At the Conservative Party conference Eric Pickles, the communities secretary, talked of ‘home rule’ for big cities. The government will, he announced proudly, allow councils to pool the budgets across the public sector – social services, care, housing and health improvement. He went on to talk of elected mayors and pay cuts for chief executives, but by now my attention had wandered. I was remembering a visit I made recently to a social services team in the South of England.
Based presumably on roles I have played in both the NHS and industry, I was asked to advise on organisational change. I ended up as near to tears as an old ferreter is allowed to get. The only organisational comment I could make was that the service is so dangerously understaffed that it can no longer function at safe levels no matter how hard the remaining employees work. In fact they are so stretched that more and more are succumbing to stress-related illnesses. The irony is that their super-human effort is making the situation worse by the day.
Nowhere are the effects of this more evident than in mental health. I am less than proud of what my self understanding tells me on this. I imagine that many of you are, like me, afraid of the subject and afraid of the unfortunate victims. We prefer not to see or hear about it and reserve our comments for the headline cases that hit the news headlines. These are invariably followed by an inquiry which berates a failure of social services but fails to mention that many of the workers there have case loads well beyond anyone’s abilility to manage.
The situation at the unit I visited was already grave under the last government, now more cuts are filtering down through local authorities and the situation has lurched out of control. In many serious cases a whole day is required, in reality an half-hour sometime next week is all that can be realistically promised. In that time a lot of things can go seriously wrong, not least amongst them suicide. Social workers are responsible for decisions about compulsory ‘sectioning’ but in border line cases these deserve careful screening and visits. And whilst mental illness can strike any family, some of those worst affected in inner-city areas are themselves problematical.
To add to the nightmare the number of mental health hospital beds are reducing, a fact that adds to the amount of administration required by the social worker concerned. I spent a day with the team and had to confess that nothing in the NHS prepared me for this. In NHS hospitals, staff in areas such as A&E and Intensive care are regularly under great pressure as they deal with life or death situations. Social workers also face these plus a constant threat of violence, but unlike their NHS colleagues have to do so often alone and outside the reassurance of a safe environment where colleagues are usually at hand.
My impression was that morale in many areas of social services is reaching rock bottom. The staff are in many ways similar to nurses in their dedication and compassion but they see no protecting hands outstretched for when the going gets tough. Their dwindling numbers mean that their sense of isolation will worsen yet their clients and their families will heap more and more abuse upon them. Understandable, since they too are desperate and the social worker is the face on the front line, the one that has to attempt to justify hardship born of budget cuts.
Of course we all hate the present and impending wave of service cuts in areas such as libraries and Council funded leisure activities but their outcomes bear no resemblance to those hitting social work. Perhaps the most fundamental weakness here is the organisational link wih local government. A good deal of social work borders on health issues and from time to time governments have attempted to bring them in to a merged structure with the NHS. They have regualrly backed down in the face of opposition from town halls across the land. Hanging on to empires has transcended the needs of people for whom a social worker is the only lifeline. In the NHS, if all else fails, a chief executive has the right to appeal to seniors close to the Department of Health. Social services have to rely on Councils, not a situation one would relish on even day-to-day problems.
My gut reaction when listening to Eric Pickles or even David Cameron was to rant. But in truth they know nothing of these things. I am sure that if the Prime Minister had seen and heard the stories I did he would be shocked. But even he is far removed from issues such as mental illness and Alzheimers and it may well be that, like me, he prefers it this way.
I desperately wish I could see even the smallest light at the end of this dark tunnel. But I can’t. All I see is a total collapse of a vital service and endless headlines criticisng social workers. Even that assumes that there are any left to criticise.
It is a scandal that shames our once proud and caring society!
KEEP YOUR FINGERS CROSSED FOR DELHI!
Having listened to, or read of, endless stories of chaos in Delhi it was a pleasant surprise to see a very impessive opening ceremony to the Commonwealth Games. Sadly all the adverse publicity led to many leading athletes pulling out and the games will be the poorer for their absence.
Of course it is too early to aim retribution at the many ‘experts’ who filled column inches with dark forebodings but, if all continues to go well, that day will come. As things stand they have managed to drag India’s reputation through the mud and many are beginning to ask if their exposes were not a tad premature.
The next few days will see reputations ruined. Let us hope that the organisers and those athletes brave enough to attend are the ones that emerge with theirs intact!
YESTERDAY’S QUIZ ANSWERS 1. Amsterdam 2. 1974
TODAY’S QUESTIONS 1. Which Egyptian king was the museum hit of 1972? 2. Which opera house staged its opening night in 1973?