The 1980s was the decade in which, as in every other walk of life, the concept of service in UK Social Care suffered a lingering death. This was subtly subordinated to profit.
During the first five of these years the purchaser/provider system began to dominate and convert the task of Social Workers to shoppers for facilities which their departments had once managed themselves.
Until then field workers who needed a provision, such as a placement for children, would negotiate with another section of their agency, to find a residential placement for them. We in the Area Teams would now, through use of budgets, be required to buy the facility from the residential department.
With the increasing trend towards outsourcing across the board Local authorities’ own provisions were slowly reduced as we saw the advance of private agencies treating what were still called Social Services as profit making businesses. In Newark during the 1990s I met at a dinner party a man who had set up a group of care homes for people with learning disabilities. This was the flavour of the month at the time. The gentleman, amenable enough, had neither knowledge of nor real interest in the residents, but was openly taking advantage of government financial incentives.
Because of the shortage of available accommodation for teenagers leaving care homes in the early 1980s I had, in my own time, chaired a group setting up a voluntary agency to provide some of what was needed. This was the Stepping Stone Community, about which more will follow in time.
I was beginning to feel that the writing was on the wall as far as I and Social Services were concerned. This was compounded when yet another reorganisation was set in motion. The Area Managers were to lose their Deputies and another layer of management was created between the Director and the Head of Fieldwork. He and I would be effectively demoted.
The Director told me not to apply for the new post. When I asked him why not he replied that I was not in the forefront of change. I could have spoken about the Stepping Stone Community or I could have mentioned the Summer Sports Project, but I saw no point, and replied: “Someone’s got to do the nurturing, Bill”. This project had been an imaginative use of a fund to help keep vulnerable children out of care. Once again the administrative staff were fully involved. In our area there were numerous sports facilities such as the Jubilee Hall Sports Centre, various parks, and football fields. We bought the necessary equipment for a range of activities. Each staff member was allocated an arena and a group of children, depending on interest and skills. This was so successful that we had to abandon it after a year or two because the older child members were being sent with too young siblings in their charge.
Home Helps were a team, under my wing, who visited elderly and disabled clients in their homes and carried out a range of tasks involving cooking, cleaning, and personal care. After I left these, too, were outsourced, their services radically reduced.
Jackie, who worked in Merton until the first years of the current millennium, first as a Carer, which is what Home Helps are now called, and latterly as a Care Manager, which is a current term for Social Workers, was told by her senior manager that a carer spending time listening or talking with clients was a waste of resource. She was required to explain why helping an elderly person to shower would take more than a quarter of an hour. Sometimes it would take that long for the client to answer the door.
These services are all now farmed out to private agencies who pay minimum wages, use often untrained and inexperienced staff, expect the carers to provide their own transport, do not pay for time travelling from one job to another, and cut considerable corners in time allocation. Consistency of carer is a thing of the past. My own mother was subject to the consequences of all these aspects, until she transferred to a care home. The amounts Local Authorities can contribute to such are woefully inadequate. At least half the cost has to be funded by the family, which generally means, as in our case, that the resident’s house has to be sold to pay for it. The National Health Service can only fund Nursing Care – without medical need it is the responsibility of the Local Authority with its own limited budget.
Hospital beds are being blocked because otherwise well patients have no available residential provision. This is now being seen as a crisis in Social Care. It cannot be resolved without changes in attitude and training.
The above factors all contributed to my giving my Director six months notice of my departure. I used this time to build up a freelance practice, and was amazed when I was given a day a week contract by my boss to be available for consultation to all sections of the department. I was left to manage this myself, and did not go short of referrals.
It is indicative of the changes in technology that when asked what I would like as a leaving present I opted for an electronic typewriter. Today’s widespread use of personal computers had not yet arrived.
Some two decades later, John Munt, Jackie’s manager, when leaving his post, presented each of his staff members with a calculator, informing them that they would need them.
It must’ve been shocking to witness.
