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Social Protection and Social Responsibility in the Care Industry

New legislation needed

Additional legislation is needed to strengthen the legal basis for redress within theHealth and Social Care Bill 2011. A counter-balance with social work values is neededto Part 3, Chapter 2 of the Health and Social Care Bill 2011. Without this pricecompetition and competitive process will be unworkable and interfere withfundamental rights.

A Code of Practice for Social Protection and Social Responsibility will enable publicauthorities and third party public bodies, to look to the future and recognise thatanything other than clear, transparent decision making will increasingly be seen asunacceptable. We must ask why is it that when so many industries have recognisedthat one of the keys to developing industry excellence is not to inspect defects out, butto create systems in which defects cannot arise. In the care industries, investigationsof systemic failure has become an industry in itself.

Behaviour management standards that are in place are designed to ensure the carequality and economic welfare of providers. The term welfare has a specific meaning inEU Competition law and is wholly dependent on economic models of competition  – this will only add further frustration and complication to delivery of public and socialpolicy and social welfare law.

A progressive stance on EU and domestic rights is urgently required. We must ratchetup our expectations of what can be delivered against these rights and offer UKproviders a seedbed to become the world's most successful.

Health and social care are too important in developing the social value of economicgrowth to be allowed standards that are, sometimes, second best. World-classcommissioning has not ensured excellence in health and social care so a detailed,robust and tightly structured charter of fundamental rights must. Why should we

expect anything other than this in the care industries? Other industries like cars andphones already have this in place.

Cases of failures dominate discussion of the care industry. Dozens of articles andreports provide a rule of thumb - organisational insight is inversely related to thenumber of articles cited to reinforce it.

Little has been said about the acquired employment rights of temporary and low paidand unpaid care workers. The current draft of the Bill is silent on what an effectiveremedy really is? And what does the term 'concerted practice' actually mean?

The key driver of health and care management lies in establishing a Code of Practicefor Social Protection and Social Responsibility. This will inform the success or failureof commissioning in relation to EU and National law on organisational behaviour by

adding an unambiguous statement on fundamental rights and social responsibility.In short, successive Governments for the past thirty years have failed to tame thesestructural problems and protect the fundamental rights of those most affected byreform of the welfare state. A House of Lords amendment or Ten Minute Rule Bill titledthe Health and Social Care (Code of Practice for Social Protection and SocialResponsibilty) Bill 2011 is now urgently needed.

Front line staff and team managers continue to achieve great things for local residentsin the face of increased pressures from purchasers, regulators, and residentsthemselves. Nevertheless, it would be condescending to pretend that theseachievements are sufficient to satisfy what is becoming an increasingly demandinguser base.

Increasingly, the range of new approaches and methodologies are becoming integralto the way in which care is delivered. Market Studies, Purchaser InterdependencyMatrix, Supply Chain Logistics, Price Discovery Mechanisms, Common Procurement

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Vocabulary, Category Sourcing and Management and Contract Management are allpivotal to the way in which the industry evolves. Of course, care quality will always becentral, but increasingly we will all have to recognise that some of these economicapproaches may be in conflict with the ethic of caring. Indeed some have alreadyargued that marketisation, managerialism and codification are aligned solely to welfareeconomics and not social justice. They are not wrong. A Code of Practice for Social

Protection and Social Responsibility will provide a mechanism for improving andamplifying the ethic of caring - a framework for 21

stcentury care management -

safeguarding the rights of service users, and local residents in an increasinglycomplex and diverse world of welfare economics.

Health and Social Care will continue to be an economic growth area. For example theOffice of Fair Trading (2005) estimated that the residential care home industry wasvalued at £8 billion a year; there are few UK industries that can boast about suchgrowth and we have to ask who really benefits. A code of practice for social protectionand social responsibility will address these sewn-in issues head-on, not least becausethe real care economy of low paid temporary workers and informal carers continues togrow without adequate legislative protection.

My final points on these structural issues is that real progress cannot be made until all

stakeholders recognise that whole system improvement demands that they have adetailed understanding of fundamental rights and social responsibility. Such anunderstanding needs to be in place to resolve issues of subsidiarity and derogationand the role of competition that will arise.

There is an urgent need to re-educate front line staff, team managers and seniormanagement in the industry from top to bottom.