Normal Service Will Not Be Resumed

Listen to ministers and you could be forgiven for believing that although cuts in the public sector are necessary, services will be maintained. It’s true, change in social care isn’t just a matter of throwing money at the problem and despite resource shortages we all know that whatever area we work in, efficiencies are possible. In reality, where resource allocation filters down through layers of bureaucracy and policy to the point where workers and users meet, these assurances are worthless. Last week I came across two examples where cuts in one area will have adverse consequences in another.

Children and Young People Now reported that local authorities’ spending on child care staff training was cut by over 40% last year. Four authorities have no budget at all. I suspect this does not come as too much of a shock to anyone who works in the public sector because training budgets typically take a hit whenever savings are required. However, it comes at a time when more and better training is recommended in each and every area of social care in order to increase standards and improve the service. It’s a staple of each report, every service review, all inquiries. I’ve often heard the argument that such cuts protect frontline services. Clearly in the long run they undermine them.

Another example concerns the impact for some foster carers on the changes in eligibility for housing benefit. From April, foster carers living in social housing will not be able to claim housing benefit for bedrooms occupied by fostered children and young people. It’s sparked a frantic rush of agitated audits as local authorities work out how many placements this will affect. The context is an existing shortage of around 8,700 foster carers as estimated by the Fostering Network. This change could reduce current numbers and deter potential new recruits. It will affect inner city authorities badly – off the top of my head, Southwark for example has over 65% of its properties as social housing.

The intention behind the change is to deter under-occupation, basically to not subsidise empty rooms. This will compel many to move from homes and communities where their families have been brought up because their children have grown up and moved on. In terms of children in care, according to the HB rules, foster children are not classed as permanent members of the household. Also, between placements the room is unoccupied. Therefore, no benefit will be paid.

This is not a deliberate policy, and that’s my point. Changes made for other reasons by another department in order to meet their savings target could have serious consequences for foster care in general and for children and young people in placement in particular. If carers can’t afford to carry on, children may have to move.

The Fostering Network have campaigned on the issue and there is now a £5m discretionary fund that in theory is available to compensate for any shortfalls. Minister Edward Timpson, who grew up in a family that fostered, is genuinely sympathetic and has promised to keep highlighting the problem but the FN is concerned the cash could be swallowed up by the larger housing pot and not reach its intended target. Anyway, when the words ‘benefits’ and ‘discretionary’ are linked, forgive me if I harbour grounds for scepticism. 

There’s no conspiracy here, rather the unintended consequences of resource-led decisions. Different departments have different agendas and priorities. Yet the devil is in the detail. I’m certain that nobody planned to undermine foster carers doing vital work for the vulnerable, they just didn’t bother to look too closely at the implications of their decision-making.

This is serious. The government is trying to create a myth that decent levels of service can be maintained with inadequate resources. Sure, we can all do better, and every professional I know is determined to put everything they can into their work in 2013 on behalf of users in defiance of the cuts. However, the government has to understand this simple thing – there is a limit as to what is humanly possible. The demands on services and professionals for higher standards are greater than ever, and rightly so, but if we don’t have the tools to do our job, there’s a limit. What really hurts is, the government know the truth but carry on undaunted.  

 

Generic Condemnation of This Thing That Person Said on Twitter

Words cannot express the outrage I feel after reading this thing that person said yesterday on Twitter. Such comments are a clear betrayal of the principles of Insert Cause Here, as well as being deeply socially irresponsible.

I have already been sufficiently outraged that I’ve had to write a blog post. If I get any more angry I may have to set up a Tumblr.

I am also surprised by the silence of Insert Prominent Tweeter Here over this issue. Their failure to comment on this thing that person said may well be a sign that they secretly agree with them. I tweeted them 20 times repeating the same question in different wordings, and they promptly blocked me. I can’t imagine why. I’ve already posted several tweets expressing glee about having been blocked. Later, I will be engaging in one-upmanship discussions with other tweeters about who we’ve been previously blocked by.

I’m also shocked by the failure of the mainstream media to cover this issue. It’s as if they don’t care about this thing that person said.

I hope you’ll all join with me in getting off the fence and giving your unequivocal condemnations of this thing that person said. I think we can all agree, what they said was worse than the Nazis.

 

 

 

 

Calling all Health and Social Care Writers

Given Ermintrude’s announcement today that she’s retiring from blogging, this seems like a good time to put out an invitation to those with an interest in health and social care and feel like they have something to say.

