Are There Four Systems of Social Care in the United Kingdom?

Derek Birrell University of Ulster

Paper Presented at Social Policy Association Conference

University of Birmingham

July 2007

The context of devolving social care functions

The process of devolution in the United Kingdom in 1999 was not new, with various forms of autonomy existing during the twentieth century. Any consideration of the impact of devolution must take account of the system of administrative devolution prior to 1999, through the Scottish and Welsh Offices and Northern Ireland’s previous experience of political devolution (1921 – 72), and administration devolution under Direct Rule procedures from 1972-79. Territorial government departments had responsibility in each country for the administration of social care but with limited discretion regarding policy. This contributed to each region of the United Kingdom having some distinctive components of social care. Drakeford (2006, p.547) acknowledges Welsh social care policy was extensively integrated into Whitehall processes with limited scope to initiate and affect change. Mooney and Poole (2004) suggest that differences in Scotland did not signal a significant departure from central themes in social care. The Scottish and Welsh Offices were not policy-making departments and policy divergence mainly concerned systems of service delivery (Keating, 2005). Also, historically different administrative structures in Northern Ireland have been the most distinctive feature.

Both the Scotland Act 1998 and the Northern Ireland Act 1998 give a legislative and executive competence over personal social services to the devolved administrations, except some contingent matters which remained the responsibility of the UK government and parliament. These are listed as reserved powers with reference to Scotland and as reserved or excepted services with reference to Northern Ireland. The Government of Wales Act 1998, listed social services as one of eighteen fields in which Welsh Assembly government would have competence through secondary legislation or executive functions. In practice the constitutional settlement over policy autonomy has remained in flux in relation to Wales and Northern Ireland. It is anticipated that the revision of Welsh devolution through the Government of Wales Act 2006 will lead the Welsh Assembly to have enhanced legislative powers with the future possibility of primary legislative powers. Northern Ireland has faced uncertainly regarding the permanency of devolution, but the suspension of political devolution between 2002 and 2007 did not signal the end of the development of policies different from the other parts of the United Kingdom.

A further contextual factor is the financing of the devolved administration. Scotland, Wales and Northern Ireland obtain their funding through the allocation of block grants from the United Kingdom Treasury, but have a substantial degree of discretion over how this money is allocated and prioritised. The operation of the Barnett Formula has distributed a population share of increases in public expenditure agreed with Whitehall departments on comparable programmes (Bell and Christie, 2005). The Barnett Formula is a population based mechanism to allocate increases in public expenditure, not a needs-based formula, but does mean the devolved administrations are not constrained by the details of spending patterns set in Whitehall (Heald and McLeod. 2002) and thus have a degree of choice over the allocation of expenditure to social care services.

Analysis of Divergence

This paper seeks to analyse the differences that have emerged between the four territories of the United Kingdom in social care. The areas for this analysis are adopted from the identification of divergence in the current literature which is focused on health and social policy. In health Greer (2004) identified four areas: organisational forms, extent of public-private provision, regulatory controls and reduction of inequalities. While Woods (2004) uses; policy areas, structures and governance, performance management and provider diversity. Categories examined in relation to social policy by Mooney and Poole (2004) are; institutions, policy, finance and inequalities. Chancy and Drakeford (2004) analyse the distinctness of social policy in Wales through the social policy agenda, ideological principles and, policy agendas and the policy formulation and implementation process. Schmuecker and Adams (2006) identify; patterns of expenditure, an analysis of divergence in social care, strategies and targets, and outputs/services. The categories we suggest for social care are: delivery structures, policies, regulation, ideology and values, and future concepts of social work.

Differences in delivery structures

Social care services remain the responsibility of local authorities in England, Scotland and Wales. There has however been an ongoing trend away from separate single social sendees or social work departments. This was originally influenced in part by internal local authority restructuring. The reorganisation of local government in Scotland following devolution led to a break-up of single departments. Some social work departments merged with housing, some came under a community care umbrella and in some areas children’s services merged with education (Cheetham, 2000 p. 627). In Scotland, criminal justice remained within local authority social work departments. More recently, in 2005, eight community authorities have been set up in Scotland representing groups of local councils to plan, coordinate, monitor and report on the development of offender services.

