Checks defy service user ethos

The case of an approved social worker’s battle to be registered without conditions (news, page 8, 27 October) has highlighted the experience of disabled people and those with mentally illness in the registration system.

Peter Van der Gucht, who has bipolar affective disorder, came up against the General Social Care Council’s duty to ensure that social workers are “physically and mentally fit” to practise safely.
The GSCC backed down during an appeal to the Care Standards Tribunal but has denied that its original decision to place conditions on Van der Gucht’s registration was discriminatory. It has said that its duty to consider an applicant’s health in registration is problematic.

It has sought advice from the Disability Rights Commission about how to apply the duty without discriminating against disabled people or those with mental health problems, and consulted the Department of Health.

Removing the checks would require amending the Care Standards Act 2000, the legislation that set up the GSCC and the register.

A GSCC spokesperson says it is “uneasy” about the check and will advise the government if it gathers evidence that it is not workable, is not achieving the right effect or is discriminating against disabled people.

The duty is not uniform across regulators. A spokesperson for the Council for Healthcare Regulatory Excellence, which oversees nine health professional regulators including the General Medical Council, says it is “looking at the prospect of developing a framework for good character at registration”, but “nothing is in the pipeline” on the health of applicants.

Although the GSCC, the Care Council for Wales and the Northern Ireland Social Care Council require applicants to report conditions affecting their ability to practise, the Scottish Social Services Council (SSSC) does not.

The Scottish executive had originally proposed a health check in a 1999 white paper but changed its mind after consultation.

SSSC registrar Geraldine Doherty says the decision was not based on fears of discrimination, but a response to submissions saying that the relevance of health was job-specific and should not cover something as general as the register. She adds: “Respondents said it should be something done by employers. If someone was blind there would be some jobs in social work they could not do but others that they could. The eventual white paper decided that the new system of regulation should not usurp the role of employers.”

The GSCC has tried to be flexible by stipulating that applicants need to be fit to perform any role in the section of the register they are applying for, not a specific job. But this is not enough for those who think that the existence of health checks in itself is discriminatory.

Ian Johnston, director of the British Association of Social Workers, says: “We were opposed to the health check being introduced because we felt that it was contrary to the Disability Discrimination Act 1995.

“People say they need to safeguard service users but there’s no evidence to suggest that people with health issues represent any greater threat than anyone else.”

This assumption in the system runs counter to the ethos of user involvement in delivering services, says John Knight, head of policy at disability charity Leonard Cheshire. “I think it contradicts the way the social care agenda is going when we are saying that we want more user-led service delivery and design.” he says.

The same point is made by Peter Beresford, chair of user organisation Shaping Our Lives, who gave evidence for Van der Gucht in his case. He says: “Disabled people have worried for some time about the way the GSCC processes would work because of the way their rules were structured. I hope this case prompts a change.”

The GSCC says it will have to deal with more cases like Van der Gucht’s before it can decide on the workability of health checks.

The DRC is more cautious, suggesting that a change in the legislation may be a distant prospect. Policy and communications director Liz Sayce says: “We do plan to look at a range of professions to see how these fitness-to-practice requirements can act to exclude people in these professions. But some of this is in the way it’s applied, not the legislative framework.”