National Care Service white paper: campaigners raise concerns


Two leading disabled campaigners have welcomed the government’s plans for a National Care Service, but have raised serious concerns about some of the proposals in the white paper.

Baroness [Jane] Campbell said she was “quietly satisfied” with the basic structure laid out in Building the National Care Service as she had “fought for a long time for a comprehensive service like the NHS” which would raise the status of social care and support.

And she said she was “thrilled” with the white paper’s commitment to “portability” –allowing disabled people to move to a new area and not face a reassessment of their needs – adding: “Disabled people have been fighting for the right to freedom of movement for over a decade.”

But she said there was a need for “a bit of reconstruction” and some additions to the white paper.

She said she was concerned at the suggestion of a licensing scheme for personal assistants (PAs), with the possibility of “compulsory statutory regulation”.

Baroness Campbell said the independent living movement had “fought very hard” for “permissive” and not “mandatory” regulation of PAs, and a licensing system would “undermine independent living and the right to risk taking”.

Rowen Jade, the newly reappointed chair of Equality 2025, the government’s advisory body on disability equality, shared her concerns.

She said registration could prevent her taking on inexperienced individuals with potential, and “take away opportunities for people that cannot provide bits of paper as proof that they will be good personal assistants”, and would “limit choices” and “limit the pool of available employees”.

Jade said she also wanted to see “definitions and explanations” of many of the phrases in the white paper, such as the government’s promise of “high quality” services.

She was particularly concerned about the emphasis on “reablement” and what that might mean for some disabled people.

The white paper says those approaching their council for support should be offered “a period of re-ablement” before a needs assessment takes place.

Jade said she was concerned that, for example, a council might persuade a disabled person who needed an hour’s support to be fed to have a feeding tube installed instead “in the name of independence”, but really as a cost-cutting measure.

Jade said some of her concerns had been “erased” after her first brief look at the white paper, but added: “I feel there is now a lot of work to be done in taking what is written in the document and making it work for disabled people.”

She said Equality 2025 would now be scrutinising the white paper “very carefully”. She added: “Equality 2025 will be working to make sure that those that are currently best served under the postcode lottery are the benchmark for the National Care Service.

“Realistically, there is never going to be a time when there is enough funding, but if there are cultural changes [across the whole infrastructure]a little bit of funding can go a long way, so I am optimistic.”

A Department of Health spokeswoman said the new licensing scheme would be run on a voluntary basis for all social care workers, and would be trialled first before the government decided “whether any particular groups of workers might need compulsory statutory regulation in the future”.

She said: “We are committed to making sure people receive high quality care, and there are a range of options that could ensure that a regulatory regime is proportionate.”

But she said it was “a complex issue and requires a sophisticated approach”, and the pilot scheme would allow the government to “give full consideration to the risks, costs and benefits associated with models of regulation”.

1 April 2010

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