Ladyman’s risky game

If a car dealer insists you need a new car, you might ask yourself
whether their recommendation is entirely unbiased. If a leading pen
manufacturer tells you pencils are a thing of the past and you need
to switch, you might question its motive.

It seems only logical, then, that service users might question the
impartiality of decisions about their eligibility for services when
those decisions are made by the organisations responsible for
delivering the services. Far from pushing people towards greater
use of services, however, council assessors are likely to make
access more difficult thanks to ever-present budget constraints.
Alternatively, they will guide service users to pre-existing
services rather than developing ones that meet actual needs.

To resolve this conflict, community care minister Stephen Ladyman
has proposed an independent assessment service. This would carry
out assessments of individuals against which councils and the NHS
would then be expected to perform.

The rationale behind such a proposal is faultless: it would lead to
a system where all need was identified and met. It would also aid
the long sought-after shift from reactive to preventive services.

In the real world, however, things are not quite so simple. Despite
the advantages of flagging up unmet need, what happens when the new
swathes of freshly identified demand outstrip supply? Will the
service user be expected to contribute more? Is there a risk we
will be forced to waste further council funds on litigation and
compensation as people who have been told they need services take
action when these services fail to materialise?

The Association of Directors of Social Services is warning that
social services departments are facing “grave uncertainties” over
their budgets and already expect next year to be tough. The outlook
beyond that is no better, with July’s spending review demanding
annual efficiency savings and revealing annual increases for social
services budgets averaging just 1.3 per cent a year between 2006
and 2008.

Despite all the arguments in favour of Ladyman’s proposed service,
increasing demand at a time when supply is at best static would be
a dangerous game to play. Until additional resources are
forthcoming, introducing such a service would do no more than raise
expectations and lower satisfaction at a time when the sector is
already facing an uphill struggle. CC

l See news, page 6