Under health, by stealth

Care trusts are the government’s favoured vehicle for the
delivery of social care and if local authorities show any reluctance to form
them, they will be imposed. That was the message from health secretary Alan
Milburn to the national social services conference.

Last week’s attempt by Carole Bell, the Department of
Health’s care trust supremo, to reassure local authorities that the trusts
would not be compulsory was a disaster. Not only did her attempt appear
irrelevant coming two weeks after Milburn’s speech, but she went on to ignite
further fears by admitting that money in care trust budgets could be moved to
where areas of pressure were discovered.

The health secretary already has extensive powers under the
Local Authority Social Services Act 1970 to impose whatever he wants if he
decides an authority is failing. And there is no doubt that Milburn would take
on any opposition. This government did the same with primary care trusts, which
began life as voluntary bodies but were eventually imposed.

The government does not even need to use compulsion. There
are other ways in which it can force the introduction of care trusts: it could
offer inducements in the shape of further freedom and financial control to
local authorities that form care trusts. It could also offer larger shares of
special funds, just as the social services departments that win three stars in
the new rating system have already been promised.

In this whole farrago the government has never stopped to
ask whether social care service users will benefit from the development of care
trusts. But this process is not about improving service delivery for them – the
Health Act 1999 flexibilities did that. This is about central government taking
control of local authority-run social care services. And the way they plan to
control those services is via the centrally-run NHS.

The government must now admit this is its aim and stop
trying to take social care into health by stealth.

See News, page 6

Social care needs men

Social care agencies must strive to reflect their
communities, but it will soon be impossible since an overwhelming 92 per cent
of young people studying for vocational qualifications in health and social
care are girls.

The Equal Opportunities Commission (EOC) is campaigning to
challenge career stereotypes. But it may be all too easy to divert girls from
stereotypical career choices (thereby exacerbating the social care recruitment
crisis), without boys having much desire to replace them. As we know from
family roles, girls readily appreciate they have just as much right as boys to
high status activities like earning money and forging careers – then they come
home and do the child care and housework. It seems only women abhor a vacuum.
Men abhor a vacuum cleaner.

Social care must not become a women-only occupation. Both
the EOC and, more importantly, the Department of Health in its current
recruitment campaign, should specifically target boys and men to promote social
care as a career.

But the lack of men also highlights another truth about the
recruitment crisis: advertising will not succeed unless the status of social
care is higher. And this requires concerted effort on two fronts: pay and
conditions, and the public image of social care. If those could be improved, we
might start to resolve the gender imbalance. Even more importantly, it would
acknowledge the skills and commitment of millions of women.

– See News, page 12