This structure of comprehensive social services departments in England has changed mainly because of the trend towards integrated service delivery. Each country has endorsed integrated working between social care and health but they have approached the issue somewhat differently. Since 2000 in England with the agreement of local authorities and health trusts, it has been possible for new care trusts to be established covering aspects of social services and primary health care and mental health. To dale, a relatively small number trusts have been set up (ten by 2007) and the majority of these have limited functions, mainly in the area of mental health services. Instead social services have chosen to establish various forms of formal partnership as a way of joint working with primary care trusts or mental health NHS trusts.

The structure in Northern Ireland demonstrated a clearer differentiation from the other countries with the structural integration of health and social services in four health and social boards for planning and commissioning purposes and eleven integrated health and social care trusts with no direct local authority involvement. (Greer2004, pp 170-1: Heenan and Birrell. 2005) The current implementation of the Review of Public Administration, initiated by a devolved administration, will lead to total integration of social services with all health services including all acute hospitals in a streamlined structure, with probably one integrated central health and social services authority responsible mainly for commissioning and performance management and five integrated provider trusts. Thus in Northern Ireland social services will operate in a much more integrated structure, but with less of a separate identity.

Scotland has taken a more uniform approach to partnerships. Integrated working in Scotland between local authorities and the NHS has been advanced mainly through the Joint Future initiative to provide faster access to better services through improved joint working. At delivery level the scheme operates through community health partnerships with joint management, joint governance and joint resources. (Scottish Executive 2006. p4) In Wales local authorities and local health boards are jointly responsible for formulating local health, social care and well-being strategies. Wales has given funding to support collaborative working and the new strategy paper is committed to reducing barriers between health and social services and increase integration at all points. (Welsh Assembly Government 2005) However, the local authority/health agencies structural division remains. The latest document in Wales on the future of social services also does not move beyond better partnership and collaboration between councils and health organisations. (Welsh Assembly Government 2006. p6)

The other integrationist influence on structures has come through recommendation for the integration of children’s services with England moving rapidly to set up structures to reflect this integration and divide social services into adult services and childcare linked to education sen/ices. The model of new children’s trusts within local authorities has been piloted as a structure to be widely introduced in 2008. These configurations have not been adopted in Scotland, Wales or Northern Ireland. In Wales there will be no requirement to establish children’s trusts and directors of social services continue to have responsibility for child social care and adult services. The report ‘For Scotland’s Children’ (Scottish Executive 2001) called for more integration between health education and social work services. While a Changing Children’s Services Fund was set up to encourage further integration, to date changes have been small scale and limited. While in Northern Ireland the restructuring has ignored the developments in England and retained totally separate services for social care and education

Policy Divergence

Policy divergence has been the major focus of the post devolution debate. In analysing social care it is useful to make a distinction between four types of policy related developments. Firstly, it is possible to identify the ‘flagship’ or ‘big ideas’ policy differences that have emerged. The aspect of policy divergence in social care that has drawn most attention is free personal care for older people in Scotland, whether in the community or residential or nursing home. Simeon (2004) sees free personal care as Scotland expanding the welfare slate through the principles of universal access. Stewart (2003) describes this as personal care provided on a universal basis in Scotland while on a selective basis in England. This development has been described as the most significant policy divergence in the United Kingdom, following devolution. (Mitchell 2004). According to Woods (2002, p.43) no other issue has demonstrated the power and consequences of political devolution. To date, Northern Ireland and Wales have not followed the Scottish example. Another major innovation was the introduction, in Wales, of a Children’s Commissioner. The Welsh example was followed by Scotland’s appointment of a Commissioner for Children and Young People with a wide policy, advocacy and research role. Following an extensive consultation process Northern Ireland has also appointed a children’s and young person’s commissioner with similar functions. When England also decided to have a children’s commissioner it produced a devolution issue in that a UK commissioner was established who, despite Welsh opposition, was given responsibility in England, Wales and Northern Ireland for non devolved children’s issues as well as direct English responsibilities. Wales has also established a new post of Older People’s Commissioner to promote the interests of older people, help eliminate discrimination, encourage best practice in the treatment of older people, review legislation and practice and undertake research.

