Hospitals are in chaos because they cannot discharge older
people quickly enough; social services are in chaos because they
cannot fund enough residential care placements.
This week the crisis is in Birmingham but it is an old story
that has been told many times in many parts of the country. What is
disturbing in Birmingham’s case is that the council has been forced
to plunder £3 million from its neighbourhood renewal budget to
pay for residential care.
There are at least two morals to be drawn here. The first is
that there is a desperate shortage of money to run core services,
despite the many specific schemes with earmarked funding. Quality
Protects, the children and young people’s unit, intermediate care,
and neighbourhood renewal – all have come with their own pots of
cash. In the meantime, frontline services for client groups
including children, families and older people have been left
gasping for the oxygen of adequate resources and full, vacancy-free
Former Labour leader Neil Kinnock called this week for a
hypothecated tax for the NHS and community care, a proposal that
the government may eventually have to adopt even if it has to run
the gauntlet of middle England to do so.
The second moral is equally fundamental. It is that preventive
projects conceived with the aim of empowering disadvantaged
families and communities will always lose out when local
authorities are required to service more urgent needs. If social
care services were able to spend less time putting out fires and
more time building a communal fabric resistant to those fires, so
much the better for society.
The neighbourhood renewal unit, based in the new Department for
Transport, Local Government and the Regions, has been tasked with
strengthening communities and creating the conditions in which
individual hopes and aspirations can gain a foothold. But, as
Birmingham’s example shows, the chances of success will be much
reduced as long as the next emergency beckons.
Where has social work been in the debate about social exclusion
and neighbourhood renewal? The question is moot because these
policies used to be what social work was about. Or supposed to be
about. The Commission for Racial Equality, following the recent
unrest in Burnley, Oldham, Leeds and Bradford, cried out for
“leadership on the ground” and for marginalised white and Asian
communities to be given reason to believe that they have a stake in
It ought to be a providential opportunity for social work, but
while their health colleagues have risen to the challenge of health
action zones, social workers have been reticent. Understaffed,
under-resourced and under-paid, social work’s frontline has reached
breaking point. The tragedy is that, unless something changes
rapidly, so will many more of our communities.