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July 29, 2009

The Social Work Taskforce: Why Not Just Pay Them More?

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The British government's Social Work Task Force was set up to review "frontline" social work practice and to recommend improvements and reforms of the social work profession. Its interim report, out today, is entitled Facing Up to the Task.

Everyone can see that social work in our country is in a mess. If social workers fall down on the job they are treated like murderers; if they try to do it properly they get treated like the Gestapo. If they spend all their time on the "front line" they have no time left to talk to each other and to other agencies; if they talk to each other the way the government requires, they spend all their time doing paperwork and have no time for their clients. In the words of the report (page 12):

Widespread staffing shortages mean that social work is struggling to hold its own as a durable, attractive public sector profession, compromising its ability to deliver consistent quality on the frontline. There is no robust, standing system for collecting information on local and national levels of vacancies, turnover and sickness, and for forecasting future supply and demand. Local authorities are finding it hard to identify effective methods for managing the workloads of frontline staff. Staff shortages and financial pressures are making these challenges harder still.

In other words, a big problem facing social work managers today is that demand exceeds supply. That sounded to me like an economic problem. As an economist, without a background in social work, I thought about the Economics 101 solution: if demand exceeds supply the price should rise. Maybe social work would become more manageable if we paid our social workers more?

Sounds simple -- maybe too simple. How would it work? Well, in several mutually reinforcing ways:

  • With higher salaries, more people with better qualifications would be attracted into training for the profession. (In today's Guardian, David Brindle quotes Sue Berelowitz, deputy children's commissioner for England, as saying some universities accept students on social work courses with E grades at A-level; some courses have pass rates for essays and exams of just 30%.)
  • There would be fewer unfilled vacancies.
  • A larger number of better qualified and more competent social workers would share out the work, so workloads would become more manageable.
  • Properly managed, with higher salaries and lower workloads, even existing social workers ought to become more effective.

Given higher salaries, it is true, social service departments would probably have to reduce their social work staff complements. But this would be a price worth paying. With fewer posts unfilled, the number of social workers actually in post ought to increase. Departments would be spared the expense of frequent resort to expensive agency workers and consultants to make up for staffing shortfalls. And at least some social work catastrophes would be avoided, sparing everyone those other sorts of costs that then arise: deaths and injuries, investigations and trials, commissions of inquiry, imprisonments and sackings.

Given higher salaries, why would the existing social workers perform better? There are two reasons. First, the existing workers would have more, better people around them with whom to share the work. The other reason is that, the higher your salary, the greater is the cost of losing your job. Assume that bad social workers eventually lose their jobs. If so, then a higher salary would increase the cost of being a bad social worker, and so make existing social workers work harder to avoid being seen as bad. Of course, this depends on good performance management being in place so that bad social workers are actually let go.

All this is first-year economics. I wondered what the Social Work Task Force would make of the first-year answer. I note that the report emphasised the need to achieve "a much more sophisticated understanding of supply and demand." I looked for what this might involve. I found two things (both on page 18):

First, numbers of workers supplied and demanded:

A better future for social work depends on an appropriate supply of suitably qualified applicants into stable teams with the right mix of experience. The supply, recruitment and retention of social workers is therefore a central issue for reform. As a prerequisite for improvement, there need to be robust and durable arrangements for understanding and forecasting supply and demand across training and the job market.

I think what this means is that, in the view of the task force, one of the main instruments for bringing supply and demand into balance in the long term is forecasting demand and then increasing training places to match. The reference to retention, however, suggests an important role for pay, the factor that an economist would see as bringing supply and demand into balance. This brings us to the second thing I found (which actually came before the first one):

Social worker pay has also been raised in a number of different ways with the Task Force.

  • Levels of pay are felt by some to be too low and not reflective of the importance of what social workers do and the pressures they currently work under. However, others have argued that levels of pay in themselves are not necessarily a decisive issue but assume importance because of wider problems with status, recognition and investment in training, support and the working environment.

  • Pay differences within local authority teams between permanent staff and agency staff who may not be handling the same complexity of cases) are a source of some frustration and disillusionment.

  • Shifts and variations in pay between local authorities are causing some dissatisfaction and may be contributing to movement and turnover in the workforce, with authorities competing to attract staff and address shortfalls through localised improvements in pay and conditions. This has led some to suggest that the profession needs a single national framework for pay and other conditions of employment in the statutory sector

Now, I understand very well that pay is not everything. If it were, I wouldn't be an academic. People come to many jobs, especially those involving education, health, and social care, because they are drawn to the work itself rather than the pay packet. In fact, people who care only about money would make bad academics and probably bad social workers too. Because of this, not offering very high pay can be a way of screening out people that care only about money (at this point we've moved from first-year economics to the second year).

However, it does not look to me as if the main problem in British social work today is that the profession is being invaded by money grubbers. On the contrary, there is an equal risk from offering relatively low pay: it can be felt as society's way of saying that the job is unimportant and a professional motivation is rubbish.

Because of this, for the sake of their motivation, it is important to pay people in proportion to their responsibilities -- and frontline social work is a very responsible job. If social workers are to match up to their responsibilities, commitment alone is not enough. The profession also needs to attract people that, in addition to being committed, are organized, fair-minded, team-oriented, competent, knowledgeable, and decisive, qualities that are valued highly -- and often highly rewarded -- in business. All this suggests that raising salaries could be part of the solution.

Raising salaries would seem to be a much more promising line of advance for the profession than the failed route of responding to crisis through frequent and costly reorganizations, reforms, and commissions of inquiry and task forces.