A second category of policy divergence is reflected in strategies, priorities, programmes and projects. Overall, however, many of these strategies and programmes reflect a difference in emphasis rather than fundamental variations. The Welsh Assembly also made a priority of universal high quality services for older people in Wales to tackle discrimination, prolong well-being and enable them to live independently. In Scotland the Assembly has also produced new strategies aimed at improving care, support and providing for older people, as well as introducing a range of funding schemes to tackle area based multiple deprivation, the new institutions in Wales and Scotland can also be seen as giving a great deal of attention and priority to early years services. It has been argued that in Scotland the narrow issue of child protection has dominated social work practice rather than wider concerns with social, physical and development needs of children (Ferguson 2005, p229) and the overall thrust of children’s services in Northern Ireland has been similar. Since devolution, an emphasis on early years work has promoted integration in early years services with social workers working alongside health visitors and child carers and in schools with teachers and school nurses in Scotland. Wincott (2005) suggests devolution has led to some significant differences in early childhood care between the four countries in the United Kingdom but major initiatives have also been made in England with integrated working, eg Sure Start, integrated children’s centres and extended schools (Wincott, 2005, p89). Sure Start was also adopted in Northern Ireland but it has lagged behind in other early years measures.

Mental health is an area where there have been a significant number of different innovations across the four countries. One of first major policy acts of the Scottish Parliament was the 2000 Adults With Incapacity Act which aimed to protect the financial and welfare interests of people with diminished capacity. This Act had been on the political agenda for over ten years but time for at legislation could not be found at Westminster (Cheetham, p626). The Mental Health (Care and Treatment) Scotland Act 2003 which came into force in April 2005 has been described as more progressive than English proposals, in advocating involvement sen/ice users and less formal tribunals (Ferguson 2005, p231). It contains a number of measures designed to alter the balance of power between the mental health professionals on one hand and the service users on the other. Mooney and Poole (2007) contend that the Act is simply a Scottish reflection of broader trends within the United Kingdom and cannot be seen as divergent. The Mental Capacity Act 2005 came into force in England and Wales in 2007 but there is currently no equivalent law on mental capacity in Northern Ireland. The Welsh Assembly has given priority to an adult mental health strategy with greater emphasis on users, equality and effectiveness Northern Ireland has also carried out a separate review of services for mental health and learning disability. A further specific example is the priority In Scotland given to new dementia services.

The third comparative dimension is the existence of distinctive approaches to social care. These may relate to countries’ specific needs. Northern Ireland has had to adopt a distinctive response to the years of communal conflict, violence, and associated issues of discrimination, sectarianism, post-traumatic stress responses, including approach based on anti-sectarian practice (Smyth and Campbell, 1996; Smyth et al, 2001). Another example is the significance of the Welsh language and bilingualism in social work in Wales. Other distinctive approaches may relate to the organisation of practice.

The policies in Northern Ireland which are distinctive in the support for the integration of Health and Social Care with benefits for community care. The integrated structure of primary, secondary and social care can be seen as a divergent policy strength. It has such distinctive features as social work and health staff having the same employer body, the easier funding and planning of hospital discharges and hospital bed closures with the same agency, the management of multi-professional teams (Heenan and Birrell 2006. p58 1) and there have been innovations in integrative and flexible practice (Campbell and McColgan. 2001 pi 16), for example, frail elderly rehabilitation or mental health crisis teams. Northern Ireland also has seen a strong emphasis on the community development social work strategies. These have built on a strong and urban community sector and incorporated into special strategies by boards and trusts. Devolution has seen the continuation of Scotland’s distinctive approach to criminal justice social work located in local government social work departments where work with offenders is pail of the role of the generic social worker. Criminal justice social work differs considerably from those in England, Wales and Northern Ireland with a greater emphasis on social work and welfare rather than law enforcement. Croall (2006), however, sees some tensions arising between the welfarisl social work tradition and moves towards a more punitive system. However, differences between Scottish and English criminal justice policies have been dismissed by Mooney and Poole (2004. p.466) as not that significant.

