The Price of Everything and the Value of Nothing


To continue my theme (at least initially) for carers’ week, I wondered a while on the purpose of these weeks and days and months we have devoted to various issues.  They are about celebration, gratitude and recognition for the most part. Celebrating Mothers Day, for example,  doesn’t make us less grateful or thankful for our respective mothers on the other 364 days of the year so what is it about having a special day or week that is necessary.

I’m not a cynic. It is a good focus for events and allows particular issues that can be forgotten to be drawn out into the news agenda for a discreet period of time (a week is good – it can focus the attention). Campaigns can be built around days or weeks or months and themes can be wound up in the consciousness of the ethereal ‘general public’ whose attention can be fickle and fast-moving.

So it is that Carers Week is upon us but for it to be truly meaningful over the longer term there has to be a more systemic change in the process of social care and the way it is done in this country.

I engaged in a very brief ‘Twitter chat’ yesterday with a carer, Casdok, who writes a blog here. She mentioned that since her child had moved from childrens’ services to adult services she had noticed that she was listened to less and (I’m extrapolating a little here because it was in very short messages!) the service received was less good.

A brief exchange mentioned the loss of the relationships with particular social workers – you know, when the social worker used to pop round for a cup of tea – made me wonder what we have lost in the rush towards ‘care management’ which was to be the way that adult social care was organised after the NHS and Community Care Act.

I worked in an adult social care team before I moved into Mental Health services. The office had something of a ‘production line’ feel to it. Assess, review, close. Assess, review, close. Sometimes you would linger if there were direct payments involved but that would mostly be about referring to a different agency or part of the council to set up the payments and advise about employment regulations and advertising for assistance.

The relationship was and is lost. Is this what we study for? To assess, review and close with some safeguarding thrown in with increasing regularity. The processes have been streamlined almost to the point of any independent thought and true ‘assessment’ in the sense of being able to give professional judgements being rattled out of the processes to simplify.  This process has streamlined the heart out of social work for adults.

Critical analysis and reflection, yes, there is an option but it has to be in your own time and at your own rate. When we lose the critical analysis and reflection in our work though, we cease, to all intents and purposes being social workers and become care managers.

And where is the relationship-building? The listening. The advocacy. It has been costed out of the equation. It cannot be reduced to a performance indicator and therefore it has no value.

The issue is that it does have a value. It has a value to carers and to service users but often that value is unquantifiable and in a world of measurements and costs, unquantifiable is not where you want a value to lie. Because it is discarded.

The reason I moved from adult social care into mental health social work was because I felt my brain was stagnating to a point. Of course, things may have changed with self-directed support being more available now but I hope I always assessed in a person-centred and creative way. I certainly set up a lot of direct payments packages.

For the moment, in the mental health teams we do have a little more time to spend building therapeutic relationships. We have  more time to listen. It is all measured, of course, against outcomes because we have to be able to justify every minute we spend on paid time  but the ability to build relationships and to listen are, at least, embedded more strongly in the role.

I can’t see us ever going back to the days of being able to pop in for cups of tea. And we have lost much much more than a piece of cake along the way. We have lost the soul of the profession at the sniping jaws of employers who want to distil creativity out of the job because we need to meet specified targets in specified times. Everything is quantified.

Sometimes though, we need to be less complacent as employees. There are jobs going. There are changes coming in our services. Last years cuts are only the very start. They will come more quickly. Social Work is changing. It will move out of local authorities and I don’t think that will necessarily be a bad thing. It may be the best thing for the profession as a whole, in fact, if not for individual employees who won’t necessarily have the rock solid pensions and the now laughable idea of job security.

Perhaps we need to take more responsibility for our own work and our own profession in order to retain the values that remain at its heart and move into community work and macro-social work.

I occasionally get glimmers of real hope and drive for the future and the ways in which this profession can change and be changed and then, I look at the people at the top and wonder if there is any desire for truly structural changes in the way that social care and social work is delivered. Yes, I want personalisation to work, I really do but I want the value of good (and I really mean good) quality social work to be recognised in the process.

Yes, there are coercive elements to our role. I know that only too well as an Approved Mental Health Practitioner. I didn’t go into this job to be loved and as for respect, for the most part, I can take it or leave it – except for self-respect. I have to be able to feel I am giving the best every day I am at work and that regardless of some of the more coercive elements of my work, I am able to work according to my moral and ethical compass.

Sometimes I worry that has been lost but perhaps among the structural changes that are going on around us in social care, some true change can be affected.

I hope so.