A shared responsibility

The current crisis over the funding of care
home places for older people looks like a clear-cut case of age
discrimination. But the truth is more complex. The amount local
authorities are willing to pay for older people to stay in
residential care is certainly a national scandal, but it is not one
of their own making. Scotland may have moved a step closer to
resolving the dispute between care homes and councils, but in parts
of south Wales and the south of England the situation is grim. Care
homes are demanding substantially higher fees and some councils
have stopped referring clients in consequence. Councils rightly
blame chronic underfunding from government.

These developments could hardly have come at a
worse time. Local authorities are facing unprecedented pressure to
speed up hospital discharges and, presumably with the wave of a
wand, solve the perennial problem of bed-blocking within two years.
Never great, the chances of success will be even more remote if
councils cannot rely on the full co-operation of care homes in the
private sector. Yet hospital trusts and their friends in government
are likely to turn up the heat relentlessly.

So is it age discrimination? Well, yes and no.
True, local authorities have consistently prioritised children’s
services over older people’s services. Child protection and the
needs of children and families have frequently dominated the social
services agenda, perhaps because there has seldom been a time when
the subject wasn’t in the headlines due to one inquiry or another.
And perhaps also because this government, through initiatives such
as Quality Protects, Sure Start, and its commitment to end child
poverty, has laid so much emphasis here.

Help the Aged, which has launched a campaign
against age discrimination, says that the malaise is “endemic
across public institutions,” pointing to unofficial upper age
limits for NHS treatment as another example. But the government’s
response is muted because people allow it to be. The simple truth
is that there are more votes in children and families than there
are in older people. Until age discrimination is recognised as the
responsibility of us all, not just a few hapless officials in the
public sector, social services priorities are unlikely to change.
 

– See news, page 8 and 14

Dangerous obsession

Evidence from Haringey voluntary organisations
to the Victoria Climbie Inquiry this week suggests the management
culture in the social services department could have assisted in
creating a climate where staff failed to raise concerns about
pressure on the child protection service.

Senior management were focused on meeting
government targets at all costs rather then ensuring that a child
was protected from abuse. Addressing needs came second to meeting
targets and obtaining the crucial thumbs-up from government
inspectors, thereby avoiding a lambasting by health secretary Alan
Milburn. This top-down approach to managing performance means
workers are not heard. They become disillusioned and stop informing
their bosses about day-to-day issues. They become defensive and
feel they have no ownership of the service they are providing. The
result is a divided department with potentially dangerous
outcomes.

Yet senior managers are merely abiding by the
government’s rules. Rules devised by a government which mistakenly
believes that meeting often ill-conceived targets equates with
providing high quality services. This obsession with targets must
end and social services managers must be allowed to focus on
clients, not inspections.

– See news, page 6