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12 noon
Mr. Alan Milburn (Darlington): The hon. Member for Mid-Kent (Mr. Rowe) deserves all our thanks for initiating such a sensible, level-headed debate, which has been free of the crisis-ridden atmosphere that all too often dominates our discussions of social work issues.
As the hon. Gentleman pointed out, this is an appropriate time at which to discuss the subject--25 years after the creation of the modern social services department. As he also said, in that quarter of a century the nature of social work has changed dramatically. We now have an opportunity to take stock, to appraise the successes as well as the failures and to plan for the future.
Hon. Members on both sides of the House have drawn attention to the dramatic changes in social services in recent years. Social work has been in the front line of all those changes. Social workers, who are often vilified, provide invaluable services, usually for the most disadvantaged, and sometimes for the most disturbed and disruptive, members of the community. The overwhelming majority of social workers do a good job in very difficult circumstances. Their role requires them to make sensitive decisions within a tight legislative framework and limited budgets, and the legal context in which they operate is becoming ever more complex and demanding.
The ink had barely dried on the Local Authority Social Services Act 1970 before new legislation was being planned. We have had the Chronically Sick and Disabled Persons Act 1970, the National Health Service Act 1977, the Mental Health Act 1984, the Registered Homes Act 1984 and the National Health Service and Community Care Act 1990. All those Acts have changed the lives of many people, but they have also placed new and complex responsibilities on the shoulders of social services staff. In particular, they charge social workers with assessing need and commissioning services as well as delivering them.
While every area of social work has been affected by those changes, children's services have inevitably attracted the most public attention. The recent announcement by the Secretary of State for Health of an inquiry into organised child abuse is welcome, provided that it leads to urgent action. My hon. Friend the Member for Morley and Leeds, South (Mr. Gunnell) rightly referred to the need for appropriate safeguards for children in need. Events in Staffordshire some years ago, and the crimes of Frank Beck, demonstrated how abuse can be organised, while Cleveland and Orkney showed how difficult it is to investigate.
Inevitably, the pressures caused by a combination of new legislation and public opinion have led many social work staff to feel that they have moved too far from preventive work. There are no easy yardsticks in child care. As my hon. Friend the Member for Wakefield (Mr. Hinchliffe) pointed out, social workers tend to be damned if they do and damned if they don't, but those who err on the side of caution, and on the side of the child, must surely be in the right.
Unfortunately, life in front-line social work is pretty complex; it is rarely straightforward. Social workers perform statutory duties that have major ramifications for those they help. Although the thrust of the legislation requires them to involve users in decision making, in reality many people are referred to social workers against their will, and securing their co-operation requires considerable skill. Social workers often operate in the context of the courts, and are sometimes caught in a legal minefield.
The onus on staff undertaking assessment for care management, and on those involved in direct care provision, is particularly challenging: the role requires a high level of decision-making ability and personal competence. The social work task is more diverse than it has ever been. Potentially, social workers could be working with all age groups, from babies to the very elderly, in different ethnic communities and in the field and in day and residential settings, dealing with issues ranging from health care to juvenile justice and offering
services ranging from family support to legal intervention. The depth and breadth of the tasks with which they must cope is immense.
Perhaps it should come as no surprise that, as my hon. Friend the Member for Morley and Leeds, South pointed out, there is a crisis of morale and stress-related problems in social work. Social work has also been in the front line of the social and economic changes that have confronted Britain during the past two decades. People needing social work help tend to become ever more dependent, which makes the social worker's job ever more difficult. That, too, should come as no surprise. After all, during the past 17 years unemployment and crime have doubled, child poverty has trebled and the poorest in society have seen their real incomes fall. Arguably, our country is now more divided than at any point in this century, and all too often social work has picked up the tab for social division and economic failure.
That situation cannot continue. The country will cease to be able to afford its key public services if our economy is not modernised and our society reunited. Unless we have a society in which young people feel hope again and families once more form the building blocks for stronger communities, our country's caring services will simply be overwhelmed, and social work will be reduced to a firefighting exercise.
