On Friday, a group of senior leaders from council social services departments got together with colleagues from the Department of Health team writing the social care White Paper due later in the Spring. Sue Bott from Disability Rights UK and I did our best to keep order in a passionate debate about how to tackle a question as old as social care: what role should the state play in helping people to help themselves and each other? Peter Hay, this year’s ADASS President and social services Director for Birmingham, opened and closed the discussion and outlined a situation common to lots of areas: demand for services increasing whilst budgets shrink, coupled with recognition that even the best services cannot meet some of the most pressing needs, like isolation or exclusion from community life or employment opportunities.
I felt privileged to listen to the risks which local leaders are taking to turn a dysfunctional system on its head: it’s so very easy to panic and take a short term view when faced with a crisis in funding, but there are places around the country who have refused that easy option. There will soon be an open call for examples of citizen-led approaches to care and support, to which I’d encourage anyone with knowledge of promising local work to respond. But in the meantime, by way of processing some of what I heard and hopefully widening the debate, this blog and one or two following will set out some of the questions we kept returning to.
My first observation is that when groups get together to discuss citizen leadership and ‘social capital’, we often end up arguing about the merits of competing approaches, which in reality are not mutually exclusive. Here are a few questions, to which I think the answer might be “both”:
- Should we argue the case for citizen-led change in terms of what’s right (being connected and independent is better than being isolated and dependent) or what’s cost-effective (when people help themselves and each other, they rely less on services)?
- Should we pilot approaches and rigorously evaluate their cost benefit, or let a thousand flowers bloom?
- Should we accept that the best citizen and community led activity is built on close relationships and therefore happens at the micro-scale, or should we always be thinking about how to scale up?
- Does leadership need to happen at community or council level? At local or national level?
- Is the most important thing to aim for a truly universal offer, which reaches everyone, or at gathering better risk data, the better to target specialist interventions?
I’m going to say more about the answers to those questions in the following blogs, but in the meantime, I’d be interested in your thoughts.
The answer also depends on where you are in the ‘system’ – self funder, mixed funded, direct payment, provider brokered, carer etc.. Councils have more control/influence over some of these areas than others… and also who you are – what level of control do you want to exercise around your support or are able to. The overall system will have to accommodate a wide range of needs and aspirations if it is to work which is a challenge for organisations who need to measure just about everything in order to prove they’re getting it right. Which begs the question are they the right organisations to be leading the change? J
Interesting contribution, thank you.
I’m reminded of a paper by David Brindle for Joseph Rowntree Foundation a couple of years back – might be a useful conceptual framework as part of the debate.