Social Care Steps out of NHS Shadow
We all know the Department of Health worries deeply about the state of the NHS and seldom spares a thought for social services. But we are wrong, says David Behan, who stepped down last week after two years as chief inspector of social care. Behan will shortly take up a new position on the department’s senior board as director general for social care. He accepts that the DH has traditionally focused more on the NHS. And this was particularly true recently when Sir Nigel Crisp combined the jobs of departmental permanent secretary and NHS chief executive.
But those positions have now been separated, with David Nicholson taking control of the NHS, leaving Hugh Taylor, the acting permanent secretary, running the department.
Behan says the split is hugely significant. He thinks it will allow the department to pay more attention to social justice and equality – overarching issues that affect care of every type, whether it is provided in a hospital, care home or the individual’s own home.
“My sense is that there is an increasing focus on the way we provide services for older people,” Behan says. “They are going to rise up the political agenda. The generation that marched against the Vietnam war and marched to ban the bomb will not accept services that don’t allow them to maintain independence of mind as well as body.”
Behan says his priorities in the new job include giving older people more control of the services they receive, and giving social care’s million-strong workforce more access to training. Inspection results show that care homes where more than 50% of staff had NVQs (national vocational qualifications) are a lot more likely to provide a quality service.
There is also work to be done to help prepare the DH’s case for the Treasury’s comprehensive spending review next year. Behan wants that to include ideas proposed by Sir Derek Wanless in a report for the King’s Fund health thinktank in March. “We have to work out the role of the state and the role of the individual in providing for their own care,” he says. If Wanless was right, both will have to contribute more to provide a decent quality of service.