The Simon Heng Column

    When New Labour came to power in 1997, one of its boasts was that
    it would apply “joined-up thinking” to government. Ever the
    optimist, I assumed it would eventually get around to applying this
    idea to social care provision. To an extent, this has begun, with
    the development of health and social services partnerships across
    the country – notably in mental health and learning difficulties.

    Stephen Ladyman, the minister responsible for social care, is now
    proposing a green paper on the future of adult services. He wants
    people to “think the unthinkable”. So here are some of the points I
    believe he should consider.

    The whole issue of paying for care in the community needs to be
    addressed: transparent it is not, even to the professionals. The
    interlocking systems of payment are overcomplicated, including as
    they do the independent living fund, local social services, primary
    care trusts, Supporting People and the benefits system – for
    example, the severe disability premium of income support. How about
    recommended or statutory rates of pay – and status – for paid
    carers? And don’t forget the appallingly low benefit payments to
    informal carers.

    Encourage people to work, by all means. But appreciate, and allow
    for, the fact that many people, owing to their conditions, may not
    be able to sustain regular paid employment. Many of us can be
    helped and encouraged towards purposeful activity, which may
    contribute towards our communities but which is not seen as
    meriting payment.

    Examine how things are organised in other countries, and how the
    service users feel about their provision. There must be some
    research into comparative cost, transparency, level of involvement
    and service user satisfaction. If there isn’t, commission some. The
    Scandinavian countries are often held up up as model providers of
    social welfare – it would be interesting to find out if they live
    up to their reputation.

    Finally, don’t be tempted by a “one-size-fits-all” model. Although
    there are various umbrella terms to describe adults who need social
    care, our needs are diverse and complex.

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