David K Affleck
The dawn of the 21st century saw two monuments to the Victorian era still standing but with boarded up windows and an air of desolation: Prestonkirk (East Linton) and Wedderburn (Inveresk) Poorhouses, had long since ceased being used for their original purpose. They were examples of the marked change that took place in the last thirty years of the century, a change accelerated by the introduction of the National Health Service and Community Care Act of 1990 which posed the challenge of providing care to those in need where they lived, thus diminishing the need for people to have to move into residential care.
From Poor Law to the Promotion of Social Welfare
In 1945, the front-line welfare service was provided by Local Government officers acting as Inspectors of the Poor. The East Lothian officials were located in the main county council offices at Dunbar, Haddington, Tranent and Prestonpans. Some were still in post in 1970 such as Mr Lowe in his ground floor office in an adapted Council house in Prestonpans, who still had his certificate as an Inspector of the Poor displayed on the wall. They also operated as Registrars, managed the local county council office and dealt with welfare assistance, including issues of school attendance and the need for care in the two Poor Law institutions run by the county councils for Midlothian and East Lothian. They had a wealth of local knowledge but by 1948, their duties had started to decline, with central government dealing with the need for National Assistance from 1948 and the introduction of a new Children Act in that year, requiring the appointment of a Children’s Officer with a separate department for children in the care of local authorities. This dysfunctional approach with welfare services administered either from Edinburgh or through decentralised local government arrangements, was to provoke further inquiries into deficiencies in the organisational arrangements and reform of local government in later years. One of the most significant inquiries was the Report by the Kilbrandon Committee on
those juveniles alleged to have committed crimes or offences, children in need of care and protection, children who are refractory or beyond parental control and who are persistent truants. (HMSO, 1964 p9)
This Committee argued that priority needed to be given to diagnosis of the child’s position in family and society, a challenge then taken up in a government White Paper, Social Work and the Community, and its recommendation for a single department of the local authority to reduce the difficulties of co-ordination and co-operation between the separate social work services. It also changed the focus of earlier legislation with a new power ‘to promote social welfare’, although it added restrictive conditions including a limitation on assistance through the provision of cash. Income support was still to be a central government responsibility.
The new Social Work Department.
The new local government department of Social Work was launched in November 1969. Putting the recommendations into operational practice posed two major dilemmas for both East and Midlothian councils.
- The desired administrative structure was likely to need a collaborative approach between authorities as had existed since 1948 for Child Care and Probation services. A new Joint Authority was proposed, consisting of six councillors from East Lothian, twelve from Midlothian (which then included Livingston new town,) and three from Peebles.
- The proposed size of the front-line service unit was designed to serve a population of about 50000, to take account of the shortage of trained social work staff and the viable size for a management and administrative structure. In addition, there was the need to develop skill sharing between previous specialisms such as the social work contribution to Mental Health services and Child Care/Adoption services, and the need to develop new skills such as community development, advocacy and contractual work with children and families in trouble. Consequently, the initial organisational base for its community-based services in East Lothian was to be an office in Haddington, with Musselburgh being served separately from an office at Dalkeith. Expectations of a more local approach would immediately be frustrated with skill shortages, insufficient financial resources to meet the raised expectations and perhaps the worst of all worlds; a system of having to get the budget for the new Midlothian, East Lothian and Peebles Social Work Department agreed by the three parent county councils.
The new councillors were in for a surprise, partly because of a major deficiency in funding but also because the changes were a top down Government proposal and had not yet been ‘owned’ by the majority of councillors in local government. As a Progress Report to the new Social Work Committee in April 1970 explained:
Apart from helping individual persons to solve their problem, attention must clearly be given to developing community strengths where they are deprived of good facilities or where they face special problems. The difficulties which some families face are often a symptom of an unsatisfactory environment and it would clearly be more effective to make improvements in the environment rather than to help people live with unnecessary difficulties. (Department of Social Work, 1970 p1)
The first years of the new department were tough. The Chronic Sick and Disabled Persons (Scotland) Act of 1970 raised expectations: people with a disability wanted to live at home with aids to daily living and adaptations to their property. Finances, however, were so limited that any expenditure for fittings in houses such as a ramp had to be rationed with individual approval by a sub-committee of the social work committee for the three Counties. Short-term foster parents were few, care plans for children in care were not formalised, trained residential child care staff were scarcer than gold and there were no registered child minders in the East Lothian county council area.
