Simon Bottery, Senior Fellow, Social Care, The King’s Fund
There is a terrific cartoon about an alien, arriving on planet Earth for the first time, asking an office worker to be taken to see their ‘leader.’ The worker is bemused. ‘I’m not sure about a leader. Will my manager do instead?’
The joke has dated of course (the alien might now have difficulty finding an office) but had they landed in the social care sector during Covid-19 there would have been no shortage of leaders on offer. The sector has never been short of representative bodies and the pandemic arose at a time when there were some strong, able and articulate people in charge of them. You only had to turn on the TV or radio to hear a national body speaking with knowledge, authority and – all too often – anger about what was happening in adult social care. So we heard vocally from ADASS, the LGA, National Care Forum, National Care Association, Care England, UK Homecare Association and many others, including leaders of individual care providers, pressure groups and charities.
At a time when the sector and its users felt forgotten, and when there was a vacuum of social care knowledge within the Department of Health and Social Care, this was exactly the kind of leadership that was needed to bring the focus back on social care. Though it did not get all that was needed (and a huge cost had already been paid), it achieved a great deal.
Now, however, circumstances are changing. Firstly, the immediate task is shifting. Covid-19 was a huge, obvious challenge but as the pandemic recedes, the focus will shift towards the wider issue of long-term reform. Here, however, the issues become less obvious and the solutions become fuzzier. Should we focus reform on the workforce, unmet need, choice and control, a cap on care costs? How should we provide services, commission them, regulate them? While there is common ground within the sector on at least some of these issues, there is far less consensus among sector bodies about the order of priority for change.
Secondly, the sector’s leaders will be dealing with a different, more muscular, DHSC. Directly as s a result of Covid-19, there has been a huge increase in social care staff within the department and it will be led (after a gap of several years) by a dedicated Director General post. It may take all these staff time to get up to speed but soon there will be no lack of people and brainpower. Its mandate will have changed too: the department’s proposed powers in February’s Health and Social Care white paper suggest that, after several years of being very hands off within the sector, DHSC expect to be more hands on.
In these new circumstances, can the sector’s leadership help bring about the longer-term and more fundamental reform that social care needs? At this stage, no one can say with certainty but in any case this leadership structure is not changing anytime soon. The wide range of different voices in social care leadership is an inevitable consequence of a sector that is itself large and diverse. The challenge for the leadership in the sector is now to move from tackling a crisis to creating long-term reform. That will require leadership not just of the sector but within it, attempting to carry support for reforms which, if they are to happen at all, will inevitably involve unpopular compromises. This is leadership but of a different kind. Only time will tell whether it exists in the sector and, if it does, whether it will be enough