The fourth dimension rather follows from policy and is and is a comparison of outcomes and expenditure. Data is not so readily available but one recent study (Economic Research Institute/Institute of Fiscal Studies. 2003) found differences in expenditure per child between the four countries on personal social services. The figure for Scotland was £513, for Wales £424. for England £402 and for Northern Ireland £287.

Social Work Regulation, Training and Inspection

The current system for social work regulation, education and inspection reflects devolved governance. CCETSW had responsibility throughout the United Kingdom for promoting and regulating social work education but this was replaced by separate bodies in 2001: the Scottish Social Services Council, the Care Council Wales, the Northern Ireland Social Care Council and the General Social Care Council in England. The Councils in Scotland, Wales and Northern Ireland are responsible for training for the whole social care sector and were established to promote and develop education and training for the social services workforce, including a registration scheme, the establishment of national sets of standards and accreditation of social work qualifying and post qualifying training. However, responsibility for the development of national standards and qualifying framework and workforce development strategy for social care workers in England since 2005 rests with two new bodies: Skills for Care for Adult Services, and the Children’s Workforce Development Council. One consequence of the territorial bodies has been the facilitation of the requirement for the degree of social work in England, Scotland, Wales and Northern Ireland to suit local conditions. For example, the development of post qualifying education and training for social workers has seen differences emerge with England committed to three different academic levels whereas Northern Ireland has only one level. Northern Ireland also appears different in restricting access to post-qualifying or specialist training to registered social workers.

Also set up following devolution in 2001 was a Social Care Institute for Excellence with a UK wide remit to promote and disseminate and good practice, guidance and provide resources and e-learning material for workers, managers, commissioners, policy makers, education and students. There have been some other developments to promote practice in social care. England has a number of its own initiatives to improve practices. The Care Services Improvement Partnership supports projects while the Integrated Service Improvement Programme provides guidance, tools and techniques to encourage joined-up working across local health and social care organisations. Wales has introduced the innovative Social Services Improvement Agency mainly to support and improve local authority services by providing information on policy, legislation, good practice, performance management and research findings for children’s services and adult services. The Scottish Institute for Excellence in Social Work Education is a consortium of all nine Scottish universities. On the other hand Northern Ireland has seen little attempt to promote research and development in social care.

The arrangements for the regulation and inspection of social care clearly reflect the existence of four different territories in its structure. The trend was for each country to have a social work inspectorate and a care commission to carry out different levels of inspection and regulation. Thus Scotland has a Social Work Inspection Agency which carries out performance reviews of social work services. The Scottish Commission for the Regulation of Care is a separate body in regulation on care services and reports on the quality of care in institutions and agencies and deal with complaints. Wales, following devolution, has a similar structure of a Social Services Inspectorate for Wales and a Care Standards Inspectorate for Wales but in 2007 the Welsh Assembly government announced that the two bodies would amalgamate into a new Care and Social Services Inspectorate Wales (CSSIW) to provide a more integrated view of social services and care. This reflected a strategy already adopted in England which also had its own territorial bodies. England had moved to a single inspectorate, the Commission for Social Care Inspection, which combined the work of the former Social Services Inspectorate, the SSI/Audit Commission Joint Review Team and the social care work of the National Care Standards Commission. Northern Ireland has a Social Services Inspectorate which can carry out inspection of social services provision but also has a role in providing proCessional advice to ministers and departments on social services. Northern Ireland has a separate new care inspection body, the Regulation and Quality Improvement Authority, which covers residential and children’s homes. This body does also reflect different structures in Northern Ireland for the integration of health and social care as its remit covers health services provision including independent clinics, hospitals and nursing agencies. The differential impact of the configuration of services is also demonstrated in Scotland where the Social Work Inspection Agency carries out performance inspections of”criminal justice services. Territorial structures have not perhaps resulted in major differences but clearly they facilitate divergence.

