Sell-Off Of Care Services Attacked

Vulnerable people are having their lives disrupted as charities are forced to compete with each other to take over council-funded services, it has been claimed.

The process can lead to anxiety on behalf of service users, as care services and staff they have grown to depend on are replaced by a rival organisation whose bid is preferred by the council – who pay for their care.

Many charities and service users believe councils use the process to cut costs and prefer cheap bids over high-quality ones. However, councils reject this and say some voluntary organisations are themselves stirring up unnecessary fear among the people they support.

Frustration over the way some councils commission social care services has boiled over with the publication of two highly critical reports.

Voluntary organisations which carry out work on behalf of local authorities have been cautious about speaking out over the retendering exercises being carried out by many local authorities, but the reports accuse several councils of disrupting the lives of vulnerable people for no real benefit.

Leading agencies on the other side of the argument, including the Association of Directors of Social Work (ADSW) and the councils themselves, concede that there have been some problems and are calling for a “mature debate” over the vexed issue.

The first report, from Community Care Providers Scotland (CCPS) contains the results of a survey of the experiences of organis-ations involved in 14 separate retender exercises in 10 local authority areas.

The report refuses to name and shame individual councils, but claims hundreds of people dependent on social care have had their daily lives affected, including clients of six learning disability services, one mental health service, four services for older people, two for children and young people and one autism service. So too have at least 500 members of staff.

Overall, the 14 retenderings resulted in 24 transfers of business between 19 provider organisations.

In recent years such tenders have been common, ostensibly in the interests of efficiency and modernisation. Argyll and Bute, South Lanarkshire and East Ayrshire are among the areas where the process of recommissioning work – such as community support for people with learning disabilities or dementia – has caused anxiety.

In some cases councils wish to cut the number of providers they deal with in the voluntary or private sector. They insist the quality of services and interests of users are their main priority. However, CCPS says the main reason for the exercises seems to be to meet European procurement regulations or budget restraints, or both.

Their report questions whether there is any benefit to the clients of social services in the process, pointing out that retendering can cause anxiety and stress for those affected.

The report details a catalogue of concerns, including: l None of the councils involved had assessed existing services beforehand to determine whether they were good or bad.

The process appears to fly in the face of policies encouraging personalisation and self-determination: clients were often not consulted until late in the process, if at all, and some families were told they couldn’t be involved as they “might be biased”.

In some cases charities were unable to bid for the work they currently did without bidding for additional work – forcing them to compete to take over contracts from fellow charities.

Claims from some providers that very minor differences in the scores awarded to rival tenders, staff and services could be transferred on a “massive scale”.

Many of the providers who responded expressed grave doubts over the weight given to quality in deciding on the strength of bids, particularly in relation to the priority given to cost.

CCPS has also objected to the terminology used in some tenders. When South Lanarkshire Council contracted out care services a year ago, bidders were invited to tender for “lots” of varying numbers of people with learning disabilities.

The second report was the outcome of a recent Learning Disability Alliance Scotland conference on competitive tendering. Members of LDAS, which includes Enable, Quarriers, the Scottish Society for Autism and Leonard Cheshire Scotland, reflected similar concerns.

Ian Hood, of LDAS, said competitive tendering was the wrong way to commission services for people with learning disabilities.

He said people were having their services interrupted and changed without any clear benefit to themselves. In many case links were broken with voluntary organisations which the person had worked with for many years.

Hood claimed that commercial secrecy was replacing colla- boration and individuals with learning disabilities risked having their rights and status seriously undermined by the lack of consultation.

“What they have done goes against the spirit of the law in terms of consultation and empowerment and making sure people are involved with the decisions that affect them,” he said.

“They were kept out of the loop so they wouldn’t get upset. It is an extremely patronising way of treating people with learning disabilities in the 21st century.”

Harry Stevenson, executive director of Social Work Resources at South Lanarkshire Council, said councils were keen to have a mature debate over the problems with retendering, but added they were obliged to secure best value and ensure continuous improvement, while observing European regulations governing the awarding of contracts.

