|SocialismToday Socialist Party magazine|
Social care provision faces savage cutbacks – on
top of years of underfunding. This will have a devastating impact on the
lives of the most vulnerable in society. As ever, social workers will be
expected to pick up the pieces. This is the bleak background to this
discussion article by BRADLEY CHAMBERS outlining his view of social work
in Britain today.
Social care provision faces savage cutbacks – on top of years of underfunding. This will have a devastating impact on the lives of the most vulnerable in society. As ever, social workers will be expected to pick up the pieces. This is the bleak background to this discussion article by BRADLEY CHAMBERS outlining his view of social work in Britain today.
BEING BESET FROM all sides with an onslaught of attacks – in the form of vicious government cuts or media misrepresentation – might lead one to conclude that the main reason people pursue a career in social work is sheer masochism. Yet the main motivating factor remains the desire to ‘make a difference’. Compassion and genuine concern for the disadvantaged in society and a commitment to bringing about real and lasting change are great qualities and are emphasised in various social work recruitment campaigns. Sadly, the theory of social work and the reality of what it has become mean that these qualities are too often subdued rather than realised.
Whether newly qualified or highly experienced, social workers are all too well aware that the job is not what it once was. Decades of small but significant changes have culminated in a qualitative shift in the role itself: from being an enabling and therapeutic profession to a role which is intrinsically part of the neo-liberal agenda to undermine the welfare state. It is worth recalling precisely how this change came about, not least as it may help to explain where the profession is heading.
A Marxist interpretation of the state situates the profession of social work as an upholder of the principles of capitalism. While practitioners work hard to alleviate the worst excesses of the capitalist system, in the sense that they attempt to take the edge off the poverty endured by service users, this is often the most that they feel able to do. Social workers seldom recognise a role for themselves in overcoming the capitalist system. Yet the ruling class is under no such illusions. Fully aware of the potential of social workers to work alongside the oppressed and the vulnerable to promote active resistance to the system which causes such social ills, the opportunities for radicalism and innovation in the profession have been gradually but assuredly eroded.
The emergence of radical social work
THE FATE OF social work depends greatly upon the wider social climate in which it operates. The year 1968 witnessed an explosion of social revolt and rebellion. Powerful social movements emerged globally and included the anti-Vietnam war movement, and those for LGBT (lesbian, gay, bisexual and trans), black people’s and women’s liberation, alongside a resurgent trade union movement. While it was often not entirely clear what the rebels were fighting to achieve, it was abundantly clear what they were opposed to. Consumer society had alienated an entire generation and the post-war period had failed to solve the problems of poverty and social decay. Unsurprisingly then, this was the period in which radical social work re-emerged as a serious (although limited) force.
Radical social work entailed a search for an alternative way of relating to clients based on mutual solidarity and a shared recognition of the exploitative social structures which caused want, need and vulnerability. The defining text for this model was surely Radical Social Work, by Roy Bailey and Mike Brake. They defined it as follows: "Radical work, we feel, is essentially understanding the position of the oppressed in the context of the social and economic structure they live in. A socialist perspective is, for us, the most human approach for social workers". (1)
Historically, social workers have been viewed as agents of social control. They have the ability to remove children, insist that adults enter formal care, assess and ration scarce resources and carry out surveillance of poor families and ‘risky’ individuals. It is unsurprising that they have been viewed with mistrust and fear by the poorest sections of society and are perceived far less sympathetically than other welfare professionals. Radical social work acknowledges this reality but presents an alternative role for social workers in working alongside individuals to challenge the sources of oppression, discrimination and poverty.
Paving the way for privatisation
UNFORTUNATELY, IT IS the remedial model of social work, whereby social problems are individualised, and the client effectively held responsible for his or her own plight, which holds sway today. This model manifests itself in psychotherapeutic approaches which include psychoanalytical, cognitive-behavioural therapy (CBT) and person-centred interventions. As a result, the material factors which underpin individual circumstances are largely ignored.
Whenever a problem is encountered, the solution and the presumed cause is generally assumed to be an individual one. This is why CBT is relentlessly presented as a treatment for mental illness. Into the bargain is that CBT is a relatively inexpensive intervention. Yet there is scant evidence that CBT is effective in treating anything more than the mildest manifestations of depression.
The remedial model was fully encapsulated within the 1990 NHS and Community Care Act which continues to underpin social work practice. Throughout the Tory governments of the 1980s, marketisation within the public sector was nurtured, allegedly to promote best value and increased efficiency in service delivery. In reality of course, it paved the way for partial privatisation which, in turn, led and will continue to lead to full-scale privatisation of the public sector unless this trajectory is forcefully resisted.
One of the core ambitions of the 1990 act is the development of a "flourishing independent sector" encompassing private and voluntary organisations. The big society agenda continues to emphasise the importance of this sector but always at the expense of the public sector. Marketisation has led to council care homes being sold off and other forms of provision, including respite care and home care, being greatly diminished, often with only the most acute facilities remaining in the control of the local authority.
