Milburn’s new roles given frosty reception

Tucked away in health secretary Alan Milburn’s speech at
the annual Association of Directors of Social Services conference
was a proposal that, if implemented, would probably see the
traditional social worker role abolished and replaced with a
new-style social care professional, writes Sally

This new breed, which Milburn said should have “more specialised
skills not just the traditional general mix of social work skills”,
would be better equipped to deal with the “complexity of modern
social work problems”.

Possible hybrid roles cited by Milburn included that of a family
care worker, which would combine the “skills of the health visitor
and the social worker”. But initial responses to the creation of
such a new role have been frosty.

Liz Timms, chairperson of the British Association of Social
Workers, who attended the conference, says the general consensus
among her social work colleagues is that Milburn’s grand plan
would be a grand flop.

“We are not in favour of anything that fudges the differences
between professions. A health visitor brings something different to
a family from a social worker,” she says.

At the heart of Milburn’s proposals is the desire to
deliver a simpler service to users by reducing the number of
agencies they come into contact with. But Timms warns that while
creating hybrid roles would appear to be achieving simplicity for
the service user, it is in fact likely to result in a reduced

She argues: “It is a good thing that families have the
opportunity to get two perspectives. The key is that this should
not be confusing for the service user. We have to make it clear to
them that what we offer is different.”

Instead of creating combined roles, she says, service users
would be better benefited by improving collaboration between
agencies so that the distinct elements of each is retained.

Sceptics might interpret Milburn’s desire to do away with
current roles as a clear sign of a loss of faith in the concept of
joint working, the language of which has dominated the social care
sector for the past decade.

But Timms is certain that, while it is not without its
challenges, the commitment to improving collaboration between
agencies is the direction in which social workers and their
colleagues in other agencies should be heading. It is, she
believes, the best way of providing an efficient service.

“All I have read and all the work I have done has shown that
joint working takes time. It takes time to build relationships, and
there must be a recognition of that fact by everyone from the
government down,” says Timms.

Social worker Chris Chambers agrees. As one of around 150 social
workers based at what was the country’s first fully
integrated social care and NHS trust, the Somerset partnership, he
knows both what the benefits of joint working are but also the
problems it can present.

He too worries that this latest announcement is premature. “They
(the government) haven’t given true partnership working long
enough to get off the ground before saying it doesn’t work,”
he argues.

As a frontline mental health worker, Chambers believes that what
is being proposed is unworkable. “What we are asking of people is
probably bigger than what any individual can achieve. It seems like
we will be asking the worker to become a sort of superworker where
they will be expected to be a psuedo doctor, nurse and social
worker rolled into one.”

“No one person can do that.”

He adds: “There is a fundamental divide within mental health
between the medical model and the social model. Both have their
place, but I don’t know how we can ride both horses.”

The practical problems of expecting a single worker to perform
so many different, and what will inevitably be at times
incompatible, functions is also highlighted by Timms.

Mark Jones, chief executive of the Community Practitioners and
Health Visitors Association, says: “The reason I suspect this is
being advocated is that more and more health visitors are doing a
lot more social work because there are not enough preventive social
workers. So the work falls to health visitors by default.”

But, like Timms, he is aware that combining the two roles would
cause problems, arguing that while he appreciates the pressures
facing social workers, “the answer is not to bolt-on social work to
the health visitor role because that diminishes the public health
work that we should be doing”.

Instead, Jones argues that while the CPHVA is not flatly saying
‘no’ to Milburn’s plan, it is definitely saying it is too

“There isn’t yet a robust argument for the combing of two
or more roles. We are a long way from that point. What we need to
do first before we go down that road is build on the good examples
of joint working that are around. There is a lot of good work going
in Sure Start where co-located teams have been introduced.”

“We should try and replicate some of these teams before
introducing hybridisation overall,” he adds.

But Timms is resolute. “I don’t think it will work, and I
hope they think again,” she says.

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