The fears of many in social care have been realised: the profession
is losing a powerful voice as the Department of Health
restructures, before the new partnerships for its future have been
developed.
The DoH’s current structure for social care is based on its
relationship with social services departments, which looked almost
solely to the DoH for policy, legislation and guidance. Social
care, although provided across various agencies, was largely shaped
by social services departments: by far its most powerful
structures. Even as the role of voluntary and private providers
increased, so did their dependence on social services departments
through contracts.
In the DoH, the chief inspector of social services became the
equivalent of a chief nursing officer or chief medical officer –
the country’s top social care professional, with the ear of
ministers.
The new-look department has much to recommend it, especially its
commitment to “steering not rowing”. But while social care is
intrinsic to the vision, its separate identity is not. The vision
fits a world without social services departments, in which social
care – in a far wider range of structures – will refer,
particularly in children’s services, to several government
departments; perhaps to the DoH only in its partnerships with
health. The government’s full plans for children’s services have
not been revealed. But the Home Office and Department for Education
and Skills are already at least as influential as the DoH.
Meanwhile, the government’s vision for adult health and social care
remains fixated on the NHS.
New structures, as Community Care has argued before, are
less important than the influence of social care values. The
independent Commission for Social Care Inspection, the General
Social Care Council and the Social Care Institute for Excellence
will (though they do not yet) support social care’s professional
status and its influence on policy and practice. They are evidence
of the government’s good intentions.
Yet the new DoH lacks a voice for social care at the highest level.
There is no social care professional alongside the chief nursing
and chief medical officers. This must change. It deprives social
care of political clout and diminishes its professional identity
just when it needs both more than ever.
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