Examination of Witnesses (Questions 460-479)|
14 OCTOBER 2003
Q460 Baroness Knight of Collingtree:
So further consultations are actually scheduled?
Mr Collingridge: I have spoken
to the people and yes, they have given an undertaking to meet
with us to work out in more detail the implications. That is particularly
dependent on, I think, the report of this Committee and what exactly
are the implications on and the expectations of local authorities.
Q461 Huw Irranca-Davies: I have listened
with interest to the immediately preceding comments in respect
of the Bill as it stands now and the impact on resources. If,
to go back to the previous discussion, we were to look at the
much more strengthened, central role of the rights of citizenship
and so on, you must have put some thought to this as to the impact
on resources of much more central, much more focused rights of
Mr Dixon: I think it would have
some greater resource implications but I think it would be more
that it would be underwriting the change in public policy that
I think is happening already and which I think needs to be given
an additional push. It would be very difficult to quantify.
Q462 Huw Irranca-Davies: So you anticipate
those demands will become apparent regardless of what we put on
the face of the Bill?
Mr Dixon: Yes. I think, to some
extent, that affects the whole of this Bill. For example, in relation
to Court of Protection work, Hampshire has started to do this
work on Court of Protection, obviously, before this Bill has been
enacted, and we have done too. It is because there are changes
in expectations that we have got to respond to anyway, and the
issue about adult protection has become a very major issue around
the country. Again, without proper resourcing I think it is important
that it is brought within the legal framework.
Q463 Mr Burstow: It is that point
I wanted to go back on, the whole question of adult protection.
Two or three years ago now the guidance was issued by the Department
of Health No Secrets. Can you tell us what assessment you
have made of the implementation of that guidance by local authorities?
Are we still at the stage of codes of practice and training or
are we now at the stage of having procedures that are actually
having a reaction on the actual delivery of service and in dealing
with abuse in care settings?
Mr Collingridge: My conversations
with my colleagues around the country on this issue over the last
week have revealed that there are quite different responses from
authorities. My own and Herefordshire (who have just agreed to
take the lead on this in our ADSS) have got some well-established
guidance and local overview committees, practices and training
in place. Other places have not really begun to implement it very
substantially. It is not a matter that, at the moment, is regularly
reported on to the Department of Health. As far as I am aware,
there has been no particular inspections. So, frankly, we do not
have, as yet, the overview. We would expect some time in the new
year, with our new committee ourselves, to have a bit more of
a feel, but it does feel a bit patchy at the moment.
Mr Dixon: Could I just add that
we do feel bothered that after No Secrets had been launched
it has tended to slip a bit out of the public eye. I am Chair
of the Adult Protection Committee in West Sussex and we have quite
significantly taken action in this area, we have had a number
of adult protection investigations; it was on the television about
a care home in West Sussex, an independent care home, last week
and automatically the National Care Standards Commission picked
it up and referred it to an adult protection investigation. So
there is a lot of activity going on around this.
Q464 Mr Burstow: Are there any ways
in which this Bill could help facilitate the roll out of No
Secrets and the strengthened implementation around the country?
Mr Collingridge: There are. We
have heard some lobbying and I think you have probably heard it
toosuggestions that local authorities should have statutory
duties to intervene. I believe, for example, in the general authority,
when that has not been working terribly well or there is conflict,
perhaps there is a role for local authorities there. You can certainly
think of issues around that area where we should have stronger
powers to intervene, and perhaps a duty.
Baroness Fookes: I do not have a clear
picture of precisely what additional resources would be needed.
Could you reduce it, as it were, to one local authority, one social
services department? Would you need X number of additional social
workers? What would be the cost per year and how is this going
to be sold not to the Department for Constitutional Affairs but
to the holder of the purse strings, the Treasury?
Q465 Baroness Barker: I have an additional
question that follows straight on from that. Does the way in which
social services departments relate to different client groups
in different ways have an impact on the quality of the service?
Does that have a very significant impact for a detailed Bill that
covers very different client groups?
Mr Collingridge: As I said before,
we cannot give you detailed numbers. I can tell you, for example,
in Hampshire how many social workers we have got.
