A false division

Chapter 12 of the recently published adult green paper,
Independence, Well-being and Choice, professes to recognise the
“important role” played by the voluntary sector in building the
strong communities necessary for the care and support of older
people. The challenge will be the same whichever party emerges
victorious from the election, though, to judge by the manifestos,
Labour alone thinks the place of the voluntary sector in a
well-functioning civil society merits a mention, albeit a single
paragraph at the bottom of page 105.

The new government will have to give careful thought to what it
means for local authorities to engage more effectively with the
voluntary sector, as the green paper urges, but the question of how
the voluntary sector can be helped to engage with local authorities
will also require attention. It is not too much to hope that, if
its vaulting ambition survives the test of practical
implementation, the green paper will lead to great things. But only
if the priorities of the voluntary sector reflect the green paper’s
aims.

Section 64 grants, introduced nearly 40 years ago to help voluntary
organisations pursue the government’s health and social care goals,
are one of the few reassuring constants in the sector’s financial
arrangements. In Independence, Well-being and Choice the Department
of Health explicitly undertakes to develop section 64 investment
priorities so that they “more closely reflect and support the
delivery of strategic aims for health and social care service
reform”.

The implication is clear: section 64 funding will be distributed
differently. Indeed, a 21-charity coalition has already written to
the DoH claiming that next year’s allocations are focused
disproportionately on health, particularly physical health, and
expressing concerns about a “distinct shift” away from social care.
The coalition has a point – if, as one of its leaders fears,
voluntary sector services for older people, people with learning
difficulties and disabled people are sidelined, the objectives of
the green paper will be defeated.

But the DoH’s emphasis on physical health should not be dismissed
lightly. According to the green paper, the hour has come for
preventive care, that is, for voluntary sector services that keep
people out of hospital and in their communities. Inevitably,
physical health will be at the centre of any effective prevention
strategy. If the policy is to work, the old divisions between
community health and social care will gradually cease to make
sense.