Afraid so – it has all been ruined. Thanks very much, Sheree
😞
I believe that we are part of a fortunate generation, the only generation that has enjoyed the NHS and the social care system as it was originally intended. I look on with sadness as I see it being systematically dismantled and privatised.
I noticed the same changes here. Diminished resources and poor care for those in need. A friend of ours, Danny Fitzgerald was left to languish and die in a hospital bed because there was no space for him in a facility that should have looked after him. He was a jazz musician who helped train Madeleine Peyroux.
So sad, Sherry. Thanks very much
It is sad to read that things are no better concerning care services in your country than they are in mine. As you know, my siblings and I cobbled together an exhausting and expensive system to provide my mom with care with each of us taking a shift, too, but which also left her unattended for many hours.
So true, Merril. I do, of course, remember your plan. Our Mum was not neglected in her care home, but it was very costly compared with the Local Authority allocation. Thanks very much.
You’re welcome.
What a shame to be told, “a carer spending time listening or talking with clients was a waste of resource.” Definitely a down-turn in the field of social work. Aren’t you glad you served in those earlier years when you could do for the needy what you knew they needed? We have a nursing home here in Ennis that serves its residents with the utmost of care and compassion. It gets the highest ratings whenever an evaluation team from the state comes to do their inspection. I feel very blessed to be able to volunteer there. I have to do a rapid COVID test and wait 15 minutes for the result before going in each time, but that is one more example of the care they take to be sure the residents CAN have visitors and still be safe.
You are right, Jan. When I began Social Work was in the ascendancy. Your nursing home still sounds exemplary. Thank you very much
Increasing Commercialisation of social care and health care is one of the worst evolutionary trends of capitalism. It can quickly turn critical institutions involved in the process into dysfunctional peripherals. You have held your head and standards high through the transmogrification of it all.
Thank you so 8uch, Uma. Unfortunately you are right
It’s all about the money! So sad to see how everything was ruined!
Thanks very much, Ribana. I am afraid you are right.
The whole point of social institutions is to provide for the health and well-being of EVERY citizen and the betterment of the society as a whole–not to make money by exploiting our most vulnerable citizens. ARGH!!
You have nailed it, Liz. Thank you very much
You’re welcome, Derrick. (I wish I hadn’t.)
This is so interesting, especially the part about the time allocated to each patient.
My mum had two different types of lung disease and needed twenty-four-hour oxygen; she was limited in what she could do for herself but was determined to stay in her own home. Two carers visited morning and early evening, almost always the same two.
One day, a manager visited Mum to ascertain what she could and could not manage to do, then she told Mum she ought to be doing more for herself.
A day or two later, the manager contacted me and told me that Mum’s carers would be changed because they were spending too much time with my mother and that she was taking advantage of them by not doing enough for herself.
I was appalled at this and said as much. My mum could only manage a few steps at a time; it was physically impossible for her to do more.
A couple of weeks later, my mum’s carers were changed; Mum was upset and took a dislike to the new ones.
Her health deteriorated, so we asked her to move in with us. We asked for carers for the mornings because at the time I worked only in the mornings; the arrangement worked well for both of us. Mum remained with us for four months until she was admitted into hospital, where she died a month later in January 2003. I always blamed the manager for my mother’s swift deterioration.
Thank you very much, Sue. A rather familiar story, I am afraid.
I forgot to say that Mum’s original two carers came to her funeral and took the opportunity to tell me how much they had enjoyed looking after her.
That is really good
Yes, I thought so too.
This is an all-too-familiar and heartbreaking story. I’m so sorry you went through this.
Thank you very much for your kind comment, Alys.
Thank you so much, Alys
Oh, Sue! I was so sorry to read about your Mum and all that she, and you all, went through. So sad. And shouldn’t have been that way. 🙁
One of my SIL’s was a home health nurse/care giver for years and such a good one. But she moved on to a different job when she was given similar orders like your Mum’s caregivers were given. 🙁
(((HUGS))) <3
Thank you, Carolyn. 🙂
How sad, Derrick. Although I can not speak from personal experience, I fear that something similar has been happening here in the U.S.
