Social care supremo aims to put adult services back on the map

    Meeting the first ever national director for social care is
    reminiscent of watching a British Telecom advertisement: both
    repeatedly insist that it’s good to talk.

    For Kathryn Hudson, the thing she is looking forward to most
    about taking up the newly created post in the Department of Health
    on 2 August is “being able to spend time talking about social
    care… thinking about what it is, what does it do, what is the
    value base”.

    Hudson, who has more than 20 years’ experience in social care
    and is director of social services in Newham, east London, is
    certain that social care has only been allowed to slip down the
    political agenda because the public don’t fully understand or
    appreciate what it is.

    “Inevitably, there has been a very strong focus on health – and
    that’s right because of the concerns of the public – and perhaps
    the social care agenda has not been as widely recognised,” Hudson

    “The important thing therefore is to get it back on the agenda
    and being talked about and I think you will then see the profile
    grow both within the DoH and within wider conversations that take
    place about the sorts of services we want in future, and about how
    we help maintain independence.”

    Alongside this awareness-raising and profile-building, Hudson
    says her new role has two other key functions: improving
    communication between the DoH and social care providers and
    developing the new strategy for adult services announced by
    community care minister Stephen Ladyman in April.

    The former, Hudson believes, has been weakened by recent changes
    within the DoH, including the loss of children’s social services to
    the Department for Education and Skills and the departure of the
    former Social Services Inspectorate, whose successor is based
    outside the department.

    In relation to Ladyman’s strategy, Hudson is in no doubt that it
    is time to put adult services back on the map. “A lot of attention
    has quite rightly been focused on children and children’s
    services,” she says. “We need to mirror that in terms of adult
    services in order to develop a range of opportunities for adults
    which enable them, if they have disabilities or as they grow older,
    to participate in the community, to make use of universal services,
    and then to provide the additional services that they may well

    Hudson is unsure where the new community matrons which health
    secretary John Reid has put forward as the answer to care for
    people with chronic illnesses fit into this strategy. But she warns
    against reinventing social care – which many of those with chronic
    illnesses require – under a different name, adding that
    understanding exactly what social care is will help ensure this is
    not allowed to happen.

    She also accepts that, despite performance indicators
    pressurising social services directors into moving as many service
    users to direct payments as possible, there are other ways of
    offering people choice and meeting their needs, and that direct
    payments are not necessarily right for everyone.

    Hudson insists she has no preconceived ideas about the shape the
    strategy for adult services should take and is keen to consult as
    widely as possible with service users, carers and social care staff
    before any decisions are made.

    “I would like to have a look at the work that has been done so
    far, talk to people, then be able to input into what I know from
    working in adult services over the years.

    “But it is also extremely important that we are consulting with
    people who probably have far more experience than I do in adult
    social care services and taking on board their ideas so that the
    end product is something that people across the country are going
    to want to get behind and sign up to.”

    This is typical of Hudson’s approach to decision-making and
    implementing change – a style of management she perfected at Newham
    Council, where she was bought in three years ago and helped ensure
    the social services department was removed from special measures
    just 15 just months after it was placed on them.

    And it is this approach that Hudson hopes will help her succeed
    at the DoH, despite being social care’s sole representative in the
    department and despite being line-managed by chief medical officer
    Liam Donaldson, whose background is public health.

    “I don’t think in the end I will be a lone voice,” Hudson says.
    “What is important to me is to build a consensus of opinion around
    social care and what the fundamental values are, what the practice
    looks like, how it can be effective. And then you end up not with
    one lone voice, you end up with a lot of voices, not necessarily
    saying identical things but all working in the same area, and
    moving things in the same direction. And that is extremely
    effective in achieving change. It is certainly the way I have
    worked at Newham.”

    Although Hudson can see potential difficulties around the
    separating of children’s and adult services, she points out that
    there has always been a boundary between services somewhere and
    always will be.

    “There were boundaries between education and social care which
    were not necessarily in the interests of children. But, similarly,
    if you rearrange the services in a different way you then need to
    look at the interface between children’s services and adult

    “There are particular issues there for children with
    disabilities, children who have mental health problems. You also
    need to take into account that you have parents who need adult
    services who have children. But the boundaries will always come
    somewhere and the important thing is how we work across them.”

    Hudson is also clear that being based in the DoH will not
    prevent her from representing social care in its widest sense – not
    just adults’ social services or issues on the health-social care
    border. As such, she expects to work closely with the DfES, but she
    also expects to have regular dealings with the Office of the Deputy
    Prime Minister and the Department for Work and Pensions.

    “The role of this post is … about bringing a social care
    perspective to a much wider agenda,” she says. “Social care is
    about people in all circumstances. There are many people who
    require social services in order to maintain their independence who
    are not actually ill. If you push social care into always looking
    at that agenda it denies really important things about people’s
    lives, like social inclusion, and about how they have a sense of
    well-being and satisfaction in their lives. Things like social
    exclusion are extremely important to the social care agenda.”

    In the 1997 and 2001 general elections, the Labour Party made
    education their number one priority. Last week, Labour and the
    Conservatives made it clear that health and the state of the NHS
    will be the main battleground in the 2005 election. Perhaps, if
    Hudson’s lobbying is effective, social care will one day be able to
    shake off its Cinderella status and take its turn at the political
    top spot. 

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