Ermintrude’s retirement is by no means the end of this blog. There’s not only me writing here, but also the likes of Politicalnurse, Gary, Bonklesoul and Abe Laurens. Over time our traffic has grown from 2,648 views in October 2011 when the blog was first set up, to 14,468 in November 2012 (the traffic reduced a bit in December due to Christmas, but has rebounded strongly in the new year). I see no reason why the Not So Big Society can’t continue to grow and develop.

Even so, Ermintrude was and is an informed, incisive and prolific writer, and her departure leaves a gap.

So, if you’re interested in such topics as health, social care, social policy, poverty, inequality and the occasional dollop of small-p politics, then this invitation is for you to come and write for us.

We don’t have a “house-style” as such. There’s not a minimum or maximum word length for blog posts, though I tend to think anything over 1500 words is probably better broken down into a couple of separate posts. Obviously, posts shouldn’t include anything offensive or libellous, and writers are expected to adhere to the social networking guidelines of any professional regulators that they’re registered with.

Interested? Leave a comment to this post, or e-mail me on thus_spake_z at hushmail dot com

Moving On and Looking Back

Forgive me for the slightly self-absorbed post. Blogging by its nature can be the epitome of self-absorption but I attempted to write with a look to the wider world, particularly in the sector I know best, social care. I put this in the past tense as this will be the last post I write.

When I started writing, I had the voice of a social worker and AMHP (Approved Mental Health Professional) in a Community Mental Health Team. I was trying find that voice amid the policy and processes that we found ourselves, as practitioners, caught up in and trying to extend outward some of the frustrations and observations garnered from the ‘frontline’. It felt and it feels like that policy happens from afar, away from the homes I visited, the wards we attended, this was my world and it felt like a completely different world from the one defined by officials in the Department of Health when they remember ‘social care’ is a part of their remit.

I believe wholeheartedly in social work as a profession and social workers as professionals but I became frustrated at the lack of professional leadership. There is no doubt that the last year of my professional life has been one of the most challenging. I’ve worked in social care for 20 years (gulp – I look younger, I promise!) as anyone can imagine, I’ve seen many changes in that time. ‘Reconfigurations’ were nothing new to me. Working with change and in organisations that change frequently is one of my fortes but the most recent one was the most painful by far. While parts of my job, I loved – particularly when I was able to work with and alongside individuals and families and walk with them through some of those moments of crisis – working in an organisation and delivering services which were being ripped to pieces was difficult. Defending organisational decisions became impossible. The fight was still there inside me to promote and present a better way of working and honest interactions with everyone who needed our service, I saw waiting lists grow and discharges of people who I felt would benefit from more support. I saw the effect of the programme of cuts in the NHS in a very visceral way. I was and am very lucky. I have been able to walk away. I find myself in a job that excites and interests me and presents many new challenges. The same ease with which one can move on cannot be said for those who are reliant on the support of social care services and I remain acutely aware of my privilege in being able to.

I found a different (but related) job and thought I’d be able to continue writing with the passion I never stopped having but I can’t. The situation has changed and the voices need to be heard from the frontline I’ve stepped back from. I have become the person I resented for so many years. As a social worker, I always had a hint of scorn for those who took the ‘desk jobs’ and moved away from the direct work with people who use the services we provide but I’ve become one of those people.

In defending myself to the old me, I’d say that changing the world can happen in different ways. I am no less committed to the same ethical standards of making the world of health and social care better for those who use services. I am seeing that social work and social care happens in many different places. Is it an attempt at justifying my decision to leave social work behind? Yes, probably but that’s something I’m reflecting on a great deal at the moment.

I have been disillusioned by the time I spent working in the statutory sector as a social worker. As a parting salvo as I head off into the sunset, I want to reflect on a couple of themes that revolve around social care at the moment.

Kneejerk funding decisions lead to more expense, both in terms of quality of life and finance in the longer term. I’ve seen panic cuts both at a national and local level. The problem with panic cuts is that the things that are easily destroyed cannot be built back up in the ‘good times’.

