Eating Disorders: Medical Training
Debate between Lord Watson of Invergowrie and Baroness Manzoor(6 years, 2 months ago)
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Baroness Manzoor
Yes, my noble friend makes an interesting point. HEE is working very closely with the health profession and the General Medical Council to ensure that the curriculum set meets the needs of today’s population.
Lord Watson of Invergowrie (Lab)
My Lords, many people with an eating disorder suffer in silence without receiving a diagnosis, yet research by the Postgraduate Medical Journal found that half of the universities that responded did not include questions on eating disorders in their final undergraduate exams, and only two universities included a specific requirement to assess clinical skills in eating disorders before graduation. So there is a real need for a review to consider the extent to which eating disorders are covered in the assessment of medical students and junior doctors. It was not clear from the Minister’s reply whether she accepted the premise of the Question from the noble Baroness, Lady Parminter. Will she clarify the Government’s position on a review and further undertake to ensure that other key health professionals such as nurses, dieticians and occupational therapists also receive sufficient training to enable them to diagnose and support those with eating disorders?
Baroness Manzoor
My apologies to the noble Lord if I was not clear. In addition to medical school training at undergraduate level, there is a further two-year training at foundation level where students undertake a four-month rotation in psychiatry and a four-month rotation in general practice. Then there is further training at speciality level in psychiatry, and there are modules to do with diet, further education and eating disorders. As I have already mentioned, HEE is working very closely with the devolved Administrations to ensure that the review is completed by 2021 on what further can be done.
Social Workers
Debate between Lord Watson of Invergowrie and Baroness Manzoor
Baroness Manzoor (Con)
My Lords, I congratulate the noble Lord, Lord Kennedy of Southwark, on securing this important debate. I thank all other noble Lords for their valuable contributions today. There was a small number of speakers, but the debate has been excellent. Noble Lords have set out many challenges that social workers can face, and I will endeavour to answer as many questions as I can in the time I have.
This report, Social Workers—Working Conditions and Wellbeing, raises some pertinent questions for all of us who want to see social workers valued and recognised for the vital work they do. I agree with all noble Lords who spoke—the noble Lords, Lord Kennedy, Lord Parekh and Lord Watson and the noble Baroness, Lady Walmsley—that we need to understand and think about the vital work that social workers do and really recognise the efforts that have been made. I recognise that this is a difficult time for social work and for social care. We know that local authority budgets have faced pressures in recent years and of course the noble Lord, Lord Kennedy alluded to this. That is why we have taken steps to help to secure a strong and sustainable social care system. We have given councils access to up to £9.4 billion more dedicated funding for adult social care over three years. Moreover, we have supported councils to use the flexibility in funding for children’s social care to increase spending to around £9.2 billion for children and young people’s services in 2016-17.
This summer, the Department for Health and Social Care will publish a Green Paper on care and support for older people and a joint health and care workforce strategy. These publications will be vital in helping to achieve a long-term sustainable future for the social care system and address the challenges facing the social care workforce. I agree with everyone who spoke that we want social work to be a respected and valued profession that supports people to remain in it for the whole of their career, should they wish it. We recognise the impact that high workloads, stress and low morale have on recruitment and retention. That is why the Government continue to provide the £58 million social work bursary, which supports over 4,000 students into social work courses. We also continue to provide £20 million through the education support grant for practice placements for social work students.
The Government must do all they can, as has already been said, to empower and champion social work, but we must also acknowledge the responsibility of local authorities to ensure social workers have manageable workloads and receive quality supervision and support, which prioritises practice over process. The noble Lord, Lord Kennedy, said that 92% of social workers are leaving over time. I have to stress that the survey looked at only 12,000 social workers out of a 92,000 workforce. While this number is troubling, it is not really representative of the whole profession when new practice models and improved supervisions—
Lord Watson of Invergowrie
I thank the noble Baroness for giving way. Frankly, that statement cannot go unchallenged. Opinion polls covering the whole of the UK—some 60 million people—are held to be reasonable based on 1,000 respondents. A survey of 12,000 out of 90,000 seems to me to be a pretty high and representative sample of the profession.
Baroness Manzoor
The number is 1,200. If I said 12,000, I apologise. I am not saying that it is not troubling, but I am saying that the survey looked at only 1,200 out of a workforce of 92,000. Although it is troubling, it is not really a fully representative picture of the whole profession. However, I understand the problems: the noble Lord shakes his head, but what I am saying is that we need to look at improving working conditions and practice quality. I entirely agree with the assertion that the noble Lord has made.