Central Government must take the lead. We need an approach that ensures that social work operates in the context of a new national effort to improve opportunity, spread prosperity and strengthen community. Social work needs to take place in an environment where a nationally led anti-poverty strategy seeks to tackle the unemployment, deprivation and sheer lack of hope that have come to dominate too many local communities. The time has come to relieve the pressure on our hard-pressed public services, including social services. That would allow social work to reclaim some of its heritage of family support, rather than sticking to its current role as merely a family crisis agency.
Mr. Rowe:
Not all the problems are directly related to poverty. The Trustee Savings bank survey suggests that people between the ages of 15 and 19 spend an average of £14 a week on alcohol.
Mr. Milburn:
I have some interest in that issue, as a former chairman of the all-party group on alcohol misuse. But I know from my discussions with social services departments--the hon. Gentleman will have had similar discussions--and with front-line social workers that many of the problems that they confront are a direct product of poverty and deprivation, particularly in inner cities.
I am not just calling for a new policy approach in the Government's tackling of those difficulties; I am also calling for a new spirit of co-operation between Departments in policy making. All too often, the failure to co-ordinate policy in Whitehall produces cracks that cannot be papered over by local services. If social work is to meet the next century's challenges, therefore, a new approach to policy making and new national policies need to be accompanied by something else--the point that the hon. Member for Mid-Kent made about training.
To juggle the often conflicting demands that social workers face, they clearly need to be properly and appropriately trained. The need, however, is not just for
the right sort of entry qualifications, but for appropriate in-work training that continually updates skills and knowledge. The most pressing priority is for all social workers to have to demonstrate general competence. Whatever pressures they face, there should be no excuses for incompetence. Service users should be confident that the professionals charged with making important decisions about their lives are working to agreed standards of practice.
Currently, practice is measured against a range of standards, some of which are organisational and some of which are professional. Clarification is needed to ensure consistency and clarity. Standards for services and standards of practice and of conduct for staff should all be related to outcomes for users and for carers.
Despite the heavy responsibilities that social workers bear, there is, as all hon. Members have said, still no statutory body to which social workers and other social care staff are responsible for their standards and conduct. In this sense, social workers are unique compared with their peers in the medical, nursing and health care professions. Labour Members back the creation of a general social services council, precisely to ensure the highest possible standards and conduct among care staff who work with vulnerable people.
Although there is much work to be done to make the proposal a reality--perhaps the Minister will update us on that--and to ensure that it does not make demands on the taxpayer, a general social services council would have enormous benefits. My hon. Friend the Member for Morley and Leeds, South pointed them out. There would be benefits not only to users and employers but to staff. A GSSC would protect staff against people who are incompetent or unfit, and whose activities undermine confidence in the profession.
A general social services council would give the social work profession the status that it deserves, but I do not want to create a new vested interest, divorced from other caring professionals. Social workers have a responsibility to protect the most vulnerable members of society and to promote a better quality of life for people under stress, but they are not alone in that task. We favour a multi-agency approach to service delivery. We want to end unnecessary duplication of effort and, most important, we want the multi-dimensional needs of service users to be reflected in multi-disciplinary working, where professionals from a variety of agencies co-operate for the benefit of the individual. After all, a person with a mental health problem who is living in the community is as likely to need help from a community psychiatric nurse and a local authority housing officer as from a social worker.
All too often, however, multi-disciplinary working is frustrated by the lack of appropriate joint planning of service delivery. In that sense, the confusion in policy making at central Government level finds a ready reflection in what goes on locally. That is why I want local authorities and health authorities to work much more closely together in planning community care and in implementing its delivery.
Such an approach is especially necessary if a "care in the community" approach to mental health policy is to command genuine public confidence. Time and again, in report after report, we have been warned of the fault lines in mental health policy and practice, which can give rise to tragedy. The messages are always the same,
particularly the failure to communicate and to co-ordinate. Only better co-operation between health and social care professionals can overcome those problems.
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