The price of independence

The
shock withdrawal from Wales of the Children’s Society has led Jane
Hutt, the Welsh minister responsible for children’s services, to
call for a task force bringing together all relevant interest
groups in Wales.

What a
good idea. What a shame such a body couldn’t have considered the
Children’s Society’s move beforehand, in the context of services
across the principality.

Meanwhile, the NSPCC faces allegations, from its own staff, that
cuts made by the charity will leave gaps in service provision in
parts of England. The NSPCC is merely exercising its right to make
decisions autonomously, on the basis of its own priorities and
funding position. But even private firms, if they provide essential
services, are subject to the overview of a third party – regulators
would not allow areas to be left without water, for example.

Services
for the most vulnerable and damaged children are in turmoil across
both statutory and voluntary sectors. The statutory sector is
starved of funds, and as social services departments confine
themselves to statutory work, other equally vital services have
increasingly been left to charities.

Now many
charities find donations are falling and campaigns – such as the
NSPCC’s Full Stop campaign -Êare raising less money than
forecast. And when charities in turn withdraw from vital services,
there is nobody to pick up the pieces.

There
should be a strategic overview of the provision of children’s
services in all parts of the UK. Any agency – whether statutory or
voluntary – should be called to account if it plans to abandon
services which have been identified as necessary.

Only
last week, Treasury minister Paul Boateng told charity chief
executives that the government would never threaten their
independence. But that independence has its price, and vulnerable
children are paying.

Ultimately, the government must be called to account for the
inadequate funding of children’s services across the board. The
independence and autonomy of charities, which currently cannot be
challenged even in extreme cases, is a smokescreen behind which
those who should be responsible for the bigger picture are
hiding.

See
news, pages 6 and 12

The right kind of merger

The
government has said that it is determined to end the annual
bun-fight in which social services and health blame each other for
the inevitable winter “bed-blocking” crises. It has put up an extra
£300m to cure the ills of bed-blocking by 2004, an ambitious
target even by this government’s standards. The money may go some
way towards producing a more co-operative spirit between those
social services departments and health trusts which have been at
loggerheads over how and when to discharge older people from
hospital, but it is unlikely to go the whole way.

So the
British Medical Assocation’s call for a merger between the National
Care Standards Commission, which will monitor standards across
social care from next April, and the Commission for Health
Improvement, responsible for health service inspections, deserves
serious consideration.

The NCSC
will be responsible for inspecting a range of nursing home and
intermediate care facilities in the independent and statutory
sectors. The CHI will also be able to inspect health service
delivery in these facilities. It makes sense to combine inspections
in one organisation, and not just for administrative reasons.
Integrated inspections across health and social care boundaries
could help to integrate services. That is a goal well worth
achieving.

See
news, page 6