The noble Baroness, Lady Walmsley, also asked about heavy caseloads leading to a lack of preventive work. She spoke of Cafcass and the very important improvements that have taken place there in relation to children’s social work. There is increasing evidence of innovative practices and approaches for supporting children and young people. I agree with her that this shows examples of very good practice. Ofsted inspections are including caseloads and supervisions in their judgments on quality of local authority children’s services, and this is to be welcomed.
The noble Baroness and the noble Lord, Lord Watson, also asked about further workloads and improving supervision and support of social workers to ensure that they had appropriate workloads. We are improving staffing capacity and the children’s social workers have increased to approximately 30,000 in statutory children’s services over the last two years. The noble Lord also asked about pay. As well as outlining the challenges facing the profession, the report suggests that there are some solutions to help improve social workers’ working conditions. I have just alluded to what we are doing in relation to pay.
The noble Lord, Lord Kennedy, asked about strategies that the Government are undertaking overall. The Government have an ambitious programme to raise the status and standing of the social work profession. I want to highlight the action we are taking in some key areas, which will help to deliver the improvements we all want to see.
In professional regulation, an area raised by all noble Lords, we are establishing a new specialist regulator for social work, as the noble Baroness, Lady Walmsley, mentioned: Social Work England. Focused purely on social work, this bespoke regulator will cover the whole profession and have public protection at the heart of all of its work—the noble Lords, Lord Watson, Lord Kennedy and Lord Parekh, said that they wanted to see greater emphasis placed on prevention. The new body will be about more than just this. We want to support professionalism and standards across the profession. As a social work-specific regulator, it will be able to develop an in-depth understanding of the profession and use this to set standards for the knowledge, skills, values and behaviours required to become and remain a registered social worker. That addresses the comments made by the noble Baroness, Lady Walmsley. Finally, it will play a key role in promoting public confidence in the profession and helping to raise the status and standards of social work.
As the noble Baroness, Lady Walmsley, said, I am sure noble Lords will join me in congratulating the noble Lord, Lord Patel of Bradford, on his role as the newly appointed chair of Social Work England as he leads work to establish the regulator in 2019.
As the noble Lords, Lord Kennedy, Lord Parekh and Lord Watson, and the noble Baroness, Lady Walmsley, said, education, training and continuous professional development is absolutely key. I have already addressed the issue regarding Cafcass that the noble Baroness, Lady Walmsley, raised, the importance of staff development and case planning and the improvements that Cafcass has undertaken. I am sure that the new regulator will look at those models very carefully.
We are making sure that those entering the social work profession receive the best training possible. We have established 15 teaching partnerships, bringing together universities and local authorities to improve the quality of social work education. We are also delivering fast-track programmes to bring high-potential graduates into the social work profession. For newly qualified social workers entering the profession, the transition from education to the realities of practice can, as we know, be daunting. That is why we have introduced an assessed supported year in employment to provide social workers with valuable additional support during their first year in practice. The programme has benefited over 20,000 child and family and adult social workers since 2012, helping to improve recruitment, retention and performance management.
For established social workers we are funding a range of assessment and development programmes to enable people to progress into more specialist or senior roles. I hope that addresses the question raised by the noble Lord, Lord Kennedy. We are also supporting social workers who have left the profession and want to return, through the Return to Social Work programme, with the aim to train up to 100 social workers across three regions.
In conclusion, local authorities, like all parts of government, have had to make difficult choices to help us balance the public finances. We also recognise that demand for social care services is rising. That is why, across adult and children’s services, we are looking at how local authorities can safely make best use of the resources available. Funding is important, as most noble Lords highlighted, but a range of factors will influence service quality and workforce capacity, including leadership, support and professional development, which the Government are addressing through our reform and improvement programmes. I add that while we have made good progress, there is more to do to create a sustainable social care system that stretches beyond any electoral cycle to provide world-class care and support for future generations.
I am checking to see if I have missed any questions. The noble Lords, Lord Kennedy and Lord Parekh, asked about the Return to Social Work Programme, which I will touch on. This has been supported by the Local Government Association, the DHSC, the DfE and the chief social workers, and it is particularly focused on areas experiencing recruitment challenges. We will look at how that goes as we move forward. I am now out of time, so if there are questions I have not answered, I will endeavour to write to noble Lords and ensure that they get answers.