He conceded that describing vulnerable people as “lots” had caused upset, but said it was prescribed by EU advertising templates. “We share the concern that in relation to services involving people it is not the appropriate language.”

However, Stevenson insisted that there were clear benefits for users in the process. These include making explicit what providers were required to deliver.

The exercise had not delivered savings, but better services, he argued. “The transfer of provider has gone ahead with very little disruption to individuals and no specific complaints raised with the council about a change for the worse in the quality of the service,” he added.

Stevenson claims that services users had been involved, while in most cases staff had transferred to the successful organisations, maintaining continuity.

Many eyes in the voluntary sector are now turning to Edinburgh City Council, where LDAS has accused the city of putting vulnerable adults “up for sale” by tendering all of its “non-core” care services, including care and support for a range of groups – such as homeless people, those with learning disabilities, mental health problems and physical disabilities.

The council disputes this interpretation. A spokeswoman argued that bids would be determined by a formula which scored 70% according to quality of service and only 30% on price.

The tendering process would help address a shortage of capacity in existing services, she added. Currently 150 people with learning disabilities need accommodation and support and are on waiting lists, she said. Retendering would allow them to be provided with a service much more quickly.

Sue Brace, community care convener for ADSW, said that it was important that councils and outside service providers do not end up in an adversarial position. “There can be very valid reasons for retendering some services, for instance if quality is below the standard it should be,” she said.

“People are concerned that the cheapest bid will always win but that is not the case.”

Leading agencies are now trying to thrash out joint guidance which it is hoped will avoid some of the problems with commissioning.

Annie Gunner, CCPS director, is also looking for a way forward and met with leading organisations including the Scottish Government’s procurement division, Cosla, the Social Work Inspection agency and individual councils on Friday to help encourage alternative approaches.

She said: “Our members are concerned at the massive amount of disruption that this is causing and say that the effort that goes into dealing with paperwork is effort that would perhaps have been better devoted to improving the service in the first place.

“We would like councils to carry out an exercise to assess the quality of services before they determine what needs to be retendered – and then they could only retender any service which isn’t performing”.

A Government guidance note appears to have confirmed that councils are not obliged to retender services in all cases. However, they are required to be able to demonstrate why they have decided it is not necessary.

“If they can build up sound and objective reasons not to retender then they don’t have to,” Gunner added.

However, she said CCPS members were unhappy about the attitude of some councils, who have rejected the use of Care Commission reports or service users’ views as biasing the fairness of procurement decisions.

“If people appreciate the service that is seen as a bad thing, which foxes us slightly. When you listen to the rhetoric of service users’ involvement and control, we are always being told people should be informed what is going on and make their own choice.”

Gunner argues that tendering exercises so far have been messy affairs because of unresolvable tensions caused by imposing a procurement structure which doesn’t fit social care.

Some councils are already taking different approaches, including Dumfries and Galloway, Falkirk and North Lanarkshire, she added.

‘I was happy with the way things were’

David Brown, of Kilmarnock, says his experience is a clear example of the way the competitive tendering of services can adversely affect people who depend on them.

David lives in a supported flat for people with learning disabilities owned by the charity Key Housing. But when East Ayrshire Council put Key Housing’s contract out to tender recently, Key lost out to Quarriers, who took over the support element of David’s supported accommodation.

Now his needs for domestic support services, such as help with shopping, are met by Quarriers. He says he has nothing against them and the difference in the service isn’t significant. However, he claims he lost out badly from losing his long-standing link with Key Housing. Before Quarriers took over, David was secretary of the Key Housing Tenants Action Group and had a part-time job with the agency as a co-trainer – which gave him a sense of worth as well as a way to earn a little extra money.

He says the opportunities he enjoyed with Key gave him confidence and social engagement. In fact, David was one of two service users whom East Ayrshire Council invited to contribute to the retendering process. However, he believes the procurement team were not interested in his view that change was unnecessary. “I said I was happy with the way things were and that none of the tenants wanted change. But they kept saying they had to do it and that it was the law.

“If that is right, then why have other councils decided against this approach?”