Minister Lewis returns to social care in bid to ‘make a difference’

Care services minister Ivan Lewis has a good grounding in social care. So how will he go about improving the sector’s relationship with the NHS? Mithran Samuel reports 

Ivan Lewis’s career before entering parliament in 1997 should make him the ideal government champion for social care now he is care services minister.

His four-year stint as chair of Bury Council’s social services committee should help him sympathise with local authorities’ funding pressures.

The voluntary sector may see someone who will vigorously make the case for better contracting by statutory bodies, given he spent 11 years working for social care charities, including one he set up himself.

And users and carers may see in him an advocate who started doing voluntary work with people with learning difficulties at 14, and who claims that this cause spurred him into entering politics.

Lewis, 39, has certainly not been shy about touting his credentials in the speeches he has made since taking the job in last month’s government reshuffle, and his first interview with Community Care is no different. “Taking this job is like coming home”, he says. “It’s a wonderful opportunity to make a difference in an area of work that I feel so passionate about.”

But after nine years in parliament and five years as a minister – four years handling the skills brief at the Department for Education and Skills  and one as a Treasury minister – how relevant is Lewis’s background?

He says he is still getting up to speed on policy with briefings from Department of Health officials and stakeholders. But he says many of his priorities represent age-old issues for the sector: empowering users and carers, improving integration with health, enhancing the voluntary sector’s role, promoting dignity in care, and raising the status of social care.

On the last point, he says: “At the moment it doesn’t have sufficiently high status and value. It has traditionally been at the margins of the department.”

Hence, he is “delighted” to announce the appointment of Commission for Social Care Inspection chief executive David Behan as the DH’s first director general for social care. This is a board-level post and evidence of the DH commitment to social care. But the position of the sector within the DH is a problem at the moment.

The DH has made value for money and financial balance main priorities for the NHS, to deal with deficits in the service. But council leaders have claimed primary care trusts have responded by “narrowing the definition of health care”, increasing pressures on adult social services departments that are already strapped for cash (news, page 6, 15 June).

Lewis says this problem must be tackled: “We must not accept the argument that because people are struggling with financial pressures, interaction with social care is more difficult.”

On the contrary, he says the NHS’s financial difficulties should be an opportunity to forge closer integration with social care and make efficiencies from pooling activities.

He says the DH is crucial to making this happen: “We have to remould the culture within the department so social care is an equal partner.”

This means that every policy and guidance must be examined “to ensure that running through it is an integrated approach”.

One specific area he says the DH must improve in is learning difficulties, where his professional background is most pertinent. Momentum has been lost, he says, since the publication of the Valuing People white paper in March 2001, adding: “It’s not been given sufficient priority.”

However, while such talk will encourage social care service users, staff and leaders, there is definitely a double-edged nature to Lewis’s attitude to the sector. While predecessor Liam Byrne became famous for his openness to input from social care stakeholders, one local government source claims Lewis has not gone as far during his first weeks in the job.

And when Lewis describes social care as a “Cinderella service”, it is as much a criticism of “a victim mentality” in the sector as it is of malign external forces. This comes across in his views about social care’s prospects for next year’s comprehensive spending review.

He sees demographic pressures as a huge issue for the DH’s current review of social care funding and its lobbying of the Treasury. But social care needs to demonstrate the part it can play in the reform of public services “in return for a decent settlement”.

As a former Treasury minister, his words carry added weight on this issue. He adds: “It’s got to be more than just asking for more money.”

On the voluntary sector, Lewis has taken over at a propitious time, considering government efforts to improve the quality of public sector contracts with charities and the sector’s standing generally.

Last week, prime minister Tony Blair announced the government would produce proposals to open up community equipment provision to voluntary providers. The government reshuffle saw the appointment of Ed Miliband as minister heading a new Office of the Third Sector in the Cabinet Office. The Cabinet Office and the Treasury also launched a government inquiry into the third sector last month, designed to influence the spending review.

And the DH’s voluntary sector task force, set up by Byrne to remove barriers to the sector providing health and social care, is due to report next month. But a source close to the task force suggests it will disappoint, with momentum lost since Byrne’s departure. And, when asked a question at this month’s NHS Confederation conference about the problems charities faced in their dealings with the public sector, Lewis mentioned the joint Treasury and Cabinet Office review as evidence of government action, but not the task force.

However, Lewis is adamant that he wants the task force to achieve a “sea change” in the way councils and primary care trusts commission from the voluntary sector, and he wants the group to continue beyond next month’s report.

Alongside pronouncements about his background in social care, Lewis has also made confident claims about his effectiveness. Notably, he has claimed that he helped raise the status of skills in the DfES from an afterthought, behind schools and universities, to a priority, and can do the same for social care in the DH.

The fact that the government’s first two white papers on skills happened on his watch lends credence to his claims.

But the strong business support for investment in skills puts it in a different position to social care, whose chief lobbyists carry nowhere near as much clout.

And Lewis is also the most junior minister in a department where the dominance of the NHS remains stark. For instance, “social care” was mentioned just once in the five most recent speeches by health secretary Patricia Hewitt published on the DH website.

If Lewis fulfils his ambition of ensuring all DH policies are truly integrated he will have countered any scepticism about his potential impact. This will be all the more so should social care secure one of the better settlements in next year’s spending review. By then, it should also be clear how far becoming care services minister really has been like “coming home”. 

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