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
says.

“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
need.”

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
services.

“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.