‘Choice and control’ the buzzwords of change ring very hollow to me now as I saw in both the NHS and the local authority, the way that data and information is manipulated to meet performance targets that are meaningless to people who use services. Choice is one of the most nefarious words in the sector in my opinion. ‘Choice’ is very much defined by what organisations allow to be chosen and the confidence, communication skills, advocacy support of the individual doing the ‘choosing’. I railed against processes that favoured ‘he who shouts the loudest’ but it was to no avail. Presented by the government as a panacea of positivity, I have seen the downside of ‘choice’. It has been the creation of a two-tier service in adult social care that provides those who are able to choose with fantastic opportunities but those who may not have the capacity/support to choose are left lagging behind, in poorer, oft forgotten services. With funding drying up and fewer third sector organisations able to pick up the slack, there is a massive void of support which often falls on family and friends – the ‘informal’ support networks that the government still feel able to criticise.

Dementia care is a particular interest of mine. Professionally I have worked in the area for a number of years. Dementia is moving further forward in terms of government policy making and the so-called ‘dementia challenge’ which is currently trying to increase diagnosis rates. That’s all well and good and I won’t enter that conversation but I will say this. In order for dementia to be better understood by the public it has to be better understood by the government agencies who are supposed to be providing the information. There is a horrendous lack of information about the role that supportive social care services play in improving the quality of life for people with dementia. As I worked alongside a ‘memory clinic’ which had been decimated by cuts, I laughed hollowly at the words of the government ministers about increasing diagnosis rates in primary care and for hospital inpatients. See my first point about panic cuts and lack of cohesion. Reading some of the Department of Health missives you’d be at a loss to think they ever discussed any of their plans with anyone with a current social care background. Perhaps the new Chief Social Worker (or one of them anyway) will provide a sticking plaster to this but it’s very apparent at the moment that there is no cohesive, current social care voice in the government department and it makes some of their policies woeful. The level of ignorance even of government ministers who clearly haven’t been briefed by people who understand social care would be embarrassing if it weren’t desperately sad.

Lastly about Social Work itself. I retain my social work registration and will now until 2014 at the very least. I suspect far beyond that as I don’t want to give up my registration. I am very proud to be and to have been a social worker. The ethics and values of the profession can really shine a light and guide many of our colleagues in allied professions and we shouldn’t be shy of realising our own worth. Often I hear social workers talk of status and comparing ourselves unfavourably to nurses, teachers, doctors, psychologists etc. We shouldn’t need to constantly compare. We have a fine profession with its own knowledge base, standards and codes. Having worked in a multi-disciplinary mental health team (and I think being an AMHP helped with this as we are known to be a stubborn and independently minded bunch) I never felt anything but an equal to the other professionals I worked alongside (and challenged – psychiatrists – I’m talking to you ;)). We do need to ‘sell ourselves’ more and we can’t rely on waiting for ‘good press coverage’. Do the job, however hard, with the ethics and values at the heart and remember why we are there – it isn’t to promote organisational will but to walk alongside and guide. Sometimes there are difficult, coercive decisions to be made but reference to values and ethics become all the more important there. The nature of a job that sometimes has a coercive function is that ‘hearts and minds’ will never be particularly straightforward. I didn’t become a social worker to make friends or to swan in adulation of my ‘goodness’. I went into it because I felt it gave me more opportunities to make a positive difference in someone’s life. More often than not, certainly over the last couple of years, it became more about saying what wasn’t possible than what was – but if I could deliver that with as much humanity and empathy and transparency as possible, it could be a start.

Many thanks to Zarathustra for this space and for the support he has offered to me.

And thanks to everyone for reading, commenting and responding over the last year or so. My reasons for stopping are work-related but not in a bad way. I just think my voice has changed now and it’s important that those ‘on the ground’ have the way left open to them to find it. I won’t say I’ll never write again, I may at some point in the future, but if I do it won’t be anonymously I will, though continue to knock around on Twitter I expect!

Goodbye

The Socialist Workers Party and the Rape Committee: When organisations become cults

[As the title suggests, this post contains possible triggers for rape]

Part of my interest in the (lack of) regulation of psychotherapy is to do with what happens when organisations and ideologies can accountable only to themselves. When the only idea of “correct” and “proper” conduct is that which a closed organisation says it is, then that organisation becomes, for want of a better word, a cult.

A pretty shocking example of an organisation behaving as a cult emerged on the blogosphere in the past couple of days. The Socialist Workers Party has always been a rather strange little organisation, albeit one that has at times punched above its weight politically. If you’ve ever been involved in any kind of protest march or rally, chances are you’ll have spotted them turning up, handing out placards, trying to sell copies of their magazine, the indescribably-boring Socialist Worker, and generally trying to convert the whole shebang into their event. If you were unlucky to have a conversation with any of them, you’d have no doubt been regaled with a Citizen Smith view of the world followed by a look of, “This is what you think, don’t you?”