The result has been a race to the bottom for those employed in these workplaces. Wages and conditions for workers, typically women, often working part time, have been under sustained attack. It is particularly difficult for these workers to organise, given the disparate locations in which they are employed – service users’ homes in the case of home care workers. This ensures that trade union influence among such workers is relatively weak.
A monopoly has been created within the caring sector. The introduction of competition between providers was allegedly intended to maximise choice, quality, independence and empowerment for service users. In reality, private companies, such as Bupa, Southern Cross and Four Seasons, have a monopoly of care home provision. Demographic changes mean that this sector is an expanding one. Yet, to ensure that profit is as high as possible, these companies necessarily generate economies of scale which equates to larger care homes.
For residents this increases the risk of institutionalisation. For instance, the government plans to remove the mobility component of Disability Living Allowance from people in residential care, which residents need so that they can afford to go out. It is increasingly being suggested that the wheel is turning full circle: back to the ‘bad old days’ of closed door institutions and limited regulation. As always, choice and quality of care are reserved for the minority with the ability to pay.
The squeeze on budgets
IN TERMS OF revenue expenditure, social services present one of the biggest areas of spending for local authorities. Consequently, as austerity packages take shape, capitalist governments and local authorities will seek to make savings by cutting care and support. The role of social workers is intrinsic to this and they will be required to carry out the dirty work of those wielding the axe. Essentially, they will have to deliver the message to service users and their families that they will no longer be eligible to receive a service.
There are stark differences between the realms of adults’ and children and young people’s (ChYPs) social work in terms of the challenges they deal with. Both face tightening budgets and a reduction in available services however. Appalling tragedies, such as those of Victoria Climbié and baby Peter, have further increased the difficulties in recruiting and retaining staff in child protection teams. The wealth of bureaucracy, target obsessed management and media vitriol which accompanies such work have meant that social workers in ChYPs become overstretched and often burnt out. A recent Social Work Taskforce report found that social workers in ChYPs spent around 73% of their time on client related work – paperwork and liaising with other professionals – leaving a mere 26% of time to spend on direct one-to-one work with clients. (2)
As the therapeutic elements of the social worker’s role have become diluted, the job has become a formulaic pattern of assessment, intervention, review and closure. Adult service users are assessed within the narrow fair access to care (FACS) criteria. Local authorities can choose whether to provide services according to low, moderate, substantial or critical need, with the vast majority opting for the latter two. Increasingly, as government cuts squeeze local authority budgets, the move is towards meeting only critical need. Specifically, this means that local authorities will only have a duty to provide services in certain circumstances: where life is or will be threatened; where significant health problems have developed or will develop; where serious abuse or neglect has occurred or will occur; where there is or will be an inability to carry out vital personal care tasks, etc.
Preventative work is missed from this equation completely, as is the importance of providing services to people who are suffering abuse or who are unable to undertake personal care tasks, unless this is especially pronounced. This is occurring against the tide of an ageing population, an increase in people being diagnosed with learning disabilities and dementia, and a likelihood of rising physical and mental ill health as a result of the dire impoverishment of the most vulnerable. When local authorities claim that preventative work is being done, what they invariably mean is that so-called assistive technology is being advocated as a means of avoiding the provision of an actual physical service. Yet smoke detectors, heat sensors and care phones do not constitute a genuine solution to the challenges of ageing and ill-health.
Deserving and undeserving poor
AS LOCAL AUTHORITIES struggle to justify ‘tightening up’ eligibility criteria in accessing services, they often cite the need for an increase in gate-keeping, so that fewer people can ‘out-manoeuvre’ the barriers to accessing a service. Essentially, the old labelling of who is deserving and undeserving is beginning to re-enter the psyche of those assessing service eligibility, albeit in a modernised guise.
The policy makers and managers of today can afford a nod of gratitude to the Charity Organisation Society (COS), formed in 1869. With its condemnation of ‘scroungers’ and the distinctions made between so-called deserving and undeserving poor, the COS was deliberately positioned to offset the spread of socialist ideas among the masses. It adopted a reactionary position in relation to every social reform proposed at the time, be it free school meals, old age pensions and national insurance. It stubbornly maintained that such measures would undermine ‘family responsibility’, insisting that poverty had an ethical cause. For the COS, poverty was borne out of personal choices rather than resulting from societal and economic inequalities. (3)
Arguably, so long as poverty exists, social work will survive in one form or another. It is the failure of the capitalist system to address social evils which acts as lifeblood to the social work profession. Within a socialist system, the role of social work would alter fundamentally. The whole purpose of the profession would become a mechanism for removing barriers from individuals who are otherwise unable to achieve a good quality of life or to reach their potential as equal participants in society. This would be achieved by a twofold process of increasing the power of those who are weak politically, and by ensuring that individuals are directly involved in the planning and receipt of services, as opposed to being alienated from the entire process.
