GSCC health standards caught in discrimination row

You’re a 24-year-old keen to build a career in social work, and prepared to go back to university as a mature student to qualify. You know you could earn more elsewhere, you know there will be overtime and likely high levels of stress. But you’re interested in social care partly because you have been a service user yourself due to a long-term health condition.

So you read carefully through the official standards set by the General Social Care Council. And suddenly you’re taken aback. Because as a prospective student, you notice that you’ll have to provide evidence of your “physical and mental fitness to practise as a social worker”.

For existing social workers, the wording is slightly different: they are required to provide evidence of their physical and mental fitness to practise in the field of social care work in which they wish to work.

But the upshot is the same. Anyone with a physical or mental health issue will wonder whether they will be considered unfit to practise. A would-be student might worry whether they’ll be admitted onto a social work degree and, even if they are, whether they’ll be allowed to register once they’ve completed three years of study.

An existing social worker might feel that, despite having been honest regarding their health with their employers to date, their regulatory body still doubts their ability.

Discriminatory standards

A recent report into the standards for teachers, nurses and social workers issued by the Disability Rights Commission, Maintaining Standards, Promoting Equality, is now calling for the GSCC health standard to be repealed on the grounds that it is discriminatory. Nor does enforcing the standard, says the DRC, provide any useful information as to whether a social worker poses a risk to service users.

“As part of our 18-month investigation we specifically looked for evidence in favour of the standards, but didn’t find any case where they would have made a difference,” says DRC policy and communications director Agnes Fletcher.

“The key failings in the cases where the public was put at risk – Allit, Shipman, Huntley – were at the point of monitoring people’s abilities, and lack of adequate management systems.”

The best way of deciding who should be a social worker, concludes the DRC, is on the basis of the professional standards that examine competence and conduct. Yet anecdotal evidence received by the DRC shows that people were being put off from even trying for a career in the sector.

“Young people who have experience of a health condition have a higher interest in health and social care as a career, but these health standards are acting as a real deterrent to people going into the profession, and are also making them not want to be open [about their condition],” says Fletcher. “It creates a culture of associating disability or health conditions automatically with risk, and that is not helpful.”

Ian Johnston, chief executive of the British Association of Social Workers agrees, maintaining that people with health issues are in fact likely to be extremely self-aware and responsible when it comes to monitoring their own condition.

“Given that, to introduce an extra test seems to be discriminatory,” he says. “The biggest risk in my view is from people who are unfit to do their jobs through drink or drugs, and there’s no special consideration for that in the legislation – and I think there should be.”

The social work profession, Johnston believes, should be in the forefront of promoting and supporting those with health conditions or a disability to have access to employment in the sector.

“I would like to think that, in our workforce, we’d find people with disabilities and experience of ill-health would be over-represented, not under-represented,” he says.

After consultation in Scotland, it was actively decided to drop any reference to health in the formation of the Scottish Social Services Council’s standards. The policy position taken by the Scottish executive in July 2000 says that employers at a local level must take decisions on a social worker’s fitness for the role for which they apply, and make suitable adjustments.

“Employers have to be clear about competence, conduct and character. But health is not a criterion,” says SSSC chief executive Geraldine Doherty. “Employers must make the right sort of checks, using a rigorous and thorough selection process.”

Interestingly, despite this, Scotland still has a low percentage of social workers who are registered disabled – 2.4% of all those registered in 2005.

At the GSCC, acting chief executive Mike Wardle says the council has not yet had the opportunity to form an official response to the DRC’s call for the health standard to be repealed – the recommendation is an agenda item for a council meeting this month.

He points out that the organisation can only work within the Care Standards Act 2000 as set down by government, but also notes that “we made it clear in our evidence as part of the DRC consultation process that the removal of those standards wouldn’t give us any concern”.

Declaring health problems

Of the almost 93,000 people on the GSCC’s social care register, just under 5,000 (5.5%) have declared a health issue. This demonstrates that the way in which the GSCC has operated its statutory duty to consider health in relation to registration has not prevented those who declare health issues from registering, he says.

But the experience of social worker Peter van der Gucht illustrates the distress that can be caused when competency to practise is questioned.

The three conditions imposed on van der Gucht’s registration make sweeping judgements about whether people with health conditions are fit to operate as social workers, and cannot relate with any accuracy to the case of each individual in question, believes Peter Beresford, professor of social policy at Brunel University and chair of the service user group, Shaping Our Lives.

“All but one of the people I’ve ever spoken to who’d had questions raised about their registration had mental health issues, which is very interesting,” he notes.

The irony is that many people say they appreciate the insight brought to their own individual issue by a social worker who also has experience as a service user, can understand the frustrations that may arise and knows where the gaps in provision are.

Beresford hopes the van der Gucht case may have helped the GSCC to understand that “there is a very big tension between making class judgements on mental health issues, and the reality of a person’s individual circumstances”.

With uncompromising recommendations from the DRC that the standards should be repealed, it may soon be that an aspiring social work student with a health condition won’t have to make a difficult choice before filling in their university application form.

This article appeared in the 18 October issue under the headline “How honesty could harm your career”