Within this essay, the social policies, legislation and organisational context of social work in adult services will be discussed, critically analysed and evaluated. Adult service covers a vast array of services, including probation, substance misuse, adult protection and disabilities, this essay will concentrate on Adult Mental Health. The name ‘social policy’ is used to apply to the policies which governments use for welfare and social protection and the ways in which welfare is developed in a society.
Social work practice is not only about individual needs, it also considers social context.
This social context includes the range of inter-professional agencies contributing to packages of care and protection, as well as the relationships between service users and their families, friends and communities. Social work is also predisposed by the social and political climate in which it exists. The roles of social workers and the needs of service users are both influenced and defined by the beliefs, values, policies and laws of society.
(http://openlearn. pen. ac. uk4)
Social policy in the United Kingdom can be traced back to 1572 where An Elizabethan Act made provision for the punishment of beggars and the relief of the vulnerable poor. The Poor Law lasted in one form or another for 350 years, based on the residual nature of laissez-faire, and accounts for British social policy to be dominated by the role of government. This was not the experience of other countries, where welfare more typically developed through a combination of voluntary and mutual provision, later supplemented by government action.
In 1598-1601, The Elizabethan Poor Law was a national Act for England and Wales. It provided for a “compulsory poor rate, the creation of ‘overseers’ of relief and provision for ‘setting the poor on work”. (www2. rgu. ac. uk/publicpolicy). The local parish was the basic unit of administration. There was, however, no general apparatus through which this could be imposed and the Poor Law’s procedure was not consistent between areas.
The changes of the industrial revolution led to the development of the towns, population growth, the first experience of modern unemployment and the trade cycle. All this caused escalating poor rates. The 1834 Poor Law Amendment Act established a national Commission for England and Wales. English local government developed around the Poor Law. 1871 saw the creation of the Local Government Board, which stayed in place until 1929 when the Local Government Act allowed The Poor Law Boards of Guardians to be replaced by local authorities. Read about approaches to challenge discrimination in health and social care
The Liberal government of the early 20th century put in place the fundamentals of modern-day social services. Concerns with national efficiency fuelled the desire to provide an infrastructure of public services. Included would be the large-scale public services, and facilities needed for the country that are necessary for economic activity, including power and water supplies, public transport, roads, and schools, these services were deliberately provided outside the Poor Law, to avoid the stigma associated with being impoverished.
The Beveridge Report of 1942 proposed a system recommending the establishment of a National Health Service, National Insurance, Assistance, Family Allowances, and stressed the importance of full-employment (London School of Economics and Political Science 2000. ) During the war, the coalition government also committed itself to full employment, free universal secondary education, and the introduction of family allowances. The Labour Government was elected in 1945, and introduced three key acts: the 1946 National Insurance Act, the National Health Service Act 1946; and the 1948 National Assistance Act.
These Acts all came into force on the same day, 7th June 1948. The 1948 Children Act was another important component (http://www2. rgu. ac. uk/publicpolicy). However, the system was never intended to provide for mass provision or one which anticipated with meeting the income necessities of people who wanted to work but could not, or could only work for rates of pay which tied them to poverty. It was intended for the minority of cases who fell through the full unemployment benefit trap (Clarke.J. Et al 1994). Social policy is to a large extent dominated by economic policy, because economic policy determines the amount that government is prepared to spend. There are two main views of public spending; Monetarist and Keynesian. Monetarism is based on a view of the economy as self-stabilising and Keynesianism sees government intervention in the economy as necessary for the stability of the economy (Alcock, P 2003 p220) From 1974-1979 a Labour government was in power.
Known as a left wing party, they believe in welfare, public provision, collectivist and institutional welfare, where as the Conservatives, who were in opposition, are against welfare and public provision and believe in individualist with a residual welfare state. The political consensus about the purpose of the welfare state began to break down in the late 1970s and intensified during the 1980s when Margaret Thatcher became British Prime Minister. During the first term of Thatcherism polices introduced where concentrated on monetarism; following the 1983 elections many public companies where privatised. Giddens 2005)
In 1997 labour came into power and reinvented itself as New Labour, and embarked on a course of political reform and modernisation, recognising that old politics were out of line, they moved beyond the normal categories of left and right and embarked on a new approach of centre-left, being able to avoid customary political divides it is known as Third Way Politics. This has continued to the present day with the welfare mix to develop social policies. (Giddens 2005 p436) Social Workers are employed in both the voluntary and statutory sector.
The later years of the twentieth century saw a shift between local and central government due to high standards of quality health and welfare services monitored by Social Services Inspectorate of the Department of Health. The shift saw local government, which traditionally monopolised the organisation, management and delivery of services to more control for the public, voluntary and private sector. During the 1960s the voluntary sector became very popular with the recognition that the state could not solve all the problems of society (Powell, 2001 p61).
Croft and Beresford (1997) call for limits to professionalism by using the experience of service users, or as they state “The person who has been through it”. Seeing as social work is characteristically a personal social service within different areas of the community, the voluntarism in the context of a social realm would seem to make sense. In contrast, Powell (2001) argues that the volunteer cannot be an alternative for a trained professional in a risk society any more than a charity can replace welfare state benefits.