The only local authority day nursery was at Olivebank in Musselburgh, almost on the Edinburgh boundary. Infants and babies placed into the care of the former Children’s Department had become ‘warehoused’ in residential children’s homes (despite research (1950s) that showed long term damage to the development of children who had spent their early years in institutional care.) Work had to be done urgently to place them in permanent families. This was a complex process with some emotional distress because of the limitations in the adoption law of the time and because some children had been placed in foster care with inadequate preparatory work with their natural parents.
Furthermore, residential care for older people was mainly provided by East Lothian council at the former Poorhouses of Wedderburn and Prestonkirk, except that a new home, Cheylesmore Lodge, had been purchased in the late 1960s at North Berwick. But elements of the deserving poor continued, as one Town Councillor representative (ex Provost R Henderson, Prestonpans) remembered in 1976 ‘No artisan ever went to Cheylesmore Lodge’. Even worse was the failure before 1969 of the East Lothian County Council to plan appropriate care for older people. Their new ‘purpose-built’, residential care home, Faside Lodge in Tranent, had long corridors for residents to manage, and toilet facilities with limited space and no room for a wheel chair. Waverley House at Gullane, bought from the Miners’ Welfare Organisation (who had used the building as a holiday home), had refurbishment authorised in 1969 (in the final days of the county council before the new arrangements were introduced) but its planned opening in 1971 had to be cancelled because there were no downstairs bedrooms or lift and inadequate toilet facilities. Prestonkirk still had male dormitory accommodation with no curtains and bare floorboards, while the female dormitory had net curtains over the lower pane. Even the flagship home at Cheylesmore had no working clock in its communal rooms in November 1970; they were all broken and therefore useless to help the residents know the time, (but the grandfather and mantle-piece clocks fitted the decor).
A further indicator of the level of welfare services arose when, in the mid 1960s, a group of parents and supporters (such as the late Councillor Willie Hands of Haddington), had approached East Lothian county council to establish a day centre for adults with a learning disability in accordance with the 1960 Mental Health Act. They were told the need for this was not proven, and it was suggested that they run a voluntary training centre for a year and the position would be reconsidered. The volunteers eventually ran the service from the Knox Institute, a former school building in Haddington with a roof that leaked when it rained, and with one transit bus to provide transport to and from the centre for the whole of the East Lothian area. No wonder they welcomed the new approach to the provision of social welfare but a purpose-built centre would not be provided until 1976, when responsibility had transferred to the new Lothian Regional Council Social Work Service. (By 1986, the social work service was in touch with 315 adults with learning disability and having an East Lothian connection, of whom 185 were assessed as having a moderate or severe handicap.)
Were the service standards so disgraceful? It is perhaps helpful to reflect on the following two aspects. Firstly, considerable informal care continued to be provided within family networks and secondly, in the immediate post war years and in the late 1970s, the economic position of the country was difficult. In addition, financial resources from 1948 to 1980 were still tied up providing the traditional care in residential institutions run by councils or by voluntary organisations and in long-stay hospitals. Buildings would have to close before finance could be redirected and transitional financial costs would have to be provided. But the zest for new legislation was strong as the following recommendations indicated:
children with a learning disability should no longer be declared ineducable; children with special educational needs should have their needs assessed.
appropriate care should be provided for individuals in such away as to enable them to lead as normal an existence as possible given their particular disabilities and the minimal disruption of life within their community. (HMSO, 1985 p x)
But there were other critical factors behind the words. There was a continuing ambivalence about ‘social work’, perhaps best seen in the appointment by Margaret Thatcher in 1980 of an independent and authoritative enquiryinto the role and tasks of social workers. Interestingly, the inquiry report concluded that improvements in the neighbourhood approach were the way ahead. But they also supported the historical approach of dealing with an individual’s needs by fitting people into boxes such as ‘physically handicapped’ or ‘the elderly’. They adopted the term ‘community of interest’ to cover the relationships and networks a person may have outwith a geographical area, a concept attractive to the more specific and specialist ‘voluntary’ organisations such as Age Concern or the Multiple Sclerosis Society. The management challenge was to address the need for the specialist service that a specific disability or problem might need and, at the same time, manage the multi-problem when it also arose. This challenge remained complex where conflicting care responsibilities arose (such as between a drug-dependent parent and children from the family at risk of abuse).
