In the old westerns you could always tell the goodies from the baddies by the colour of their stetsons. The bad guys wore black hats. On my social work course there was an option on philosophy and ethics perhaps it should have been called best practice and doing the right thing because that is the language of social work. At the time most students thought there was no need for such options we were after all the good guys. Ok we did occasionally assist in removing people to psychiatric hospitals against their will but only when we were confident this was necessary to help them get well.
It's hard to maintain an image as one of the good guys if your role involves identifying those who no longer meet the new eligibility criteria and removing their help and support ! It's hard to convince yourself you are helping people if you say ,"no" more often than "yes". And when the help you do provide robs individuals of their dignity and self respect like the inadequate and inconsistent home care that leaves an elderly person sitting in a urine soaked bed, cold, wet, hungry and thirsty, it may be another statistic towards meeting the supported at home target but it's not right. Just as it doesn't feel right to reduce an individual's access to respite care or replace five day a week day care with alternatives that no matter how flexible and creative will still be two days a week less support.
The separation of assessment from care management has been bad for social work and bad for social workers. The focus on assessment has led to a view that social work is about rationing services rather than supporting and helping vulnerable people. Care management which is about helping vulnerable people via a supportive relationship has become a secondary function often delegated to providers. This has resulted in a growing gap between the role social workers believe they ought to do/ joined the profession to do and the one they are increasingly required to do. With the separation of assessment and care management social workers didn't just lose touch with our clients social work with adults lost its professional soul.
If we continue down this path the adult care rationer of the future will be an unqualified worker who views the role as more a kin to administering benefits? And if they have hats to go with their smart new Virgin uniforms what colour will they be?
Blair McPherson former social worker, ex director , author and blogger www.blairmcpherson.co.uk
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