Perverse Productivity

So the coalition wants the views of the 6 million public sector workers – teachers, police, nurses, social workers, and even managers, according to a hesitant Nick Clegg today.

There are over 100,000 managers working in adult social care. They lead a social care workforce of over 1.5 million. These people work in residential homes and provide support to people in their own homes and in the community. They provide a public service much of it with public money. What is not commonly realised is that only a small percentage are actually public sector workers. Most (over a million) are private and voluntary sector workers. They have a lot to contribute to both how savings can be secured and in making it happen. That’s what managers do.

We would like to know their views and opinions on savings and efficiencies in social care. As consultants (we call ourselves Support Advisers whilst consultant is a dirty word) we know that improved productivity in social care perversely costs money. Costs to local government and the service using public that is but saves money in the NHS. We say tackle it in an integrated way and get away from a focus on just the public sector workforce. Social care is one of the biggest financial challenges facing the UK. In our view it will be the workforce and their managers – public, private and voluntary sector – who will have some of the answers.

Language with a bad name

So management is set to join bureaucracy and institutional in social care’s negative box? Institutions are structures and mechanisms of social order and cooperation. Bureaucracy has as its antithesis adhocracy. It is intended to anticipate need and improve efficiency.

Managerialism is castigated as the cause of the bureaucratic inhibition of best social care practice. It is thought likely to lead to and promote institutional thinking and practice. Self-evidently this is not the case. It is leaders who create law, policy and regulation, that set targets and determine how managers and bureaucrats implement in practice. Social care and social work are not different from any other policy area in this respect.

So for Steve Rogowski (Front Line Focus – Community Care 17 June 2010) to say: \’One cannot get away from the fact that the introduction of managerialism from the private sector over the past 30 years has been the key driver in public services, including social work. Such services have had to become more like businesses and operate in ways influenced by them, including social workers needing to be involved in the competitive stimulus of market forces. The result has been managers rather than practitioners, being the main instrument of effective social policy. This has necessitated social workers essentially having to comply with what managers, at the behest of government, required. Hence, we have had to strictly adhere to targets and performance indicators. Put simply, social work success is now measured in terms of whether someone else’s target has been met, rather than being measured by the practitioner and user(s) between themselves\’ misses the point of how managers should be supported through (good – this word has to be inserted) bureaucracy and institutions. It is the role of leaders nationally and locally to do this for social care.

Like a lot of social workers Steve appears to resent managerial power. He fears that they will carry on… controlling what social workers do. Well of course they will. It is to what purpose they control, how they go about it, their background, training and support that Steve and all of us should be concerned to influence.

In business there is a concept called customer and this is sacrosanct – meeting customer needs at a price they can afford is the key to business success. That applies whether the business is run by practitioners (social work practices), customers (user-led organisations) or managers (bureaucracies). Deviate from that and social care organisations like other businesses will fail.

The problem for social care (and particularly statutory child care and mental health) is that it is not clear who the customer actually is. Leaders in the business give managers mixed messages. This applies whether those managers are in bureaucracies, user-led organisations or in professional practices. If the customer is truly the user of services then they need to have proper purchasing power or what the state says it can afford – personalisation has a model to do this. The role of management is clear in this scenario – to secure the most effective way of meeting service user requirements. If the customer is actually the state (society, communities, the law) then that is a different scenario. Here the manager has to secure the most effective way of meeting what the state determines the service user’s needs to be.

Valuing Language Now?

Our browser has lighted upon a magazine campaigning for equal citizenship for people with learning difficulties. An excellent Spring 2010 edition has a puzzling pair of editorial comments from Elinor Harbridge. Puzzling, that is, in their juxtaposition and in the use of language.

Firstly an entirely justifiable rant about the use of the word ‘retard’ by Vinnie Jones and Davina McCall live on Channel 4. It concludes that \”only a public apology will get the message across that some language is deeply offensive to people with learning difficulty\”.

Second comment about the death of David Askew in Hattersley Greater Manchester – apparently a victim of \”the growing problem of disability hate crime\”. Here Elinor has identified the cause of the problem in one question – \”why are gangs of feral children roaming streets?\”

Wise up Elinor this is language that is deeply offensive to 11 million children. Some of whom have a learning difficulty. A lesson we at CPEA have taken from undertaking Serious Case Reviews for Safeguarding Adults Boards is that the concept of hate crime is too simplistic and that the lives of perpetrators are often in themselves tortured.