Ladyman’s bold agenda

    Social care for adults faces a period of change every bit as
    radical as that going on in children’s services. Except, rather
    than education and social care, the main movers in adult services
    will be social care in a variety of alliances with health and
    housing that cut across the statutory, voluntary and private
    sectors. Stephen Ladyman, the health minister, has invited social
    care workers to contribute to a new vision of social care, but as
    our interview with him on page 14 makes clear the outlines of that
    vision are already firmly in place. As if to emphasise the point,
    the minister was heard talking last week about an “Agenda for
    Change” in social care to mirror the one that takes effect in the
    NHS from this October.

    Agenda for Change is meant to harmonise pay and conditions across
    the health service, rewarding staff in line with the level of
    responsibility they take on and the skills required for the work
    that they do. Nurses have generally welcomed the initiative because
    it is seen as introducing fairness and transparency to pay scales.
    Experience with the 12 “early implementer” sites set up in June
    last year has shown the importance of partnership between
    management and unions, clear job descriptions set against national
    benchmarks, and consistency in the way different jobs are
    evaluated. The result is that NHS workers will get an average of
    12.5 per cent over three years for taking on extra

    But even in the health service it has not all been plain sailing.
    For example, attention has been lavished on nurses, a political
    priority for the government, at what some non-clinical support
    staff feel to be their expense. More pay for extra responsibilities
    fits well with the increasing professionalism of nurses as they
    acquire more tasks previously done by doctors, but it is not always
    so easy to see how other professional groups can benefit.

    It is even more difficult to see how Agenda for Change could be
    made to work in social care, where the multifarious workforce is
    spread across 25,000 separate employers, 70 per cent of whom are in
    the private sector. Ladyman’s professed aim is to prevent workers
    in adult social care becoming the poor relations of their
    counterparts in children’s services, where pay and conditions are
    already under review as part of the Every Child Matters
    green paper. That aim is laudable, but it will take considerable
    ingenuity to adapt Agenda for Change for the minister’s new vision
    of the future.

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