Social work guru Le Grand rejects payment by results

Policy guru Julian Le Grand has said social work is not ready for a bonus culture of payment by outcomes, in an admission that has delighted employee bodies.

Le Grand, a professor of social policy at the London School of Economics, put forward the idea of social work bonuses as part of his proposals in 2006 to form independent, GP-style social work practices in England.

He proposed a system whereby the contract between local authorities and social work practices would be at least partly based on outcomes for service users.

But Le Grand has revealed to Community Care that this approach had not been adopted by the five practice pilots already running in children’s services.

“In practice, although the pilots looked at payment by outcomes, it hasn’t really materialised,” he said.

While he did not rule the idea out for the future, Le Grand concluded that social work was not yet ready for performance-related pay: “Perhaps we don’t know enough about what works and what doesn’t.

“If worsening performance is not under the control of the person being paid, it looks like an arbitrary system.”

In its strong opposition to the social work practice model, Unison had previously argued that social workers were not “frustrated entrepreneurs who need a profit motive to do their best for children”.

Helga Pile, Unison’s national officer for social work, said: “Le Grand’s about-turn will not surprise many experienced social workers.

“Social work is much more complicated than coming up with newfangled concepts, and the ‘results’ of social work cannot be measured like units off a production line.”

BASW – The College of Social Work supports the social work practice model, but Ruth Cartwright, its joint manager for England, agreed that payment by outcomes was “fraught with difficulty”.

She said: “What do you measure and how do you measure it?

“Social work is very much about quality of life rather than things that can be measured easily, like number of visits and working to prescribed timescales.

“The lack of understanding of social work is still prevalent, unfortunately, and this could add to that misunderstanding.”

A former policy adviser to Tony Blair, Le Grand has been credited with introducing choice and competition into healthcare and education. His vision of GP-style social work practices owned and led by frontline social workers was included in 2007’s Care Matters White Paper.

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