Voluntary sector ponders green paper fault lines

To make self-determination for adult users of social services a
reality, the adult services green paper is depending on the
voluntary sector to play a crucial role.

Although leadership will remain with local government, voluntary
sector representatives are expected to sit on the new strategic
commissioning partnerships that will plan adult services over the
long term.

The sector’s role in provision will have to expand, not only to
meet the expected explosion in demand but because of the
government’s call for a shift to preventive services.

Its experience in advocacy will be crucial in empowering users
to shape their own services through individualised budgets. And its
ability to reach people untouched by mainstream services will be
vital on promoting social inclusion.

Although the green paper has received a warm reception in the
sector, concerns have been raised.
A coalition of voluntary organisations has written to NHS chief
Nigel Crisp warning that changes in priority areas for section 64
grants to charities for 2006-7 conflicted with the green paper’s
vision. In practice, the group argued, it would curb innovation and
lead to a funding shift from social care to health, and away from
preventive services in particular.

The green paper’s plan for the voluntary sector also feeds into
a wider debate over the fault-lines between the sector’s service
planning and provision on the one hand and campaigning and advocacy
on the other.

Shortly after the green paper’s publication, Stephen Ladyman,
then community care minister, went to the heart of the matter at a
King’s Fund briefing: “Where the voluntary sector gets a seat at
the strategic planning board, it can’t come out and criticise the
plan. I want to hear from the voluntary sector whether this is a
role it welcomes or whether you want to be lobbyists.”

Stephen Lowe, policy officer at Age Concern, says: “That’s a
problem for the voluntary sector, which has roles as service
providers, client representatives and campaigners.”

His solution is local protocols allowing the sector to combine
planning and provider roles with campaigning and advocacy.

Nick Aldridge, head of policy at the Association of Chief
Executives of Voluntary Organisations, rejects any contradiction
between service planning and campaigning. “Our members want a seat
at the table so the experience they’ve gained advocating for users
is reflected in services.”

But a more pertinent question may be whether the voluntary
sector will get a meaningful seat at all.

Although Ladyman had emphasised there would be duties on
councils and primary care trusts to sit on strategic commissioning
boards, there will be no such duty on the voluntary sector.

This mirrors the approach taken in the Children Act 2004.

Caroline Abrahams, head of policy at children’s charity NCH,
says the sector has been frozen out of some children’s trusts and
strategic partnerships in certain areas. She says she understands
the rationale behind this, in terms of protecting the sector’s
independence, but adds: “It leads to the impression that we are a
second-order partner.” She believes the mixed picture reflects
“individual attitudes in local authorities”.

But one problem facing councils is identifying the voluntary
sector. Des Kelly, director of not-for-profit provider coalition
the National Care Forum, says: “How do you engage with a service
sector that’s so fragmented and made up of small providers?”

John Dixon, co-chair of the disabilities committee of the
Association of Directors of Social Services, says it is unrealistic
to expect smaller organisations to become involved in strategic
planning.

He says: “There’s not too much difficulty bringing on board
representatives of the larger organisations like Age Concern.
What’s more difficult is engaging the smaller organisations that
are too fragmented and too numerous to have a seat on a local
authority board.”

Yet these organisations, particularly those from ethnic minority
and other potentially excluded communities, are crucial to the
green paper’s socially inclusive aims.

Dixon says councils must engage with such organisations through
local forums and “learn to speak the language” of the community
sector.

But perhaps the biggest fault-line between councils and
not-for-profit organisations concerns local authority
commissioning.

A key assumption in the green paper is that many services fail
to meet need and promote dependence. Councils and charities agree
that underfunding of social care is a cause of this, particularly
as this stops councils investing in preventive services. But for
many in the voluntary sector poor council commissioning practices
are also to blame.

Aldridge says: “The vision will not be deliverable without
significant change to local authority contracts. We are looking at
long-term goals. But more than 90 per cent of our members are on
one-year contracts.”

Although the private sector has the security of long-term
arrangements, he adds, many voluntary organisations are on
short-term contracts that give them no chance to invest in training
and infrastructure.

Nick Danagher, executive director of the National Centre for
Independent Living, says user-led organisations face a similar
problem. “Most user-led direct payment support services are on
contracts of about three years and are constantly retendered by
local authorities, which militates against long-term planning.”

Kelly says councils should tender on the basis of quality not
cost and create a market for the specialist, personalised services
that only the voluntary sector can provide.

Dixon agrees many councils must change, and suggests different
commissioning arrangements for smaller bodies to promote community
development organisations. “Smaller organisations are not going to
be able to gear up to competitive tendering in the same way as
larger ones. But we can improve commissioning.”

Pressure to change should come from the Commission for Social
Care Inspection, which is to use its judgements on providers to
assess councils’ commissioning performance.

But some are pessimistic about the possibility of change. James
Churchill, chief executive of learning difficulties charity the
Association for Real Change, says: “I see precious few good
signs.”

There are more positive aspects to the relationship between
local government and the voluntary sector on this issue. Several
charities have signed up to a joint lobbying strategy with the ADSS
and the Local Government Association through the Inter Agency Group
(IAG).

Dixon paints a picture of constructive engagement. “The
charities are bringing their perspectives to the table, some of
them quite critical of the way the system works.”

Yet the IAG is focused on lobbying government on common points
of interest, such as funding, and not on influencing practice
locally.

But Dixon adds this could be a useful byproduct of the group.
“By bringing people together we are hoping that we will also
influence attitudes on the ground.”

In-depth green paper analysis

Starting next week Community Care will be running a series of
in-depth articles giving expert analysis on the adult green paper,
the problems that it poses and the solutions which will help to
shape the future of adult social care. And we want you, our
readers, to contribute to the debate and play your part in deciding
what the future of adult social care should be. Our website, www.communitycare.co.uk,
is mounting a green paper campaign in tandem with our series,
including an online chat forum for all our readers to air their
views on some of the most important issues in social care. We will
compile your views into a report to be discussed at our green paper
conference, Power to the People, in London on 27 June.  Our expert
analysis series comprises:

• Role of service users – 19 May.
• Role of professionals – 26 May.
• Leadership and the adult social services director – 2
  June.
• Refocusing on prevention – 9 June.
• Performance management – 16 June.
• Strategic commissioning – 23 June.