Mammon rules, Pat. Thank you very much
You got that right. I particularly despise people who scam victims during times of crisis like fake COVID masks, vaccines, or tests, or fake solicitations for money that go to the scammer and not the victims of a natural disaster. They deserve their own private ring in hell.
I will echo the other comments. Sad. Also infuriating. Short-sighted. inhumane. Same thing happened over here, and my husband, who was a social worker, eventually left his job because he felt that he was no longer providing good care due to all the cuts. The eighties were quite a time, both in my country and in yours. Decisions made then have set many things in motion, most of them terrible. Those in charge during that time have a lot to answer for. History will not judge them kindly. On a brighter note…so glad to read that you were able to branch off on your own and have a successful career.
Thank you so much, Laurie. I hadn’t realised that Clif was also a social worker.
Clif was for many years until he felt he was no longer helping the way he should be.
Yes to to all you’ve said here, Laurie. Profits before people never ends well.
Never ever.
This is really sad, to see people who need help badly have so much difficulty. My first wife worked at what was and maybe still is referred to as, a Group Home. Several young people or older people, grouped by male and female in different homes. She was bitten more than once, I feared for her safety.
Thanks very much, John. A tough job.
This is a well-written commentary on the profits before people model. It’s heartrending to see the suffering of individuals and society as a whole.
Indeed, Alys. Thank you very much
We lost our way. The days of doing the right thing. Service was chucked out on the alter of internal markets and profits. It’s only ever getting worse.
You know better than most, Gary. Thanks a lot.
When profits come before care, we end up where we are today–unable to cope with a healthcare crisis.
Quite so, Rosaliene. Thank you very much
A very depressing scenario, Derrick. Not a lot of genuine care in certain departments.
I feel so sorry for those in need of care and those on the front line giving it.
Thank you very much for this sensitive response, Helen
😊
This is so heartbreaking, Derrick. And what Jackie was told by her senior manager is appalling. 🙁
I can understand your frustrations. When our hands get “tied” we can’t help anyone properly. 🙁
And whenever $$$ is more important than people, and caring for people, the people in need are the ones who suffer greatly. 🙁
(((HUGS))) <3
Quite so, Carolyn. Thank you very much
Things started going south in the 1980s over here, too. A global trend, it seems.
Yes, Lavinia, and we are seeing the results in so many ways. Thank you very much.
A very pertinent post.
Thanks very much, Tootlepedal
The Thatcher – Reagan years significantly changed economies in many first-world countries. Capitalism was presented as democracy, and social care as communism. We have it here, too, across the board. Even job seeking was privatised and no longer under the comprehensive umbrella of the Commonwealth Employment Service. And there are so many more examples…
That is an astute, acute, analysis, Gwen. Thank you very much for adding it to this post.
I gather that there was (or is) no system of grants and grant writing in place to solicit funding for Social Services? What you describe is execrable, and the only way we have been able to function here is through grants.
Grants are just for voluntary agencies, and can only be accessed by going through a series of hoops. Local Authorities are part funded by government and by ratepayers. Thanks very much, Dolly
What you describe mirrors my experience at the Department of Veterans Affairs here in the states. There are two good things I can think of: first is that the transition from “help focused” to “production focused” in VA in the US happened between 2010 and 2015, which is so RECENT compared to when this shift happened in most places. Similar to Jackie’s conversation, we were told there was no reason to talk to a veteran on the phone more than 10 minutes, and we would not get paid for anything longer. Often it took 10 minutes until they were done yelling and ranting or whining and complaining, before we could even begin the business part. Etcetera. The second thing I think of, which is good disguised by tragedy, is that the pay for these positions is so low that people often will only keep doing this work out of a greater sense of commitment to the people they serve. In that way, you do tend to get a lot of people filling these positions who really do care.
Thanks very much for this global perspective on the problem, Crystal