The Care Review, as yet, is unbalanced with regard to procurement and commissioning in that it has only addressed one aspect of supply, independent providers, sidestepping the issue through the outsourcing of analysis to the Competitions and Markets Authority.
The CMA has to take to take a wider perspective and look at all supply and has to include local authority homes. The CMA has to take them into account as such homes’ availability plays an active part in shaping a market, and is a transfer across budgets.
There being little true commissioning of needs led services, there could be many more specialist tenders as ‘soft blocks’, the CMA has to report on the efficiency and effectiveness procurement as determined by providers, tenders and frameworks. Reporting on the demand side, of local authority activity, is ground-breaking. It has never before been analysed in the detail the CMA has opportunity to provide.
We are about to enter a whole different discussion. Where before the focus has been entirely on providers now the way the local authorities have created the market has to be factored in. Demand and supply always work together to make a market. The CMA is the first agency who will be able to spotlight the interaction and state where responsibilities lie. Henceforth responsibilities will need to be apportioned rather than projected.
A CMA report without addressing demand factors will not have utility.
A CMA report omitting local authority provision and procurement will not have utility.
The situation is complicated by new procurement rules.
The latest update on Public Procurement Reform (October 2021) includes aspirations ‘to deliver national and local Government priorities to a greater extent than has previously been possible’ by ‘enabling the award of contracts based on their full value to society not just on lowest price or from the sole perspective of the organisation letting the contract’. In creating ‘one of the most transparent procurement regimes in the world’ government will reduce ‘350+ regulations into a single, uniform framework covering all sectors with only a very limited number of necessary sector-specific exceptions’.
Cabinet Office is working closely with health on procurement aspects of the Health and Social Care Bill, concerned with adult social care.
The lobby for children’s social care is small in number and voice. It is not looking like children’s social care will be amongst the exceptions.
The reform comes with a promise of formal training. Is this another Commissioning Academy? There are planned to be ‘communities of practice where ideas and experiences can be shared, and procurement and commercial professionals can help one another to embed the new ways of working. These communities of practice will be particularly important for encouraging the behavioural and cultural change that will be so crucial to realising the benefits of the reform’.
Procurement and commissioning activity over decades has been more of the same rather than anything new.
The situation is complicated by new DfE funding for local authorities to spend on building children’s homes.
Is it coincidence that Ofsted has guidance on multibuilding children’s homes?
The same argument is deployed, ‘innovative approaches to reduce the number of children needing care over time, address current shortfalls, including in geographic areas with fewer children’s homes, and ensure sufficient provision for children with more complex needs.’ This guidance is being analysed by NCERCC in a series of linked publications. It is by no means certain that the outcomes being sought will or can be delivered by the ideas. Indeed the homes could prove an existential threat to small independent children’s homes and there be an actual reduction in number, choice and specialism.
In an article for The New Atlantic The Caregiving Economy – The Atlantic Anne Marie Slaughter and Hilary Cottam propose that we need a new economic category for caregiving, less as a ‘bundle of services and more as a web of relationships that encourage human flourishing’.
The definition of care and the practice of care giving has been addressed in NCERCC publications at the start of the Care Review.
‘Goods are things that people buy and own; services are functions that people pay for. Relationships require two people and a connection between them. We don’t really have an economic category for that, but we should’.
Slaughter and Cottam write, ‘Recognizing the true value and potential of care, socially as well as economically, depends on a different understanding of what care actually is: not a service but a relationship that depends on human connection’ This might be what the Care Review are getting at when they talk about relationships. If so, from NCERCC’s reading, the Care Review may be taking an idea out of its context.
The extent of the multi-professional working to meet high level complex needs is both intensive and skilful. It takes professional help to meet developmental and maturational needs.
The proposals of Cabinet Office, DfE, Ofsted are made to cut spending. So too the Care Review.
The question for the Care Review is: Can the mutual-aid that seems to be being proposed meet the high level needs of children? The core of mutual-aid is “solidarity not charity”: a group of community members coming together on an equal basis for the common good.