Behaviour in schools is deteriorating and teachers are struggling to cope. The police are managing continuous low-level local problems and struggle to cope. The NHS is overloaded and is approaching a real crisis. What if I told you there was a fast solution to a proportion of this?
That solution is to stop expecting the police, doctors and nurses and teachers from being forced to act as proxy social workers and instead to invest in a proper National Care Service. Because the failure in social care is now resulting in those social problems being left to other frontline workers to deal with.
Common Weal has a group of health experts and a group of education experts who help us with our policy work and we are well connected to groups dealing with community support who rely on their local policing. They are telling us the same things. They are being expected to deal with issues they’re not trained to deal with.
But it’s more than that; they are dealing with issues they should not be trained to deal with. This week the Scottish Government concluded that violence in schools could be addressed through better training for teachers. That is like suggesting that the maintenance backlog in schools could be addressed by the geography department getting joinery lessons.
What is missing in all of this is the fact that there is a professional discipline which is trained to deal with these problems. It is called social work and it has been devastated in Scotland over the last 20 or 30 years. Investing in social work doesn’t sound that exciting but it could have a transformative effect on the other services.
Because GPs spend a large proportion of their time dealing with issues which are social rather than medical, but which have medical impacts. These are things like the problems of loneliness, the problem of hunger and cold, the problem of poor housing. Some GPs report that as much of a third of their clinic time is spent dealing with social issues.
In schools there are very good reasons why behaviour has got worse – yours would too if you were facing not having food or heat at home. But for me I think people have been much, much too offhand about the impact that a series of very long lockdowns had on kids. I’m a bit tired of hearing about how this was all ‘necessary’ without an explanation of how to fix the emotional damage.
So it is teachers that are catching the impacts of this, and they shouldn’t have to. They are not there to manage children’s housing problems or their hunger but to teach them. Yet that is what they are doing, acting like surrogate social workers.
The same is true to at least as great a degree with the police. Most police services now complain about the sheer volume of low-level (and not so low-level) mental health problems in communities they have to respond to. They are dealing not with crime but with a social problem.
People are desperate and they have nowhere to go, so they are going to whatever service they can – if they can’t get support from a care service or local authority to be able to feed their family, they will go to a GP because a GP is there
And I don’t want you to mistake what I’m saying here. I’m not saying that they are overwhelmed because of the impact of these problems on their legitimate areas of work. They are as well – social failure creates ill health, poor educational outcomes and increase crime. But what is happening is that these other professions are dealing with the primary problems as well as the secondary problems.
People are desperate and they have nowhere to go, so they are going to whatever service they can. If they can’t get support from a care service or local authority to be able to feed their family, they will go to a GP because a GP is there. If people know a neighbour has mental health issues and needs help but is causing problems, without a care service to call they phone the police.
The secondary outcomes alone from a decade of austerity, Covid and a cost of living crisis would have put these services under substantial pressure. Asking them to cover primary problems as well is pushing them out beyond the realms of manageable.
So how did we get here? To fully understand the picture I can highly recommend the (very readable) Common Weal report Struggling to Care by social work expert Colin Turbett. He documents the way that social work has been more or less dismantled since Thatcher.
Social work was one of the pet hates of Tories because it is a profession that clearly implies that failure is not individual but social. Social workers were picking up the failures caused by Thatcher’s reforms, and it really didn’t fit with the Tory narrative on those reforms.
And there were a number of scandals. There will be scandals in every field of life, but the right wing media in particular targeted these stories to create a strong anti-social work attitude among their readership (most of whom didn’t really know what social workers do). So the service was defunded and fragmented. There isn’t a single local authority with a social work department any more.
The daftness of this ought to be apparent. It’s as if the scandal over the serial killer Harold Shipman had led to the dismantling of the NHS. And yet that is the legacy we are left with.
You know what kind of an outcome you get from someone not trained to do a job? A bad one
What it has taken out of our society is very substantial. Social work is a discipline that isn’t reflected in the other disciplines across the public service. Their area of expertise includes managing violence, conflict resolution, signposting people through public services, assessing need for mental health, disability or care support, preventing child abuse and a whole range of other problems which are exactly what other services are dealing with.
And you know what kind of an outcome you get from someone not trained to do a job? A bad one. You wouldn’t want a teacher to build your house any more than you would want your local builder to educate your kids. So why is a teacher being expected to resolve violence and the impacts of extreme deprivation instead of improving literacy or numeracy?
The answer is that they shouldn’t. Hour for hour you would get much, much better outcomes from one social worker than from a dozen teachers covering the same role part time. Not investing in this problem and patching up and making do with what is there is not a solution.
Yet that’s what we’re getting. There was a perfect opportunity to reverse out of this cul de sac when the Scottish Government announced it was going to create a National Care Service. But in its own wisdom it decided that this would be management-led not social worker-led, because that’s what KPMG told it to do.
Rather than strengthen the social work role in local communities, the current proposals for the National Care Service will weaken it as it centralises power further and further towards managers in Edinburgh.
What this means is that if you want to enable a GP to be able to see more patients in need, invest in care. If you want to let teachers teach and help them deal with violence, invest in care. If you want the police to be dealing with serious organised crime, invest in care. A good care service takes the pressure off the other services.
It really is quite depressing in Scotland. We don’t break down what is actually wrong in our public services and address systematically the problems we find. Instead we wait for bad headlines and then run a PR stunt. The Scottish Government just pretended it is serious about tackling violence in schools – by allocating £178 to each school to get on with it. Dear god.
People just don’t understand what has been lost as we’ve lost our capacity to organise effective care. If I was running the show, tackling that would be one of the first things I’d do. The benefits would cascade right across public services.