The Simon Heng column

The consultation on the adult social care green paper is well under
way. If you aren’t already involved, the process includes events
for various echelons of the social and health care professions, as
well as for service users themselves.

All of these are a mixture of divination and crystal ball-gazing.
Divination, in that we are all trying to interpret what is written
– unless you are fortunate enough to attend an event involving one
of the green paper authors or Department of Health policy advisers.
Crystal ball-gazing, in that we are all, including the policy
advisers, trying to predict how these proposals might work in
practice, for frontline practitioners, organisations, the statutory
authorities and individual service users.

I wonder whether the authors had any thought as to how their
proposals would affect individuals. Do they have mental pictures
of, for example, an “average” person with learning difficulties –
someone with bipolar syndrome or chronic fatigue? Have they held
hypothetical case conferences, or conducted imaginary assessments?
Or has all of the thinking been based on received opinion, academic
research and broad-brush visions?

The cynical side of me has also wondered if some of the rationale
for change is so much spin, to sweeten the pill – or hide the truth
– about the political agenda underlying it. I understand how the
green paper fits in with the strategy paper Improving Life Chances
for Disabled People. It worries me that the hidden agenda is to
open up social care to market forces, in an attempt to keep the lid
on costs, as the government tried to do with the health service,
and to dismantle social services bureaucracies, maybe for the same
reason. If this is so, why does the government feel the need to
dress it up like this?

After one of these consultations – where I, among others, pointed
some of these things out – a mental health service user asked me:
“Do you think that they really heard what we were saying?” I
replied: “I don’t know, but unless we keep telling them, they will
never know.”