If David Cameron wants family-centred policies, why doesn’t he simply shut up and let the health and third sectors get on with doing what they do best?
Recently, I have been researching the way the government is aiming to reduce inequalities. I have looked at business plans for relevant government departments and then, by target area, tracked back to see what has gone before, what worked and what didn’t, and what was learned. I am looking at a very small number of outcomes for a population with many overlapping features.
There are some studies on the impact of past regeneration Sheffield Hallam carry out research on many programmes. Although I don’t find the same about mainstream services, like GPs, Health Visitors, Social Work. I cannot find any prior learning featuring in current commissioning plans or strategy. The past seems to be written off and we start again with the next big thing. Just yesterday, David Cameron, the Prime Minister, announced that all Government policies will now put families first. What does this even mean? Isn’t everyone in a family of some sort? And besides, hasn’t this government just taken poor families and beaten them with a big welfare reforms stick? Is what the Prime Minister said any different to anything else that has ever been said on the subject? No, it is just words.
I have worked in health and social care for over 16 years. In that time, I have seen strategy after strategy, action plan after action plan, review after review, vision statement after vision statement and words, after words after words.
I have worked in the public, private and third sectors and I think everyone knows what the problems are they include, lower life expectancy, higher risk of life-limiting illness, poor lifestyle, higher rates of smoking, drinking, unemployment and social exclusion. These factors haven’t changed: the gaps between rich and poor, advantaged and disadvantaged and healthy and unhealthy have just got bigger; the changes required to bring about greater equality are very long-term (they can take decades). The trouble is, governments change faster than people can. As they change, they scrap previous plans and the effects are never felt; it’s like Groundhog Day.
We know that these factors have a great effect on people’s long term quality of life. And yet, it seems that every five minutes someone has something new to say about it; except it’s not new, it;s just the same meaning with different words, and maybe some new jargon (Big Society: new? I don’t think so!).
The staggering thing is that there seems to be no accountability for failings. The higher up you are, the less you are held accountable. Organisations on the ground, in communities – providing face-to-face support, contact and life-changing services – are being battered. If you stand back you will be ashamed; I am.
The most obvious thing I see when researching is that policies don’t need to be marked with dates to betray which government wrote them. Policy documents in current plans are target-driven and punitive; for example, The Work Programme and DWP sanctions for Job Seekers Allowance, they take no account of the difficulties people face and there are no prizes for giving support.
The third sector could do more. It knows what works, but it doesn’t shout about it or take enough of a leadership role. The public sector could let go and trust more; it could commission for outcomes and not for process. The private sector role in health and social care needs little comment: although not all private sector organisations operate like the big players, putting profits first and people second (or further back) is disgraceful – but only as disgraceful as the people who continue to commission them.
But, at the moment, it feels like we’re fighting a losing battle.