Don’t be deluded by green paper

Can we please all have a reality check? The adult green paper’s
admirable vision of delivering personal social care services and
putting the user in control through individualised budgets and
direct payments can be attained but not as outlined. The government
is deluding itself and falsely raising the hopes of service users
and their families. It has opted for a service system which,
although popular, demands a lot of staff time and is costly to

The government must admit that the vision will cost a lot more than
current services. Deconstructing a 20-bed care home offering 24/7
intensive support and dispersing that into 20 individual services
will require more money and staff time and adapted housing stock.
Monitoring and inspection costs would rise.

The dispersed individualised services proposed require a huge
increase in the number of personal assistants. The PA role is
vital, but it can be difficult to find and keep the right staff.

On this issue alone the green paper could fail unless we ensure the
PA’s role is supported and recognised. Currently, being a PA can
provide a lot of job satisfaction, a friend for life and is a
flexible, positive job that helps others to get on with their
lives. Will this positive aspect survive the transition to a
mainstream role? If the green paper’s vision is to be achieved,
then thousands of people must be attracted to the role. But many
new care workers come from overseas and bring a different set of
training needs.

So what needs to be done? First, the government must admit that its
vision cannot be achieved within the current costs and it must plan
accordingly. Second, we must accelerate research into the gains we
can realistically expect from technologies such as telecare. Third,
we must ensure that working in the care sector remains a viable and
attractive career. Finally, we must address seriously the huge
increase in foreign care workers and support their recruitment to
and development in the sector. The green paper’s vision is great
and the ambition uplifting, but reality costs money and change is
hard work.

James Churchill is head of ARC, the UK umbrella body for
providers of services to people with learning difficulties. He
writes here in a personal capacity

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