Foundations for self-directed support in Scotland
Foundations for self-directed support in Scotland

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Foundations for self-directed support in Scotland

1.4 Understanding personalisation: the client

The late 1960s saw the development of a single, unified profession of social work, as well as the development of other professions, such as occupational therapy. This was related to the post-war determination to combat the ‘five giants’ of want, disease, ignorance, squalor and idleness that had stalked the UK in the 1930s (Beveridge, 1942). The 1945 Labour government offered solutions to these problems by addressing universal needs for employment, health, education and housing.

Activity 1.4 provides an opportunity to consider how the government of the day sought to address these problems, and the changes we have seen since those post-war days.

Activity 1.4 The family and the welfare state in 1945

Timing: (15 minutes)

Watch this short film [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] about Sir William Beveridge, an academic, civil servant and Liberal MP who was a key figure in the development of the post-war welfare state.

Make brief notes in your learning log to answer the question:

To what extent do you think this 'vision' of universal services has changed since 1945?

Discussion

Some elements of Beveridge's vision are still very evident in the UK today, for example the continuing existence of the NHS and free health care services. But you will probably have identified a number of changes since that time, such as the introduction of charges for community care services and a growing private sector, especially in social care. The introduction of direct payments and self-directed support is another example of an important change in policy since 1945. Since 1999 most decisions about health and social care policy and law have been made by the Scottish Parliament, which also means that the 'vision' of health and social care may not always be the same as that in other parts of the UK.

Although the people who shared Beveridge’s vision could see the need for one united service for health care – the NHS – this was not true for social work and social care in the 1940s. Other professions, such as medicine, tended to dominate the services that social workers were part of. To challenge this, social workers sought to be professionals in their own right, with a defined knowledge base and the ‘right’ to prescribe types of intervention related to ‘social' (rather than purely medical) needs, such as family and community support and an adequacy of income. In Scotland, social work was legally established as a unified ‘generic’ profession by the passing of the Social Work (Scotland) Act 1968.

By the 1970s 'client' had become the near universal term for people who used social work services – and is still in widespread use internationally. The term 'client' brought with it certain assumptions:

Within this relationship, the ‘client’ is constructed as someone in need of help, because they lack either the necessary abilities or the capacity to help themselves and thus need the specialist knowledge and skills of the social worker.

(McLaughlin, 2009, p. 1103).
Figure 1.6 The term ‘client’ implies a relationship in which someone who needs help draws on the practitioner’s specialist skills and knowlwedge.

We now go on to consider the shift from being a ‘client’ to becoming ‘a service user’. For some people this preoccupation with names might seem a bit abstract and ‘airy-fairy’ – nothing to do with the real world. Yet what we call people is important because it helps us understand where power might lie in any given relationship, and the impact of these relationships on the experiences of people who access health, social care and other services.

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