The transfer of social care services from councils to private providers has been bad for the sector, and government plans to go further in this direction risk wreaking future damage, say professionals.
A Community Care survey of 87 practitioners identified a strong belief that social care should be delivered by the public sector despite 20 years of contracting out that has left private providers dominating provision of adult social care.
Two-thirds said the quality of adult care had deteriorated because of large-scale outsourcing since the early 1990s, while 90% thought that outsourcing had been driven by the will of councils and governments to cut costs.
The coalition government has repeatedly emphasised its desire to further open up social care to diverse providers and the Department of Health has said council provision of services should become “exceptional”.
However, 79% of respondents said further outsourcing would reduce the quality of care.
A majority opposed plans for adults and children’s social workers to take over the services they now deliver through the creation of social enterprises to run them, for instance through social work practices (see opposite).
“Social workers need to be on board with and motivated by alternative approaches if they are to be successful,” said Professor Corinne May-Chahal, interim co-chair of The College of Social Work. “This survey suggests that there is still much consultation to be had within the profession.”
Responding to suggestions that councils are considering outsourcing child protection functions, three-quarters of respondents said this could not be done without increasing risks to children.
“Child protection services and the supervision of looked-after children are core statutory duties and it would seem wholly inappropriate to me to consider outsourcing these,” said social care consultant Stephen Barber, who responded to the survey.
Three-quarters of respondents agreed that public sector care staff had a stronger sense of public service ethos than their private sector counterparts.
However, United Kingdom Homecare Association head of policy and communication Colin Angel said the survey’s results reflected the fact that 63% of respondents worked for councils.
“I’ve no doubt that most council staff are passionate about the organisations they work in,” he added. “I would be passionate about how the independent sector provides amazing results at half the price of local authorities.”
Angel pointed to NHS Information Centre figures showing that councils in England pay independent providers – most of which are private companies – £15 an hour to deliver home care, while in-house services cost £31 an hour to run. He said differences in quality were narrower: 91% of council adult services were rated good or excellent by the Care Quality Commission as of April 2010, compared with 80% of private sector services.
The Association of Directors of Adult Social Services said the results were based on the “perceptions of a very small number of people”, and the independent sector had benefited social care, for instance by investing in care homes to ensure residents had single en-suite rooms.
What you say
● Private sector providers have to make a profit so cost-cutting and low wages will always be their first priority – Senior adult social worker, local authority
● Service users have expressed real fear about the future of social care if handed over to private enterprise – Policy officer, user-led organisation
● If service provision remains in the public sector, not only will this have no positive impact on quality but the service will continue to be dictated by professionals who think they know what an individual wants better than they do – Senior manager, private care organisation
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Special report on outsourcingSocial care outsourcing drive bad for users and staff