Ideology and Values

The analysis of ideological values underpinning social policy developments since devolution, has suggested significant differences, particularly with England. Such ideological positions are particularly important in identifying the existence of different models of social care. A general view of ideological and value differences in areas of health and social policy have been described by a number of commentators

Mooney and Scott (2005, p267) suggest that Scotland has a stronger emphasis on collectivist values, a strong social democracy tradition, the centrality of a welfare ethos and less enthusiasm for the neo-liberal agenda. Keating (2003) suggests a consensus among Scots about the importance of the welfare state. Their approach is associated with social solidarity and a stronger inclination towards redistribution, social equality and universalism than is apparent in England. Drakeford refers to the historical support in Wales for collective action and social justice (2006). On similar lines, Stewart (2004, p!43) refers to a public sector, collectivist ethos, and culture in Scotland markedly different from the current dominant value system in England. Poole and Mooney (2005) define core New Labour welfare values as social inclusion, partnership and market-led solutions

The assumption in the main is that the Scottish Parliament and Welsh Assembly Government adopt principles of allocation based on their core values. The Welsh Assembly has been described as owing more to the tradition of Beveridge emphasising universality, equality of outcomes and the individual as a citizen rather than a consumer (Mooney. Scott and Williams, 2006, p. 61 7). The variations in values are broadly reflected in social care policies and in reviewing social inclusion policies, Fawcetl (2004) contends that the Scottish Parliament has crafted a more progressive agenda based on the language of social justice than its English counterpart. Lodhe (2005) has compared and contrasted approaches to social exclusion strategies and concluded that Scotland and Wales are strongly influenced by a social justice perspective. Chancy and Drakeford (2005, pi 30) see a universalist non-marketised ideology demonstrated in the Assembly’s emphasis on equal access to high quality services across Wales for the elderly. More recently Drakeford has written that the Welsh Assembly government is a believer in progressive universalism (Drakeford. 2007, p5). Overall values held in Parliament and the Assembly relate mainly to views of the dominant political parties but as it has been expressed New Labour in Westminster and the Labour dominated administrations in Scotland and Wales have had different takes on the political philosophy of Labour(Sullivan, 2002). Mooney and Poole (2004, p475) contend that the issue of attitudes and values is complex and contradictory while a social democratic agenda is apparent on such issues as free personal care. The Scottish parliament has adopted more neo-liberal policies in regard to the private finance initiative and the transfer of council housing stock. The Northern Ireland Assembly has not had time to set down an ideological position and has not a radical tradition, but the Targeting Social Need agenda which has existed during both devolution and direct rule indicates an approach closer to selectivity.

If actual modes of provision are examined it would appear differences can be identified but are not so striking. A mixed economy of provision tends to operate in all countries. Mooney and Poole (2005, p. 464) do suggest that a mixed economy of welfare has been slower to develop in Scotland. Direct local authority provision is still rather greater in Scotland and Wales than in England but it is not very different. Interestingly, it is in Northern Ireland that there is still the largest proportion of direct public sector provision of social care and the independent sector is underdeveloped.