To give an example, every time there is a disaster, we are told that social workers failed to talk to each other and to other agencies. But competent, organized, knowledgeable, motivated social workers who are not crushed by overwork will talk to each other and to doctors and teachers without being told to do so. It is necessary to try to force social workers to do these things and to create artificial channels for them to do so, only because social workers are underpaid, underskilled, and overloaded.

To return to the report, if local authorities are being forced to raise salaries in order to compete for scarce social workers, isn't that a good thing? To judge from the tone of the task force report, "authorities competing to attract staff and address shortfalls through localised improvements" is being presented as a negative; "a single national framework for pay and other conditions" is put forward as the alternative to employer competition. When employer competition is pushing up pay, it looks like there are those that would prefer to hold it down.

A final thought on good and bad uses of money. One of the task force's headline recommendations is "The creation of a national college for social work" (page 40):

We are therefore exploring the case for a new organisation to support social work, which can play a role similar to that of the Royal Colleges that support the medical and allied professions. This might take the form of a national college for social work in England. ... In particular, the Task Force is interested in the potential for the national college to have a key role in driving learning and best practice in social work and provide a strong voice which speaks to the media about the profession. We are also considering the roles it might play bringing coherence to the professional and occupational standards which underpin different aspects of social work training and practice, and in relation to regulation of professional practice, training and education.

This Royal College of Social Work (say) would be in addition to the bodies that already exist: the General Social Care Council (GSCC), the relevant sector skills councils, the Social Care Institute for Excellence (SCIE), and the British Association of Social Workers (BASW).)

How much would this cost? In 2007/08 the Royal College of Nursing had 400,000 members and an annual budget of around £80 million, so around £200 per head of the profession it serves. In the same year the GSCC spent about £42m and the SCIE another £8m, so £50m for these two bodies to cover around 100,000 registered social workers and social work students. In other words, social workers were already paying around £500 per head for their own statutory regulation. (I'm not sure why it already costs so much more to regulate and support social workers than nurses.)

My question: wouldn't we all be better off if, instead of creating yet another expensive statutory professional body, we abolished them all and used the money saved to pay social workers more? Maybe there's a lesson in Economics 101 after all.

November 16, 2008

Child Protection: They're missing something, but what is it?

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The Guardian’s front page, Saturday Nov. 15, reported “Eight in 10 seriously harmed children ‘missed’ by agencies. Government research reveals scale of gaps in child protection.” The reporter, Robert Booth, noted that our child protection register lists 29,200 children “known to be suffering harm”. But, of the “189 children whose death or serious injury prompted a local authority serious case review between 2005 and 2007,” no less than 156 were not on the register, according to an analysis of the most serious cases that ministers will receive in the New Year. Conclusion: “The research has raised concerns that, across the country, procedures that should result in children at risk being protected by the government’s flagship anti-child abuse system are not being followed, leading to deaths that could be avoided.”

Sounds bad for social workers, doesn’t it? And yes, it’s a possible conclusion. But it is not the only evaluation we could make. I’ll show that a completely different conclusion is also possible. The point is that, in order to evaluate social work intervention we have to look at what they did do, as well as what they didn’t do. And evaluating what they did do turns out to be surprisingly difficult, because it involves asking the question: “What would have happened in the absence of any social work intervention?”

The report states that, over the three years from 2005 to 2007, 33 of the 29,200 children registered as “known to be suffering harm” were killed or seriously injured—a rate of approximately 1 per 1,000. What would have happened to these children if social workers had not registered them and watched their welfare? There’s a clue: it lies in the 156 children killed or injured that were not registered. It is not completely clear what this means, however, in so far as we don’t appear to know the size of the total pool of children suffering harm that were never spotted in advance and so never registered.

Here are two possibilities.

  • First, suppose the number at risk but unregistered was quite small, say, one tenth of those registered. In that case, the rate of death or injury among the unregistered children suffering harm must have been very high—156 divided by 2,920, or 54 per thousand. Apply this rate to all the children hypothetically suffering harm then, the 29,200 registered plus the 2,920 unregistered. That suggests, conditional on no social work intervention, more than 1,700 casualties. But in actual fact, there were “only” 189. On this scenario, by registering nearly all children at risk, our social workers reduced casualties by an order of magnitude; they deserve congratulations, not brickbats, for the successful protection of thousands of children.
  • Alternatively, suppose the number at risk but unregistered was much larger, say, as many as the total number registered. In that case the rate of death or injury among the unregistered children at risk was much lower—156 divided by 29,200, or 5.4 per thousand. This time, applying 5.4 per thousand to all the 29,200×2 children hypothetically suffering harm, it appears that, without any social work intervention, there would have been some 315 casualties. In this scenario social work intervention would appear to be less effective. Social workers missed half the children at risk, and their efforts did not even halve the casualties. In their defence, however, a further point would then need to be made. This is that, with nearly 60,000 children suffering harm, and half of them undetected and entirely lacking the protection they need, abuse must be far more widespread in our country than has been assumed in resourcing our hard pressed family services. While there is less in this scenario for which social workers should be praised, the main lesson would be that society is in much worse shape than we thought, and criticism for not recognising this should be reserved for ministers and policy advisers.

Two possibilities; which is it? I’ve never worked in or on child protection (I’m just a parent). Like you, I rely on the experts to tell me. But if the experts don’t ask, we’ll stay in ignorance.

I am a professor in the Department of Economics at the University of Warwick. I am also a research associate of Warwick’s Centre on Competitive Advantage in the Global Economy, and of the Centre for Russian, European, and Eurasian Studies at the University of Birmingham. My research is on Russian and international economic history; I am interested in economic aspects of bureaucracy, dictatorship, defence, and warfare. My most recent book is One Day We Will Live Without Fear: Everyday Lives Under the Soviet Police State (Hoover Institution Press, 2016).

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