Voluntary sector organisations do have an important role in delivery of social services and vary in different forms, including parent and toddler groups and mental health charities like “Mind”. Organisations working in the voluntary sector are not part of the state provision and therefore are not bound by statutory legislation, although their work and accountability is affected by legislation. They are also not directly accountable to government and their employees are not government officers.
It has also been noted that they are private bodies, but not part of the private market or commercial provision of welfare. (Alcock,P 2003) Working in the voluntary or statuary sector will include working in partnership with service users, their advocates and carers, and other multi-professional agencies, which can include the decision-making process that affects the services users’ life. Therefore, work with service users should be based on their significant involvement in decision making.
It is a good work ethic to practice demands that work takes place on the basis of partnership. Sometimes there can be a legal requirement to work in partnership with service users, for example, working with a service user detained under the Mental Health Act, and other agency professionals; CPN’s, Doctors and local authorities. A commitment to working in partnership with service users will often require the social worker to take account of inequality and take positive action to empower service users.
Working in partnership with other agencies can raise ethical and moral issues, it may be the case that all agencies do not share the same agenda and do not have the same professional approach to their work. (www. openlearn. open. ac. uk 2008) Although social work in the UK developed as an altruistic action on the margins of statutory services, social work has been incorporated steadily into statutory mechanisms since the 1970s (Langan 1993). Not only does the state have the right to intervene in the lives of individuals, it has effectively taken control over how this should be carried out and by whom.
Voluntary social work agencies cannot function without some measure of control over their activities by the local authority and by the legislature. “Even in the era of ‘care in the community’, it is the local authorities which inspects voluntary institutions and give out contracts for work on its behalf. ” (University of Edinburgh 2008) Social care organisations will continue to modernise for the foreseeable future, this could be by the continuing Labour government using the “command and control” model of policy management, and understanding that “one size does not fit all”, (Hafford- Letchfield 2006).
However, this could also be done by placing more rights on the service user and handing over power to the service user, as stated in the Labour Party Manifesto 2005. Social workers have to act within the law and can be called upon to justify their actions to courts and managers as well as to service users. Social workers are also employees and consequently can be called upon to justify their actions to their line managers and the organisation that employs them.
The National Service Framework for mental health helps drive up quality and remove the wide and unacceptable variations in provision. (http://www. dh. gov. uk 2008) The government White paper of 1975 “better services for the Mentally Ill” proposed a policy of “deinstitutionalisation, relocating mental health treatment to the community” (Powell,F 2001). The Local Authority has a duty under s. 47 of the National Health Service and Community Care Act 1990 (NHSCCA) to assess services users to see if their needs call for the provision of services.
Due to a service users mental health needs they are able to receive both residential and non-residential facilities under s. 7E (b) of the Local Authority Social Services Act 1970 (LASSA). Established within the NHSCCA 1990 are arrangements for people with Mental Health problems, and the Local Authority Social Services are responsible for planning and purchasing relevant social care services and for assessing the individual to determine what services they require. After an assessment, the service user may have been diagnosed as needing treatment under the Mental Health Act 1983 (MHA).
The Mental Health Bill to amend the 1983 Mental Health Act completed its parliamentary stages on 4 July 2007 and has received Royal Assent, becoming the Mental Health Act 2007, which will become law in October 2008 (MIND 2008). Before any application is made for an order, an interview with an appropriate approach must take place (MHA s. 13). This would take into account any barriers to communication that may exist including; language, culture, environment. If the service user consents to treatment, then informal admission into hospital may be in the service users best interest (MHA s. 31 para 2. 7).
Under Section 114 of the MHA an Approved Social Worker (ASW) can detain a service user; the application can be made on the basis of a medical recommendation of at least one doctor who has seen the service user within the previous 24 hours, which means that they can be detained for up to 72 hours. Once invoked, the process for a Section 2, 28 day assessment or Section 3 up to 6 months treatment can be started. The s. 4 emergency detention is followed by s. 2 assessment whereupon the medical recommendation of another doctor is required (http://www. dh. gov. uk 2008).
However, Sections 72 and 73 of the Mental Health Act 1983 are incompatible with the European Convention on Human Rights, they state that rather than requiring that the lawfulness of continuing detention should be proven before a mental health review tribunal, these sections effectively reversed the burden of proof by requiring the services user to prove that the conditions for detention were no longer satisfied (Bindman, J. 2003) It must always be satisfied that detaining someone is, in all circumstances, the most appropriate way of providing the necessary care and treatment (MHA s. 3).
Upon being discharged from hospital under s. 3 a service user automatically receives the services they require under s. 117 for as long as treatment is needed. A care plan should be implemented with the needs of the service user at the forefront and reviewed to make sure their needs are being met. It should be noted that new policies have been put in place to try to improve aftercare planning; this would include the appointment of a Key Worker under the Care Programme Approach.
