adopt up-to-date treatment
models. “There’s been insufficient emphasis on designing treatment
for the rising numbers of users of cocaine and crack cocaine,” he
says.

Last summer’s spending review announcement of £480 million
over three years for local drug action teams to purchase treatment
has also been widely welcomed. However, it risks being derailed by
difficulties in recruiting suitably skilled and experienced
staff.

Hellawell’s legacy then, as Drugscope’s Howard points out, is
new investment in treatment and prevention. But it remains to be
seen whether this will be enough to turn the tide against
spiralling drug abuse and drug-related crime.