Respect, Human Rights and Social Work: Some Thoughts on the Coronavirus Bill 2019–21.
As I write, the UK House of Commons is having the second reading of the Coronavirus Bill 2019–21: you can track the further progress of the Bill here. I’m listening to it as I type.
The Bill proposes a series of measures relevant to social workers in England, and to those who depend on their support. Alongside powers for emergency registration of social workers and temporary changes to mental health and mental capacity laws, there are proposals to suspend some duties local authorities (Councils) have to assess and meet people’s needs for adult social care. Instead, these duties would be replaced by discretionary powers. Importantly from my perspective (I am a community activist, social worker and academic, not a lawyer) sections 18 and 20 of the Care Act 2014 would be affected, meaning that people already assessed as having needs could see their care packages reduced. This is clearly not the intention of the Bill, which is aimed at ensuring Councils can make the best use of limited resources as infection rates increase. As Professor Luke Clements notes, the government’s impact assessment states that such powers are intended for the shortest period possible at the peak of the outbreak. Nevertheless, as any student of social policy will know, history is littered with the unintended consequences of well-intentioned legislation. Over the past ten years we have seen significant reductions in the numbers of people who are deemed eligible for adult social care and in the levels of support those people receive. Many disabled people’s organisations are legitimately concerned that they will be left without proper support, and de-prioritised when it comes to gaining access to scarce health and social care resources.
One inevitable consequence of the proposed changes would be that statutory guidance (particularly the Care and Support Statutory Guidance) would no longer be authoritative. There is scope to issue revised guidance, but little time. Perhaps with this in mind, the Department of Health and Social Care has recently produced a note on the ethical framework for adult social care, which is intended to “…ensure that ample consideration is given to a series of ethical values and principles when organising and delivering social care for adults.” It seems likely that people working in adult social care are going to have to rely less on written instructions and more on their own understanding of ethics and rights. The framework is structured as a series of eight principles and values, each summarised as a short sentence underpinned by a series of bullet points. Although they are not ranked, the first principle mentioned is Respect.
“This principle is defined as recognising that every person and their human rights, personal choices, safety and dignity matters.”
The framework makes it clear that respect includes striving to “…support people to get what they are entitled to, subject to available resources, ensuring that there is a fair judgement and clear justification for any decisions made on prioritisation.” The need to recognise human rights is directly relevant here, because Convention rights will set the lower limit for what local authorities can provide. Social workers and others trying to advocate on behalf of those asking for support are likely to need some familiarity with the Human Rights Act 1998, which puts the European Convention on Human Rights into English law. Under Section 6, “It is unlawful for a public authority to act in a way which is incompatible with a Convention right”. Perhaps the most relevant rights are contained in Article 2 (the right to life) Article 3 (which prevents inhuman or degrading treatment) and Article 8 (the right to private and family life). For many years, charities working with asylum seekers and refugees have had to resort to human rights to secure basic services for people denied recourse to public funds. As a result there is some case law, but hardly enough to offer a viable alternative to the current system. This guide was produced by the British Association of Social Workers (BASW)last year. It obviously wasn’t intended to cater for the current situation, but it does illustrate the limitations using human rights as the basis for social care assessments.
The eighth and final statement in the ethical framework relates to community, defined here as the “…commitment to get through the outbreak together by supporting one another and strengthening our communities to the best of our ability.” I have personally been encouraged by the growth towards a common vision for social care, exemplified by the joint position statement on social work and disabled adults by BASW and disabled people’s organisation Shaping Our Lives, and the more recent work of Social Care Future. More recently many small local community organisations have shown considerable leadership in mitigating the effects of Coronavirus. If we really are going to get through this together, it will be really important not to leave anyone behind from the beginning. This is a shared responsibility for politicians, those of us working in adult social care, and the community as a whole.