Ethical Practice in the Face of Cuts

How can I compute the process of going into peoples’ homes, often relying on good relationships which have been built up over weeks, months or years and telling them that there is no money left, that services need to be cut with my ethical compass and my adherence to a code of practice for a profession which has, at its heart, a struggle for social justice?

It’s something I’ve been toying with mentally over the past few weeks and months. I suppose in some ways this post is an attempt to become an apologist for my own practice but while I know many would argue against my justifications I can’t honestly afford to throw away my job so what can I do to ensure that my moral compass is retained.

Well, I can do my best to advocate. I can tell people about complaints procedures and urge them to use those self-same procedures to make their voices heard. Maybe when council members see the letters flowing through their respective mailboxes from constituents they will pay heed to the effects of the decisions they are taking but I’m not confident that many will take that path. Complaining, unfortunately, is too closely associated with negativity. It shouldn’t be. A complaint is, in some ways, the best way of learning about what a service needs and lacks. I wish everyone complained more. I have been subject to a fair number of complaints over the years and after the initial jolt of damaged pride, I honestly think they have been extraordinarily helpful in the long run.

The last complaint I received which referred specifically to me was from a woman I had been seeing for a while and we went through the process together of setting up a personal budget and support plan. The indicative budget though, was not enough to provide the services that she felt she needed and so the support plan was lacking in some areas that she felt were important to her – simply because there were limited resources. So she complained. She complained that I had not been able to meet her needs and also that I didn’t visit her often enough.

By the time I had explained my actions to my manager and written a draft response to the complaints department, I had been able to give everyone along the way an earful about exactly why I felt the process of determining an indicative budget from a Self-Assessment Questionnaire was fundamentally flawed and discriminated against people with mental health needs.

Her complaint gave her and others like her a louder voice.

I object and shout and discuss the processes that I see within the local authority systems but I still implement them. Does that make me less of a social worker? Again, other issues that I ponder aloud. I have tended to think that outside statutory services one might be able to take a more idealistic view but the building of competence, relationships and understanding within statutory services are a key part of the role as well.

Interestingly, when I think about the moral dilemmas of my work and how I practice, it is far more the issues that come up on the care management side that vex me because they are about the scarcity of resources. It might be more obvious for me to think about the controlling statutory role and power that I have as an AMHP (Approved Mental Health Professional) to deprive people of their liberty by making applications to detain them in a psychiatric hospital without their consent.

I find that part, ironically, a little easier to equate with my role due to the best interests aspect and knowledge that decisions that I make under the Mental Health Act as an AMHP are ones that I, alone, am responsible for and in that role I am not a functionary of a local authority machine but I am responsible for my own decisions to admit or not to admit.  While there is, without doubt, an ethical dilemma present in almost every compulsory admission, it feels different when I am solely responsible for taking that decision and can weigh up the issues myself.

So is this post an apology for the actions I take on a day by day basis in being an instrument of some of the harshest cuts in the social care systems? Yes I think it is.

As much as I strongly disagree with the way that the cuts have been weighted against those who have least, I am still instrumental, amid growing caseloads and shrinking resources in being the front ‘face’ of them to many people I know and who know me. I’m the one who tells them respite services are closing. I’m the one who tells them they have to have a pre-cooked meal delivered rather than a carer actually making a meal for them.

If everyone had what they needed though, it would be a delightfully easy job.  As it is, I continue in my role and yes, complain about it, but try and use all my energies outside my work to take the  fight back to the politicians and the officials who rely on people like me to implement the cuts they decide on behind the closed doors of power amongst themselves.

I genuinely think that it is not possible to be an effective social worker without a thought or concern for promoting social justice and both equality and equity of resource distribution.

And with that, I try to ease my struggling conscience.  It is a struggle though.

7 thoughts on “Ethical Practice in the Face of Cuts

  1. It would seem the cuts are hitting people very hard wether be it councills with stretched budgets and allready making as many savings as posible the are the cuts humane in them selves. I dont see that the cuts are humane probably cecuase i fight my cause i am in and out of hospital quite a bit doing bad things.What i wounder is david cammron who birngs in all the cuts has he thought about all turnative ways of doing things i got hit with the cuts very hard sanctions in the job centres are getting worse they now have quotas for getting peoples money stoped i was cuaght in a system where i dont think it was intended to get me but it did i had a coplete brake down with BPD or crisis and i ended up in hospital it was coming voe so i worte to my mp and she wrote to my doctor and it was lifted new evidnce came to light i now have an exemption on my jobseekers but i fear not most for my slef but the people with mental health worse than bpd they are going to get caught in that system there is even the guardian bloke investergateing about sanctions its bad i went along with the job centre for 6 mounth i played there games and i was fine what job do they expect me to get i have tryed working everytome i do my girlfriend runs away or i end up fighting with customers or getting hurt you know if the goverment really wants me to jump if not get no money bring a fireing suad up i will sign up and get shot the country get a bonus they dont have to pay me anymore thats the way i feel i am going into theropy now and i dont have to wory about the job centre for the time being thank gosd for that i wish the country as a whole didnt see us as scroungers iff the state hopefully after six mounths i will be better meanwhile the next time the job centre start im going to ask them you live my life for one day and ill live yours i think the while country should strike i know nurses cant cause that is unehical and its not a duty of care where are all these cuts taking us i wounder

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  3. You do not have to apologize for not being able to deliver if you have done every thing that you can do to try and you can prove it if needed. Then it should be the government that should apologize to the person for not providing a carer and take the fall out if anything happens not you.

  4. Another great post. I think it’s a struggle that is only going to continue, and in my state we’re facing enormous cuts too. This question is one of my continuous ongoing dilemmas – how to be part of a field that fundamentally is about social justice and protection (and I do believe it is) while at the same time working for an institution that requires certain mandatory or statutory job tasks that contradict the very values of social justice and protection we value. It’s not even about efficiency any more either.

  5. I am a grad student in America, soon to be a licensed Advanced Practice Social Worker, and I am so happy to have stumbled upon your blog! Keep up the good work!

  6. I often struggle with this dillema…if you boil the issue down to its theoretical basis I feel its a matter of conflict in terms of our perspective of exactly what social work is and should be doing…Davies (1994) was a strong advocate for a maintenance approach I.e maintaining the social order and basically doing whatever it takes to maintain the status quo, thus being agents of the state and simply implementing govt determined policy. An emancipatory/socialist collectivist approach, I.e critical social work, anti oppressive practice etc would say that you feel these conflicts because at an elementary level you know the system you ‘have’ to practice in can be unjust and needs challenging/reforming etc.

    I know this is only a theoretical basis of a very practical problem but it is one we need to consider carefully and do a little soul searching and self analysis to see just where our values lay and what the consequences of them are.

    In my first year of study and prior to my decision to become a social worker I was very left wing/ democratic socialist…feeling strong about challenging the wider structural problems we have within our society…however as times gone on and iv been ‘bought down to earth’ as someone put it recently iv found myself feeling despondent and isolated pursuing these goals within social work and find myself more and more accepting of my place simply as the face of governmental whims and ideology!

    It’s a real shame tbh

  7. Thank you so much for sharing this–it reflects, I think, the struggles of social workers around the world in this era of retrenchment. If we’re not all feeling conflicted and a bit ethically suspect, we’re not thinking hard enough about our complicity in a broken system and how we can best advocate for change. And I agree with you about complaining–what a great example of how, when we get over ourselves, we can appreciate how our clients’ tremendous courage in voicing their outrage can help to build a better foundation for others, too. There are no easy answers. But I’m glad that we’re asking the questions together.

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