Q466 Baroness Fookes: That is what
I want to know. For a particular authority.
Mr Collingridge: I have my statistics
here in front of me for Hampshire County Council social services.
For example, we have got 200 managers of various sorts, 650 social
workers and another perhaps just under 3,000 field workers of
various sortssupport workers, home care workers. Plus,
of course, you have got a whole tranche of people in the independent
sector which I have not counted there. All of those people will
need a basic level of training. Then, of those 650 social workers,
if you are going to have to allocate particular adult protection
casesand we would expect demands to go up over the next
few yearsyou might be able to factor in after a bit of
research how much extra demand, but I cannot tell you. That is
the baseline from which we are working at the moment in a total
population in Hampshire of 1.2 million. Those kind of figures
I have just given you, I can do more on that, but just to emphasise,
Hampshire is one of the wealthiest county councils and, therefore,
our numbers are relatively low in comparison to more metropolitan
areas. That gives you a ballpark figure of where we are starting
Q467 Baroness Fookes: How many additional
social workers, for example, might you be thinking of?
Mr Collingridge: We do not have
a figure to put on it at the moment.
Mr Dixon: For adult protection
an authority of the size of about half-a-million to one million
people might have appointed about three additional social workers.
It is not a vast amount. It is certainly affordable. It is, I
hope, not so much that it would scare the Treasury.
Q468 Baroness Fookes: Are they there
to be called upon? I thought there was a shortage of social workers.
Mr Dixon: There is.
Mr Collingridge: The recruitment
and retention of social workers is a major issue. The Department
of Health has been engaged in some work nationally to try and
raise the profile.
Q469 Baroness Fookes: Even if you
have the money it may not necessarily be easy to get the bodies?
Mr Collingridge: That is right.
There needs to be a whole strategy around this. If I can just
add as well to the issue about figures: I looked yesterday into
how many adult protection referrals Hampshire had had. We had
80 in the first six months of this year. So that perhaps gives
an indication of the size we are looking for.
Q470 Mrs Humble: Of course, it is
not just social workers, it is your trainers, it is the administrative
staff, it is the back room people who make sure the social workers
can do the job.
Mr Dixon: Absolutely.
Q471 Lord Rix: Could I add to that?
You mentioned independent agencies; I presume you mean voluntary
bodies, I presume you mean parents, you mean carers, etc. They
have all got to be added to the bill, too, in some way or another.
Mr Collingridge: Yes.
Mr Dixon: An adult protection
committee now comprises about 20 different organisations, including
voluntary organisations, including a range of statutory organisations
and others. Could I answer the other question about the impact
on different, what we would call, client groups? I think that
is a very important point because we do provide a differential
level of service to different age groups and people with different
ranges of need. I think part of, as it were, our bid today is
to be saying that this is a group of people who have tended not
to get their fair share of the resources that there are going
because their profile is lower. I think it is important that we
should address that because there is a groundswell of need and
a groundswell of opinion that we should move to assist them.
Q472 Baroness Barker: Following on
that point, in the additional resources you are talking about,
what would be the impact of Directors of Social Services to act
as court appointed deputies, able to take welfare decisions for
people who lack capacity? Could you answer that in light of the
different and changing financial interests of charging policies
which your departments are likely to be entering into?
Mr Collingridge: First of all,
I think possibly many more authorities are going to have to pick
up on the financial issues and have receivership units like, for
example, Hampshire has. That costs us about £120,000 a year,
of which we get back some money in charges. Secondly, there will
be additional social workers for cases. I think you will have
to have an individual person allocated to keep a close eye on
the people for whom we have powers. Thirdly, of course, there
are the legal costs and administration. We may need some additional
administrative committee-like committees to oversee implementationI
do not know. There is one other issue which you, perhaps, were
not expecting me to say on this, but in our discussion with the
Department for Constitutional Affairs they talked about not the
Director but, perhaps, people lower down in the structure having
the legal power. We have got some concern about that; we think
perhaps it should be the statutory function of Director who then
delegates down, but certainly some of the thinking was perhaps
to give the legal powers to a manager or even a social worker,
and we are not terribly happy about that. That is the first part
of your question. I cannot remember what the rest was now.
