Primary care trusts have problems. That much is clear from this
week’s National Tracker Survey.
Their problems sound all too familiar. National targets threaten
to overwhelm local priorities. The demands of change management
divert attention and resources from their core functions. And they
are simply underfunded. There is an alarming gap between
expectations and capacity.
The government made the creation of PCTs compulsory, the
pressure mounted, and frontline services may suffer as a result.
Let that be a stark lesson as the government considers – as it will
– whether to pile on the pressure to form care trusts.
For social services, as we know all too well, are struggling
with the same problems as PCTs. Ironically, social services
managers are sometimes heard to yearn for some imaginary haven of
plenty within the NHS.
Imaginary indeed. It’s a cause for serious concern when the much
vaunted “stronger partner” in an enterprise is actually struggling.
And it’s even more worrying that primary care trusts and groups
don’t see social care as a priority, and are allowing social
services representatives only limited influence.
There are two main fears. First, that structural change will
continue apace regardless, at the government’s behest, without the
cultural change required if social care is to be more than an
afterthought in some areas.
And second, it is by now a proven fact that two sides who are
both short of money will never reach an agreement that benefits
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The possibility of hundreds of children’s guardians walking out
on the service should engender fear among social workers.
Cafcass, the new body to run the court welfare service, is
threatening self-employed guardians, who make up the bulk of the
service, that unless they accept reduced conditions as salaried
employees, they will have to leave the service.
And at the same time as forcing guardians out, Cafcass has the
audacity to launch a recruitment campaign.
Those running the new body appear to have no idea that providing
a sensitive service for children involved in care proceedings is a
complex and difficult task. That’s why children’s guardians have
traditionally been experienced social workers who have chosen to
continue working directly with clients. However, those running
Cafcass seem to believe the task can be carried out by lawyers or
Social workers must boycott these contracts and refuse to work
for Cafcass. Only then it appears will it recognise the need for
experienced social workers to run this essential service.