However, neither the 1983 MHA Act nor the 1995 MHA include any legal powers to actually make a service users receive medical treatment against their will in the community. (Turner, N 2006) The White Paper, “Saving lives: Our Healthier Nation 1999” includes mental health as one of its four key areas. The Framework sets out the action to be taken by health and social service to deliver their contribution to the attainment of the target for mental health, one example is to reduce the suicide rate by at least one fifth by 2010.
In addition, a range of Government policies will also support this National Service Framework. Social exclusion can both cause and come from mental health problems. A study by mental health charity MIND, “Creating Accepting Communities 1999”, highlighted the discrimination faced in all aspects of life by people with mental health problems. Once diagnosed, people lose their jobs, are refused insurance and denied access to banks and further education, MIND are calling for new legislation to protect services users from discrimination (Dunn 1999).
The MHA 2007 does still not answer all the questions raised though. Initiatives designed to promote social inclusion like, Sure Start, Welfare to Work, New Deal for Communities and the work of the Social Exclusion Unit, will all strengthen the promotion of mental health and individual well-being, and reduce discrimination against people with mental health problems. (http://www. dh. gov. uk 2008) On the 7th May 2008 the Home Secretary, Jacqui Smith, said in a statement to the House of Commons: “I have decided to reclassify cannabis to a Class B drug, subject to Parliamentary approval”.
The decision was taken, despite advice from the Government’s official advisory body, to reverse Tony Blair’s 2004 downgrading of the drug because of uncertainty over its impact on mental health. (BBC News 2008). Growing evidence suggests that people with serious mental illness, including depression and psychosis, are more likely to have used cannabis, or had used it for long periods of time in the past. (Royal College of Psychiatrists 2006). Globalisation is a recognised feature of economic and social systems as well as social policy.
The development of a global economy has implications for national welfare policies. Mishra (1999) argues, that “Globalisation limits the capacity of nation-states to act for social protection”. Global trends have been associated with a strong neo-liberal ideology, promoting inequality and representing social protection as the source of rigidity in the labor market. (www2. rgu. ac. uk/publicpolicy) Ethical issues must always be considered in all aspects of social work; social policy and legislation are no exception.
The General Social Care Council Codes of Practice (GSCC) contains a framework of practice that social workers follow in their work. This is not the only framework social workers can follow; there is also the British Association of Social Workers (BASW). However, it should be noted that membership to BASW is voluntary; whereas the GSCC is compulsory membership if social workers are to work in the field of social work. Section 62 of the Care Standards Act 2000 requires GSCC to produce codes of practice and to keep them under review.
The codes were developed following widespread consultation with social care workers, service users and carers in 2002. The codes provide a clear guide for everyone who works in social care, setting out the standards of practice and conduct workers and their employers should meet. The codes are a critical part of regulating the social care workforce and helping to improve levels of professionalism and public protection. The codes were built on existing practice and shared values.
Many people rely on the honesty, integrity and professional skills of social care workers and these codes spell out the standards people can expect of them. (www. gscc. org. uk) Code 1 of the GSCC states that; “Social workers must protect the rights and promote the interest of services users and carers”. How this is interpreted is related to sections 1. 1-1. 6 of the code, but it does not say about legal dilemmas that may arise, an example might be that it may be essentially a legal question whether to detain a service user under the MHA, but is it ethically right?
Banks (2004) states that “Laws do not tell us what we ought to do, just what we can do”. This can then be looked at in reflection of legal obligations, this would include; respect for human rights and anti-discrimination legislation; awareness of statutory entitlement to services and that social workers should be aware of areas of law beyond statutory duties, if they do not keep up to date on all aspects e. g. family law, Housing law, Homelessness law, then ethical issues could arise due to lack of knowledge.
This would break s6. of the GSCC code of practice, and also concurs with s4. 4. 2. of the BASW codes of ethics. (www. BASW. co. uk) March 2008 saw The General Social Care Council publish the “Statement on the Roles and Tasks of Social Work”. It is described as a guide to “social work at its best”, and defines the profession of social work as being “committed to enabling every child and adult to fulfil their potential”, working in partnership with service users whenever possible and embodying values including equality and human rights.
Even though this has been welcomed by many people in social services, not everyone is happy with its publication. Peter Beresford, chair of service user body Shaping Our Lives and professor of social work at Brunel University, criticised its low-key launch and the lack of public endorsement from ministers and why there was no press release. (Mithran S, 2008)
In conclusion, the social policies, legislation and organisational context of social work are important factors that go towards the whole process of social work. It is important to know the skills and knowledge in law and policy, but also to have the knowledge and skills in interpreting and applying social work law to practice and emphasising the role of law in promoting social work values and purpose.
As stated within the essay, this is part of the challenge of social work, certain laws and policies conflict with other laws, including policies of multi-professional organisations, and where ethical issues come into place allowing the social worker to draw on knowledge and life experience, empowering the service user by using the skills knowledge and values, which will help in challenging inequality, oppression and discrimination.
There is also the requirement of the GSCC framework that social workers must be able to work in accordance with statutory and legal requirements, and carry out their work with professional conduct within multi-professional organisations and to be accountable if they fail to do so.