Clearly, a collective approach is needed but not, as critics of Marxist and radical perspectives maintain, at the expense of ignoring the emotional and psychological needs of service users. Marxists fully recognise that the mental well-being of humanity is constantly threatened by the callous and selfish logic of the capitalist system. Providing emotional support to the vulnerable would be more effective once the system which brings about this vulnerability is eradicated.
THERE IS, OF course, no perfect job under capitalism. Therefore it falls to workers to act collectively both to improve their own conditions but also to enhance the prospects of the profession. Operating through trade unions gives this struggle a coherence which it would otherwise lack. Social workers ought to guard against the growth of elitist bodies, such as the British Association of Social Workers (BASW). Bailey and Brake were portentous in writing: "Professionalism firstly implies the acquisition of a specialism - knowledge and skills not possessed by untrained workers. This isolates the social worker from the population at large. Secondly, social workers come to see themselves… on a par with doctors and lawyers. Thirdly, it encourages the introduction of businesslike career structures where ‘correct’ and ‘professional’ behaviour (such as detachment and controlled emotional involvement) is rewarded with advancement. Clearly, such an approach is welcomed by the ruling class". (4)
So hostile is BASW to active trade unionism that it has consistently and openly criticised Unison to the extent that it has attempted to launch a rival social work ‘college’ in opposition to the official college supported by the union. BASW has failed to justify this position in any meaningful way, apparently obsessed with the independence of social workers from any other workers in any other sector. The ‘worker’ in the job title seems to be a total mystery to BASW which sees no connection between the interests of all workers.
BASW has been a complete failure and has failed to recruit more than a small proportion of social workers into its ranks. Despite its intention to divide social workers from all other workers, BASW is little more than a minor threat. More serious is the paradigm of personalisation.
It is doubtful that someone could reasonably oppose an approach to service delivery which emphasises choice and empowerment for service users, flexibility and originality in service design, and which enthusiastically embraces notions such as individuality, creativity, difference and diversity. Modern social work has each of these values at its core. Yet, despite personalisation being marketed as the epitome of these concepts, the reality is a twisted, corrupted and inverted caricature.
It is impossible to deliver a reflexive service without sustained and substantive investment in the resources at social workers’ disposal. Personalisation, alongside the increase in direct payments – whereby individuals are given money to purchase their own services and thus opt out of the traditional system of the local authority acting as a broker if not a provider – have each become a front for service cuts and privatisation, precisely the opposite of their supposed intention.
A new radical programme
IT DOES NOT take long when working in the social work field to notice that most social workers and colleagues have very similar feelings about the limitations of the work they undertake. And they feel that there is little if anything which can be done to overcome the shortcomings of the profession. Neo-liberalism has had the effect of undermining solidarity across working-class communities and also within the sphere of work. Social workers can easily feel isolated from one another. Yet there are some initiatives which seek to remedy these problems. The Social Work Action Network (Swan) was formed in 2007 as the embodiment of the concerns laid bare in Chris Jones’s (University of Liverpool) Social Work Manifesto. (6)
Swan is a loose network of practitioners, students and service users committed to a radical vision of social work, opposing the increased managerialism and privatisation within the profession. Swan recognises that social work needs to be committed to social justice and to challenging poverty and discrimination. It urges its members to engage with and actively support local and national anti-cuts movements. While this is sound advice, however, for the network to fully come into its own, it needs a clear set of principles and objectives - just as the anti-cuts movement must maintain a clearly defined programme. Socialists can play a key role in putting forward transitional demands which link day-to-day reforms of the social work role with the wider struggle of overturning capitalism itself.
Also, Swan needs to expand rapidly. This is much simpler to imagine than to achieve but a national network of regional bodies needs to be facilitated, drawing together social care workers, employees in the private and voluntary sectors, as well as council-employed social workers. First and foremost, social workers need to recognise that their own struggle, and the duty they have in protecting the interests of the most vulnerable in society, is part of the wider workers’ struggle.
The work of Bailey and Brake was seminal and remains an excellent starting point for anyone seeking to understand the potential which Marxist and radical traditions hold for socially-conscious social and social care workers. In Radical Social Work they propose a programme of action. Specific points are that the capitalist state is so organised that organisation needs to take place independently of it. Social workers ought to join and be active in trade unions. Bailey and Brake recognise that capitalist society – based as it is upon private ownership, profit and the needs of a minority class – must be replaced with a workers’ state, based upon the interests of the majority. Until this occurs, the fundamental causes of social problems will remain, as will the contradictions inherent within social work.
(1) Bailey R and Brake M, Radical Social Work, Edward Arnold Publishers (1975) p9
(2) Baginsky et al, Social Workers’ Workload Survey: Messages from the Front Line (2009), Department of Health
(3) Ferguson I, Reclaiming Social Work, Sage (2008), p90
(5) Bailey and Brake, Radical Social Work, p145