The principles and values underpinning delivery systems have also received attention. The Welsh Assembly Government position on modernising services is based on the principle that collaboration should provide the fundamental underpinning for the delivery of services, not a competitive model (Welsh Assembly Government 2004). This was reinforced by the Beyond Boundaries Review (Beecham 2006) which called for a citizen model of public service delivery in contrast to what the Review saw as the customer model which dominates public service delivery in England. In Northern Ireland the initial Review of Public Administration had contained a commitment to collaborative values in the organisation of health and social care, stating that structures should be characterised not by the need to generate competition but by the creation of partnerships between commissioning and delivery of services (Review of Public Administration, 2003. p64). The view had echoes of the Scottish and Welsh positions on values underlying structure and delivery. However, the final decisions of the Review of Public Administration adopted a more competitive model following the response by ministers and civil servants to the Appleby Review of Health and Social Services (2006) which had opted for competition and commissioning to provide incentives to improve performance.

A final area for the discussion of values relates to principles of participation. Citizen centred delivery has been a clear commitment of Welsh Assembly government. In Scotland there has also been a rejection of a centralised model. However, it is more difficult to argue that different principles apply in England where in particular recent documents have set out schemes for greater public involvement in both health and social care (DOH, 2007). Again it is Northern Ireland which emerges with a somewhat different system with very limited mechanisms for public participation or involvement in social care and the continuing dominance of a managerial model.

Views on the Future of Social Work

To what extent do the recent reports on the future of social work and social care point in different directions? These reports included discussions on the future tasks, role and strategics for social work and social care development. It can be argued that similarities in views and proposals do outnumber differences. Areas of clearest similarity in the documents include; support for joint services and partnership working across agencies and boundaries, an emphasis on early intervention and early years strategies, planning to cater for more complex disabilities, strengthening performance improvement measures, the use of information technology, improved and simpler access to sendees, improving the workforce through a mix of innovative skills and providing greater independence and choice through direct payments and individualised budgets. However, in some key themes, it is possible to detect differences in views, particularly in relation to the future role of the social worker. The Scottish Report raises the question about the role of the social worker suggesting that social workers should not undertake tasks which do not require their level of training and skills, and introduces a new paraprofessional role (Scottish Executive, 2006, p.30). The Welsh document also suggests that redefining and re-focusing workforce assumptions so that professional experience is used more effectively, freeing highly qualified staff to do only what they able to do, supported by people to undertake a narrower range of less demanding functions. The Platt Review (2007, p26) in England suggests pilot projects to identify whether there is a place for a generic community care worker. The discussion document in England raises the possibility in relation to children’s services of a new role of hybrid ‘children’s professional’ and a role for social workers which centres almost exclusively on child protection function. The debate is underpinned to some extent by the reconfiguration of social care with the developing division between adult and children’s services in England and the close alignment of childcare and education. Scotland has a more continuing emphasis on maintaining three branches of one social work department covering children and families and community care along with criminal justice social work. While the Northern Ireland policy, although not clearly articulated, still supports the generic social worker with a close integrated working relationship with health.

Some differences that are identified are more target-focused. The Scottish Report pays much attention to a future emphasis on ‘personalised’ services (Scottish Executive, 2006. Ch 6). Increased personalisation is seen as a desirable direction for social work. The discussion document in England raises the importance of a slightly different idea of relationship based practice and person-centred planning. The Welsh document is rather different in pulling forward a vision of a ‘rights based approach’ (Welsh Assembly Government 2006. p. 12) founded on seven core aims based on the UN convention on the rights of the child.

The development of user involvement is also perhaps stressed most highly in the Welsh document with a commitment that services will be shaped by service users, that service users will be at the centre and services will be tailored to individual needs. The Scottish document also supports a significant role for people who use services through their involvement in the way services are delivered and their involvement in training, recruitment and in evaluation and inspection. Northern Ireland has been developing strong user involvement in social work education but the new planning and delivery structures have very little built-in user involvement. The government paper ‘Our Health, Our Care, Our Say1 (Department of Health, 2006) stresses users as partners. While the discussion paper in England acknowledges role of user views, it differs in raising some criticisms of over dependency on user involvement.