Yesterday a transcript of an SWP conference was leaked onto the internet. A senior member of their party (referred to only as “Comrade Delta”) had been accused of rape by a female member. Unbelievably, the party’s Central Committee didn’t call the police, but referred it to their “disputes committee”. As the transcript freely admits, several members of this committee were friends of Comrade Delta.

The committee found Comrade Delta not guilty of rape. Admittedly rape is a notoriously difficult crime to prove, often coming down to one person’s word against another, it’s incredible that they set up some kind of kangaroo court to attempt to deal with what is, after all, a very serious crime. One conference attendee even stated, “Comrades, we have to welcome the fact that we have a disputes committee. We have no faith in the bourgeois court system to deliver justice.” And an ad hoc tribunal of his mates could deliver justice? And what exactly did they plan to do if the allegation had been found proven? Build a proletarian prison?

There’s all kinds of allegations in the transcript about the way the complainant (as well as a second woman who made further allegations) were treated by the committee. I don’t feel qualified to comment on the truth or otherwise of these allegations, but their nature is deeply concerning.

While the left has usually allied itself with feminism, this isn’t the first time a far-left group has been the subject of claims of sexual abuse. The Workers Revolutionary Party in the 1980s is a notorious example. It attracted celebrities such as Vanessa Redgrave until their leader Gerry Healey was accused of sexually assaulting up to 26 female members. The allegations blew the party apart.

This contemporary version of that infamous case is currently being hotly debated among the various Trotskyist groupuscules. I notice people are already making statements such as, “As you’re well aware, there’s a serious possibility that such a case could be used by the state to damage the whole organisation.” I suspect that in practice “the state” won’t have to do a thing. They’re already doing a more effective job of destroying themselves than MI5 ever could.

Arguably this case isn’t so much about the far-left as about what happens when a group thinks it is definable by and accountable to only itself. It paves the way for the abuse of power – which ironically is what cults like the SWP claim to be against.

 

 

 

John Redwood MP’s unintentionally hilarious gaffe on poverty

On Friday this news snippet came out, talking about the rise in high-stakes gambling machines in poor communities. Buried halfway down the article is a quote from John Redwood MP, being perhaps a little too honest in terms of how he views the plebs.

John Redwood, the Conservative MP for Wokingham in Berkshire, which has three betting shops, said he had been surprised by the spread of bookmakers in poorer areas.

“I put it down to the fact that poor people believe there’s one shot to get rich. They put getting rich down to luck and think they can take a gamble,” he said.

“They also have time on their hands. My voters are too busy working hard to make a reasonable income.”

Seriously, he said that? Perhaps I’m immature, but I developed a mental image of him saying it while donning a top hat and monocle, perhaps while also sipping a cup of tea with his pinkie extended, and chortling loudly.

The Honourable Member for Wokingham, yesterday

Also, gotta love his distinction between “poor people” and  “my voters”.

For those of us with long enough memories, Mr Redwood was previously a member of John Major’s government. His tenure as Secretary of State for Wales was distinguished by his famous performance of the Welsh National Anthem.

These days, he’s co-chairman of the Conservative Party’s Policy Review Group on Economic Competitiveness. God help us all.

Family and friends are always biased

Recent reports that the family and friends test, often used in businesses to report faulty goods ( would I  recommend my family and friends to buy this?)  will work in the NHS is just another smokescreen for the real problems that the politicians do not want to address.  Lack of  appropriately qualified staff + increased demand = poor care outcomes ( is it really that simple even a nurse can work it out *~*)

I admit to checking reviews on the internet for most things I buy these days but I do not always listen to them especially if they do not meet my needs. The family and friends test will  not be able to identify what my needs are by the way I would expect  an expert to help me do that. Most people would agree that if you want a job doing well you would get the professionals in to do it   so why are we not complaining more when the politicians think it is okay to allow the administration cowboys all over our NHS?

Of course the family and friends test will do nothing to sell the NHS only add to its demise.  Family and friends will expect the best that they can possibly get regardless of what it costs, which is why they will always be biased (See the recent bad press for the Liverpool Care Pathway which is meant to inform a dignified death not hurry it up). Most professionals know when they are doing a bad job  they do not need reminding of it every day. What they do need is support in making the job more effective,  cutting down on the paperwork so they can spend more time with patients and spending that time in a caring role rather that a gatekeeper role, turning people away or turning their back on them is really the last thing they came into the profession to do.