Q473 Baroness Barker: I wanted to
focus particularly on charging policies and potential conflicts
of interest. If I might add to that, what are the implications
for this work when you are increasingly involved in joint planning
of services with PCTs, for example?
Mr Dixon: Clearly, we need to
think through what the implications would be for charging, but
local authorities are very used to charging where we can because,
otherwise, we are not going to be able to provide services for
others who are in need of them. So where that is feasible and
appropriate we want to explore that possibility as part of the
development of the codes of practice.
Q474 Baroness Barker: How would you
deal with conflicts of interest?
Mr Dixon: I think, to come back
to the point we made at the very beginning, we have a clear responsibility
to receive tax, to raise taxes locally and to try and square the
equation in terms of the way we spend the money in relation to
meeting our legal obligations and, indeed, our moral obligations.
We need to establish advocacy and support for families and for
service users to balance out what is that evident conflict of
interest between us. The executive, whether it be a local government
executive or national executive, always has that conflict of interest
between resources and what we spend. It is the job of advocates,
as it is the job of families, to be unconcerned about the resources
but to be concerned only on the need. We need to have somebody
who will come forward who will tell us also what that need is,
so that we can hopefully do better at balancing that equation,
but is a perennial problem that we live with.
Q475 Lord Pearson of Rannoch: Forgive
me, but should that be up to a director of social services?
Mr Dixon: I think there is an
issue there. I think there is a potential problem. On the other
hand, we do, not infrequently, intervene in people's lives whether
it be children or whether it be adults where other people who
would be expected to undertake those responsibilities fall down.
So if somebody has a general authority and is abusing that in
some way, or there is an adult protection issue around an LPA
then we would expect to intervene because somebody needs to do
so. There is a principle here, in the Bill, of the least intervention
in people's lives, and that is very important.
Mr Collingridge: Your question
prompts me to think about some of the new arrangements that have
come in recently about scrutiny and overview committees. Our one
in Hampshire has just reminded me recently that they could scrutinise
what I do, and there is a whole new set of relationships and functions
in local government whereby the executive is called into account
by other groups of elected members. So that offers a possible
check or balance.
Q476 Baroness Knight of Collingtree:
Coming back to a point you made just a few moments ago, in your
submission to us you say at one point "We would like to know
what proposals are being developed to enhance access to these
services through the voluntary and independent sector, including
the resources made available." Was that just a cry in the
wilderness or were you actually hoping to get an answer there?
If so, from whom?
Mr Dixon: That is back to the
advocacy question. I think it is not a cry in the wilderness
Q477 Baroness Knight of Collingtree:
You anticipate getting an answer at some point?
Mr Dixon: Yes, indeed.
Q478 Baroness Knight of Collingtree:
Mr Dixon: Anybody who is prepared
to give it!
Q479 Mr Burstow: I wanted to come
back to this issue of conflict of interest. It is really central
to the part that local authorities and social services departments
will play in giving effect to this legislation. Are you saying
to us today that you have a clear idea of how you would separate
out your responsibilities as a substitute decision-maker for an
individual who lacked capacity from your responsibilities both
as executive and scrutineers of your activities in carrying out
your fiduciary duties to your ratepayers, or your council taxpayers?
They are two completely separate things. If one over-weighs the
other, and you act in the interests of the ratepayer, you may
well means-test someone and charge them, dispose of their assets
in circumstances where, in fact, if they had capacity, they may
well have wished to contest the argument and, indeed, argue that
they had, for example, continuing care rights that were not being
properly discharged. How do you square that circle? Can you square
Mr Dixon: No, you cannot square
the circle. It is a continuing tension and it is one that we live
with on a daily basis. Social workers take decisions, managers
take decisions, and I, along with our elected members, oversee
those decisions on a constant basis. I think it is impossible
to take that tension and that task away from any executive. You
always have to balance out the question of meeting need with rationing
the resources that are required to meet that need.