Brighton Conference and the Fringe meeting with Socialist Health Association
When plans were made in July for Labour Social Work Group to join a discussion on Labour’s policy for Integrated Health and Care, the Party leadership was still up in the air. I can’t begin to describe the heady atmosphere at the Conference, enhanced by perfect sunny weather and the backdrop of bustling Brighton. So I’ll concentrate on the workshop.
First, I had to drag myself away from a packed conference hall just as John McDonnell was about to speak. Against that competition, I was rather surprised that there were around 40 people at the Socialist Health Association Fringe Meeting on Social Care and Health. The ordering in the title was deliberate, as the SHA committee were keen to have social care up front and not in its usual position as an ‘add-on’ to health.
As was the case with many of the billed events at Conference there were changes in planned speakers due to changes in Shadow Cabinet roles. So Emily Thornberry wasn’t there as she has been appointed Shadow Minister for Employment (where she will still have scope to put her previous experience in health and care into good use when impact of benefit cuts and work assessment tests comes up). However, it was a good opportunity to meet Angela Rayner MP, (one of the new intake – already in the Whips office and a member of the Communities and Local Government Committee). Drawing on her work as a carer (not a well-trodden route into parliament), as a UNISON rep and now from her constituency caseload, she provided powerful arguments as to why the health and social care services should work closely together, and against the fragmentation that is resulting from increasing privatisation and cost cutting. We also heard a consumer perspective from a Labour Chair of a Health Watch Board and on Health and Wellbeing Boards
I used my 15 minutes to introduce people to Labour Social Work Group (and to thank Socialist Health Association for the considerable encouragement they have given us in our fledgling months). I started by emphasising that Health, Care, Social Care and Social Work have to be conceptually ’unpicked’, when trying to come up with ways to better integrate them. I used a quote from Robin Miller of the University of Birmingham Health Services Management Centre to emphasise that in the next year or so Labour has to move beyond the warm words about ‘integration’ being ‘a good thing’ and get down to detail. In his paper ‘Is integration or fragmentation the starting point to improve prevention?‘ Miller wrote:
‘We are still trying to understand what types of integration will make the greatest impact in different contexts and for which beneficiaries. ….We need greater precision as to exactly what type of integration is being proposed and between what services. At present there is often a dense conceptual and definitional fog accompanying integration (my emphasis). The term is being used nationally (and indeed locally) in relation to a diverse range of collaborative arrangements between a host of different organisations, services and
professions in order to (hopefully) address a variety of complex issues.’
I used this quote to emphasise that the SOCIAL WORK profession, with its emphasis on the social, is key to working in partnership with vulnerable people of all ages to help them put together the combination of health, therapeutic, social and other public services (including housing, and social security payments) that best responds to individual and family needs and wishes. Much of the emphasis around ‘integration’ has been on services for the elderly, but I emphasised that working age disabled people, those with mental ill-health or addictions and parents and children with long or short term conditions and stressors, also need the benefit of effectively co-ordinated health, care and social work services.
Which allowed me to raise the question of the most appropriate arrangements for the delivery of social work and other components of social care within better co-ordinated service systems. These are likely to be different for the different age/needs groups. (We’ve already had examples of mental health social workers moving from Social Services Departments to Health Trusts and back again).
So going back to Miller’s really important analysis of what is known (or rather the little that is known) about ‘integrated health and care’ to date, now is the time for the Labour Party policy groups and Shadow ministers to move from the generality to the detail. And a joint plea from SHA and Labour Social Work Group that, in doing so, they take time to listen to the Labour party members from across the health and social care professions who have to make the systems they come up with work.
My final plea was for Labour policy makers and shadow ministers to recognise and do something about the fragmented responsibility for social work. Not only is it split between Education and Health Shadow Ministers, but also Home Office, MoJ, Work and Pensions and DCLG, are directly or indirectly employing social workers. The confusion about specialist versus generic initial training (including the rapid expansion of the fast-track specialist social work training courses – Frontline, Step-up and now Think Ahead) is just one example of the Tory agenda that the newly appointed Shadow ministers need to get to grips with. The Tories are not hanging about in their drive to outsource key decision making roles, and their intervening in social work education in order to produce a more compliant profession. Look no further than Cameron’s speech to the Tory conference.
There was a very lively debate- around whether social work is a single profession, or two; whether there is a place for mandatory reporting of child abuse, and more broadly about the impact of the social security cuts and housing crisis which are pushing more and more adults and children beyond the reach of community-based preventive services resulting in ever-increasing pressure of hospital and residential care.
I also made contact with Labour Campaign for Mental Health, and discovered class (the Centre for Labour and Social Studies- a very welcome addition to the left of centre think talk world (www.classonline.org.uk) So now there is work to be done in contacting the Shadow team, who need to quickly get to grips with social work issues if the worst of the planned Tory assaults are to be exposed. All offers of help, joining in meetings in particular areas, writing briefings gratefully received. See below list of shadow team whose portfolios touch on social work.
June Thoburn Interim Chair