‘I don’t want to over-promise’

Patricia Hewitt tells Mithran Samuel why social care professionals should keep faith with the government’s plans

Patricia HewittHealth secretary Patricia Hewitt is happy with the reception the white paper has received in the social care sector.

Recalling the fear of the sector’s marginalisation she encountered among professionals at last October’s National Social Services Conference, Hewitt says: “People were so worried that social care was going to be buried and I really do believe, with a lot of listening to the social care community, we have managed to integrate our thinking much more than we have before.”

However, question marks on funding, social care’s relationship with the NHS and workforce issues have led the sector to react cautiously to the white paper.

On funding Hewitt has encouraging words for local authorities. She says some of the planned shift in NHS resources away from acute services could end up in social care coffers: “That could happen. But I don’t want to over-promise.”

For instance, she says GPs will face incentives through their contracts to keep their patients out of hospital and, through practice-based commissioning, will be able to buy services to make this happen.

Hewitt says: “A GP, faced with a carer whose health is on the point of collapse, may use some of his budget to provide some respite care to avoid an emergency hospital admission.”

She wants to see 5 per cent of NHS resources move from acute to primary and community settings over the next 10 years, with a proportion going into prevention, some of which may reach social care.

As such, sector leaders may feel that this may not be enough for them to lead the preventive revolution envisaged in the white paper.

This leaves next year’s comprehensive spending review. Citing pressures on services in the shape of increasing numbers of older and severely disabled people, Hewitt says: “We’ll be looking to quantify this and looking at how people with these needs can be supported.”

Echoing care services minister Liam Byrne, she sets store by Sir Derek Wanless’s forthcoming report on the long-term cost of older people’s services, reflecting a positive shift in ministers’ thinking on his review. She also sympathises with councils that are picking up the pieces from NHS bodies’ efforts to cut their deficits.

Hewitt says organisations should “not try to pass the financial parcel from one budget to the other, but look at the whole picture to see how they are best able to promote health and well-being”.

But from a social care perspective, she seems to have taken a backward step on other issues.

At the National Social Services Conference, she mooted an Agenda for Change for social care staff – based on the programme designed to deliver better pay and career opportunities in the NHS.

But there was little of substance on the social care workforce in the white paper and, when asked about the prospects for an Agenda for Change for the sector, she says: “Not at this point. I’d like to look at that in more depth.”

Hewitt hopes the NHS reorganisation will not disrupt the white paper’s ambitions to bring councils and primary care trusts closer together, as Association of Directors of Social Services president Julie Jones has warned.

Hewitt says: “Change is disruptive. We are looking at having many more PCTs coterminous with social services authorities.”

But she will not be drawn on suggestions that the Office of the Deputy Prime Minister will put forward proposals to reorganise county councils in a local government white paper, despite its potential to disrupt newly coterminous arrangements.

So, can Hewitt’s ambitions for personalised, preventive and integrated care and health be realised?

As she says: “The proof of the pudding will be in the eating.”

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