Excellence on the cheap

    If ever there was proof of the government’s cavalier approach to
    social care, it is the decision to scrap plans for a massive
    investment in the future of the Social Care Institute for
    Excellence. When Scie’s takeover of seven Department of Health
    partnership programmes was first mooted last year, it was hailed by
    government sources as giving the agency the “clout” it needed to
    disseminate best practice effectively. The programmes, many of them
    influential, included the National Institute for Mental Health in
    England, the Valuing People Support Team and the DoH change agents,
    which between them would have given Scie a network for researching,
    collating and promoting best practice and the budget to do it.

    In short, the government has reneged on proposals to make Scie
    the social care equivalent of health’s all-powerful National
    Institute for Clinical Excellence. In doing so the DoH has shown
    itself at its Machiavellian worst and it may have acted for the two
    reasons that sit most comfortably in that particular tradition,
    money and power. Money because the Treasury is looking for cuts
    under the Gershon review and power because it became increasingly
    clear that Scie was determined to assert its independence.

    The efficiency savings demanded by Gershon are making the lives
    of public servants difficult in both central and local government.
    Their impact on social care locally could be regional procurement
    that flies in the face of individualised budgets and care packages.
    Their impact centrally could involve sacrificing some or all of the
    seven partnership programmes with the potential for £30m of
    cutbacks. That would doubtless suit the Treasury, but social care’s
    voice in the formulation of government policy would be weakened
    again.

    As for the second reason, power, that is just as troubling. Scie
    came to the negotiating table with the proviso that its
    independence from government would be preserved. But the DoH
    appears to have been disappointed that none of the initial
    candidates to take overall charge of the programmes was acceptable
    to the appointments panel. Was the DoH hoping to direct operations
    through its own placeman? It is a tempting conclusion.

    Scie’s merger with the partnership programmes would have enabled
    it to make a profound difference to social care practice. Thanks to
    the government, this goal will now be much harder to achieve.

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