In a discussion on commissioning the Scottish Report raised concerns over the lack of connection between those who commission and front-line providers and users, and advocated a new more flexible commissioning process. While the Welsh document stresses the importance of a commissioning partnership with providers and users. Northern Ireland is more apart on this issue with the proposed total separation of a single commissioning authority from the various provider trusts. Strong leadership of social services has been advocated in the Scottish document and the Welsh report sees the role of leadership of social services requiring greater confidence. With the new structures in Northern Ireland there is concern at health domination and the standing and status of social work and the restructuring in England has raised issues of the fragmentation of leadership in social work.

It is noticeable that the Scottish document marks a commitment to promote what is described as community social work, no longer located apart from mainstream practice, mobilising communities and based at the heart of communities. Community development approaches have received less attention in England but community development social work continues to be important in N. Ireland, drawing on a vibrant community sector.

The reports are largely similar in predicting needs following from demographic change; an aging population, greater frailty, more one person households and more cultural diversity. On some indicators one country may have a higher incidence of need than others, for example, Wales has the highest rate of adults with limiting life long-tern illness. Many predicted societal changes are similar; for example, fractured relationships, complex disability needs, mental health and anti-social behaviour. Some specific national aspects can be identified in comments on continuing issues, for example, the Welsh language and impact of community conflict in Northern Ireland. Specific national perspectives are rare in the various documents but the Scottish document does refer to a need in Scotland for a balance of rights and responsibilities between the individual, family and state. There are also proposals specific to the documents of one country and not repeated in the others, for example, the Welsh document proposes a social work practitioners’ forum at both national and local level and also a Welsh social care research strategy.

Conclusions

It is clearly possible to list or audit the main areas of divergence in social care between the four countries of the United Kingdom. It is also possible to assess the significance of existing differences including proposals in recently published strategies and reviews. The main differences we have identified are summarised in Table 1. It is a more difficult question to ask if there is evidence of a process towards different models of social care. Models can be seen as essentially a logical abstraction based on a coherence between underpinning ideas and values and allocation principles, delivery structures, priorities and forms of practice. We have identified attempts at articulating clusters of principles and values as underpinning social care provision or aspects of social care provision. These may be categorised tentatively as:

  • Scotland – social justice, social inclusion, collaboration
  • Wales – citizenship: progressive universalism
  • N. Ireland – targeting social need
  • England – social inclusion: competition: consumer based

Obviously, these sets of principles are more identifiably linked to policy, planning and provision in some countries rather then others. However, the current system of provision and incremental policy changes is too fragmented and diverse to be coherently related to an ideology or set of principles and to demonstrate clear distinctive divergent national ideologies linked to systems of provision.

There are two possible developments. The first scenario is that the pressures for convergence are such that areas of divergence will be limited to a few flagship policies plus some less important variations in provision and administration. There are both general and specific social care pressures prompting convergence. General factors include UK Treasury decisions, the UK’s single social security system, party political consensus, public opinion and overlaps between reserved and devolved functions. More specific social care factors prompting convergence are; the views of professional groups, care councils, universities. UK wide pressure groups and a consensus on professional practice and approaches.

The second scenario is that there will be continuing pressure for further divergence in social care. Jeffrey (2007) argues that devolution will open up longer-term divergence. Factors pushing forward greater divergence may be; the priority accorded to social care in the devolved administrations, the development of policy communities, popular demands, policy transfers ie. coping and changes in the composition of the parties in devolved governments.

Table 1 Summary of main forms of divergence

Statutory Structures Delivery System State-Independent Key Policies Integrationist Approach Future Strategies in Social Work
Scotland Local Government Mixed Statutory Emphasis Free Pension CareDementia Criminal JusticeSocial Work Personalised Services Integrated Delivery Community Focus
Wales Local Government Mixed Local Government Emphasis Older Peoples’ Commissioner Health Education Localism Partnership Citizens Rights
N. Ireland Quangos Mainly Statutory Fully Integrated Teams Health Community Development FocusEquality Focus
England Local Government & Few Joint Trusts Mixed Early years structure Education Health Modernisation Choice and independence

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