The government has recently, as part of its agenda to reduce government expenditure, proposed to merge the general social care council (GSCC), the English regulator of the social work profession, with the heath professional council (HPC).  What are we to think about this?

The first thing to say is that the GSCC has not been well-run, as we have seen in the replacement of the chief executive this year; it remains to be seen how effective the new chair and chief executive would be in rectifying the problems. The original report on the GSCC’s problems made it clear that part of the problem was in the original legislation: it focuses on conduct rather than service quality.

It was, of course, an HPC man who did the review of the GSCC, and so therefore his criticisms might reflect a prejudice in health care or the HPC about the way you should regulate a profession. But you can’t really complain about quality of service outcome as the main criterion of regulation, rather than some fairly arbitrary rules of conduct. However, this rather rejects the importance of the codes of practice as statements of good conduct that you might expect from a social worker; there is a tradition of things like codes of ethics in some professions to help people decide the appropriate reaction to particular situations.

On the other hand, as I have been arguing in various books and articles for many years, the reality of social work is that social workers are asked to make moral decisions on behalf of society about who is a good parent, what is good parenting, what is good care for adults, what is need, what is risk and so on. And the codes of practice and ethics are not detailed enough, and never could be, to help us with the infinite variety of human activity that we deal with. Instead, what they do is identify the areas of our activity where things are complex.

For example, the old ethical rule that clients should be self-determining – nowadays we might talk about autonomy. The problem is that the autonomous may be constrained in how they can be self-determining by widely accepted social rules that we all have to follow. You can be as autonomous as you like, but you should not be beating up your spouse. So self-determination is not really a rule, it’s really a flag of danger. If you come across a situation in which someone is not following widely accepted codes of behaviour or is trying to be self-determining and there are many obstructions, you are really being asked to think hard about the balance between rule-following and self-determination in this situation.

So I’m not all that concerned about these codes as absolute standards of behaviour, but I am concerned that there is a process that checks out whether and how appropriate decisions were made in one of these difficult situations. I also feel a lot happier about codes that are created within the profession and represent its values, rather than something that is imposed by the government – yes I know there were all sorts of consultations, but I think professional analysis in something like a college of social work (back to that move again) is perhaps a better way of doing it. Get the government out of these issues; they have too many smelly fish to fry.

So, a plus is that by moving it out from direct responsibility of the Secretary of State, there is a chance that the work that the GSCC does will be led by the interests and concerns of social workers and their service users, rather than the directions of DH political policy. This is a good thing because it means a basic reference to the quality of service provided to service users, rather than meeting the latest prejudices of the political parties in power at the time.

Does it mean that a non-social work body will take over responsibility for the regulation of our profession? Well, what did you think the Department of Health was: an enthusiastic supporter of social work professional values? The HPC has a record of doing this job for quite a few professions in a reasonably neutral way. And it has been responsive to professional pressures; my inside information (and indeed the public struggle in the press) tells me that the psychotherapists and counsellors have had a torrid time and a lot of influence in trying to construct an appropriate form for regulation for their fractured professional groups.

You may also be worried that it’s going to cost a lot more: at least double it seems, perhaps more. But as I’ve said in this blog before, if we want to have independence from the government, we are going to have to ante up for it.

It’s irritating that the recommendation comes in a document about the NHS (the DH is still unable to include social care adequately in the things it does) and I am worried that it might lead to too much of an emphasis on healthcare rather than social professions. But we might have some supporters there among the psychologists – this is one of their beefs. That is why I propose, since it’s going to have to have a new title: the Care and Community Professions Council. Let’s emphasise where the priorities should be: care and the community, not health.

The change will require primary legislation, and you might think that will never happen; but I presume the legal arrangements can be maintained within some sort of notional merger.

Another issue is what is going to happen with education. Personally, I never have quite see the point of registering students: where they are dealing with the public, it is their supervisor who should be held to account or whatever the current jargon for practice educator is, and that should be a qualified social worker. And I know from many students, including my daughter, that the GSCC has not been a particularly efficient manager of grants.

I think it would be a pity if there is no system for evaluating and checking on the quality of social work education – it’s not clear this would stay with the HPC, or post-registration education. But how about the American solution: there the association of schools of social work runs the accreditation of courses at all levels, it’s an inclusive and representative way of doing it, it pays for itself, and it is really feared because you know you’re going to be looked at by people who really know what running a social work course is about. And you only have to look at the excellent, comprehensive and detailed University Quality body’s (the QAA) benchmark for social work courses to know that this is a much better statement of what’s required in a social work course than the few asinine government requirements.

And palliative care: again, the GSCC has been too beholden to DH priorities, which are the forms of local authority social work. It will be much better to have an independent body that looks at all social work specialties, not just what the government is interested in.

We should go for independence and be prepared to pay for it.

I have excerpted the statement from the Arms-length Bodies Review, below. This is not the only thing relevant to social care in the Review, so I’ll be coming back to it again.

General Social Care Council (GSCC)

3.36 The General Social Care Council is an Executive Non-Departmental Public Body responsible for the regulation of social workers and social work students in England. It is anomalous as the only professional regulator answerable directly to the Secretary of State for Health.

3.37 We see no compelling reason why the General Social Care Council should remain as an Executive Non-Departmental Public Body in the arm’s-length bodies sector, and we see potentially significant benefits from putting the regulation of social workers on a similar footing to the regulation of health professions. This involves the regulator being funded through registration fees charged to those registered, set at a level to cover the regulatory functions. In this way members of a regulated profession buy into their professional standards, which are set independently of government, and have an incentive to ensure these are upheld throughout the profession.

3.38 Therefore, we intend to abolish the General Social Care Council and move the regulation of social workers out of the arm’s-length bodies sector to make it financially independent of government. We believe that in future, the most appropriate model for the ongoing regulation of the social care workforce is to transfer responsibility for these functions to the Health Professions Council, a well established and efficient regulatory body currently regulating over 200,000 registrants from fifteen professions. The Health Professions Council – which will be renamed to reflect its new remit – operates a full cost recovery scheme and currently charges an annual fee of £76 per year, which is considerably less than the likely registration fee if the General Social Care Council were to operate alone on a full-cost recovery basis.

3.39 The Health Professions Council has an existing comprehensive and cohesive system of professional regulation which would apply to social care workers. This differs from the General Social Care Council model in several ways:

• the Health Professions Council is solely responsible for setting standards of education and training for its registrants, whereas it is the Secretary of State’s function to ascertain what training is required to become a social worker;
• unlike the General Social Care Council, the Health Professions Council do not register students, though as part of the approval process the Health Professions Council requires all Higher Education Institutes delivering pre-registration courses to operate a fitness for practice system for students;
• unlike the General Social Care Council, the Health Profession Council does not in practice approve post-registration courses apart from those related to prescribing drugs, although it has the power to do so.

3.40 We anticipate that the differences would be explored through a review of social care regulation. The abolition of the General Social Care Council, the transfer of functions in relation to the regulation of the social worker workforce and related changes will require primary legislation. The timing of these changes is dependent on discussion with the Health Professions Council and the General Social Care Council to ensure an orderly transition.

3.41 Finally, the General Social Care Council is also responsible for the payment of Education Support Grants, and we propose that if this function is to continue it should transfer to another body.

The full review on the web: Department of Health (2010) Liberating the NHS: Report of the Arm’s Length Bodies Review. London: Department of Health: 21-23 http://www.dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/@ps/documents/digitalasset/dh_118053.pdf