We need one for all

Children
need a "champion", as Association of Directors of Social Services
president Mike Leadbetter put it this week in his evidence to a Commons
committee on human rights. That champion, of course, would be a children’s commissioner,
something that Wales possesses but that England has been denied by the
government.

Among the many advantages in the creation of
such a post is that it may prompt a comprehensive review of the future of
children’s services. There is no shortage of individual initiatives whose aim
is to improve children’s lives: Quality Protects, the National Childcare
Strategy, child tax credit, Sure Start and the Children’s Fund are just a few
of the initiatives into which billions of pounds of public money are being
poured. What is lacking is a single, unified view shared by all the agencies
working in the field about how best to serve the interests of children,
whatever their background.

What, for example, should the future hold for
children and families social services in local authorities? In some parts of
the country integration with education will be the future, but this is a
solution that too often happens by default, a by-product of the decision to
integrate adult social care with health. But surely more thought should be
given to the role of children and families social services as such and how they
fit into the jigsaw whose other pieces include not just education, but the
voluntary sector, health, Sure Start, the Children’s Fund, early years
services, and others.

In its new report, Tomorrow’s Children, the
ADSS calls for the development of a strategic organisation responsible for
commissioning all child care services, including education and youth services,
as well as social services. But, as the ADSS acknowledges, even more is needed.
Much more attention should be paid to outcomes for children and cross-agency
agreement. At present, different agencies have different responses to children
with similar needs when one answer is plainly better than the other. Sometimes
agencies may compete, however unwittingly; Sure Start for example, occasionally
duplicating services already provided by social services or the voluntary
sector.

Mike Leadbetter told the Commons committee
that a children’s commissioner would have powers to force agencies to act in
the best interests of children. But it would be better still if they did not
have to be forced.

Ask the right questions

At
last it is beginning to be possible to plan the future of care for older people
based on evidence of what will work better.

But the research paints a complex picture.
The Wiltshire study, published this week, shows that although co-location of
health and social care teams speeded up referrals and assessments, it did not
improve outcomes. The study’s authors say integration has not yet gone far
enough in Wiltshire; in Somerset greater integrations was shown to benefit
users (News, page 6, 11 April).

But what are improved services if outcomes
don’t improve? The co-located teams supported fewer people in their own homes.
And the incidence of depression among service users was higher. It is to be
hoped that greater integration will indeed translate into better outcomes, as
the authors suggest. But it could bring an even greater danger if user choice and
independence become compromised by the imperative to move people more quickly.

As integration progresses, we must continue
to seek an answer to the central question posed by this research: can users,
and a social model of their needs, still find a voice? And where users do
benefit from new structures, we must find out why – and make sure that
knowledge is shared.