The use and meaning of the word ‘community’, and the consistent evidence of policies of exclusion which permeated much of our social structure was another dilemma, helpfully illustrated in a cartoon where a woman is asking a policeman if she can be directed to the community that is to offer her care. It was impossible to work as a social worker in Prestonpans before 1975 without being aware of the differences between the burgh and the county areas perhaps only a street away. The three county councillors for the landward area each exercised powers of housing allocation. Council tenants living in the burgh had a different system of housing management. The historical boundary line for the burgh could therefore be significant in defining aspects of community life such as meeting a need for housing. In Dunbar, a house adjacent to the old Kirk graveyard was used by the town council for the accommodation of ‘problem families’. The tenants had no hope of being rehoused, despite the poor housing standards of the property at that time. Haddington town council, recognised for their attempts to befriend families rehoused from Glasgow through the overspill arrangements in the mid 1960s, hit the headlines of the local and national press in 1971 with an inflexible approach to families in rent arrears and a firm policy of eviction. It was not until 1977 that a more enlightened management approach to rent arrears was adopted by the new East Lothian Council Housing Authority. Legislation for housing ‘homeless persons’ was not introduced until April 1978 and even then, assessing a family as homeless did not mean that the housing problem was solved, especially if the assessment was that the family had become homeless intentionally. A comprehensive local authority housing service could have avoided the need for social work involvement; the fact this was variable led to inappropriate use of social work time and the scarce resources of the new service.
Boundaries; geographical, professional and organisational
Territorial tensions remain inherent in our territorial society and the evidence of them in the operation of local government is readily apparent in the archives. The new Social Work Committee of 1969 set out with the aim of having devolved sub-committees with a geographical remit; initially planned as an essential aspect to a reshaped service with the task of promoting social welfare in the community. These area sub-committees had no devolved authority and within two years they were scrapped after an organisational review. They were seen to be influenced by the local staff in identifying local service needs and were remote from the centralised control of treasurer and council clerk. There were also other boundary issues to the one of geography. In the words of a councillor of the time ‘why should the ratepayer meet the cost of saving the Health Service money by caring for people outwith a hospital?’ The challenge of the new social work department after 1969 was to help its users of services get a cohesive and co-coordinated response. The skill in cross-professional work and co-operation between organisations became a requirement to all the caring services in the field of healthcare, education, housing and welfare and led to a series of health planning reports, which were rarely given the political or financial will at government level.
It was this dynamic that the parents of Pinkie Braes in Musselburgh encountered in wanting to set up a ‘First Step’ parent/child centre in the fight to regenerate their local community. A 1987 survey of their area showed that of the 813 public-sector housing tenancies, 50% were in receipt of housing benefit and there were 129 children in the area under the age of three with no child care provision for them. But traditional education services did not have a statutory requirement to fulfil for the under-threes and the concept of the Warnock Report ‘that in the earliest years, parents rather than teachers should be regarded as the main educators of their children’ was not always shared by senior education officials of the time. Even getting political ownership for such a concept was no guarantee that professional support would follow especially if it meant professionals working under parental management.
And then there was the vexed issue of funding. Resource management was (and continued to be) a major feature in determining availability of services. Indices of rural need were rarely recognised, the main trade union favoured centralisation of welfare advice services in Edinburgh by Lothian Region as opposed to extension of local Citizens Advice Bureaux services, and the political bias towards the west of East Lothian in financial help for the running of day centres for older people remained a feature in the new unitary authority formed in 1996.
But against all this background, the era of providing social welfare in East Lothian delivered on a number of significant areas. Every convenor of the Social Work committee of the Regional council between 1975 and 1995 brought their own special interest to improving services in East Lothian. Also, in an attempt to rectify the problems of different tiers of local government providing social welfare services and housing provision, a joint committee structure had been proposed within Scotland and was adopted and sustained in East Lothian in that period. This little known Joint Links committee, despite having no budget of its own, provided a structure for political and executive collaboration with health service representation. Through its deliberations, major expansion in housing for older people was planned, services providing accommodation and support for those with a learning disability were redesigned and put in place and the community care alarm support service provided a partnership approach to care across a rural area. It was a model of collaboration that worked within the era of resource development when councils were the main service providers, helped by the enormous amount of public goodwill and the army of voluntary care within family and friendship networks.
Reference was made earlier to the significance of the Kilbrandon Report in relation to services to children. Its adoption reinforced a systematic approach of considering prevention, early assessment and measures to divert from formal care. The application of most of these aims was at the heart of the Scottish Children’s Hearing System following its introduction in 1970. An updated version of their approach to address the issue of crime management would require the following strategies:
- service intervention as close to the point of the problem and as near to the time of the incident
- early involvement and participation of the victim in the process
- measures to resolve the conflict, including where possible mediation, reparation and acceptance of the need for change
- opportunities for community management and accountability
In November 2000, a fuller review of the application of these strategies was published by the Scottish Consortium on Crime and Criminal Justice. The principles were wider in application than crime; they were equally applicable to the provision of social care in a partnership approach with those who need a service and those who have a role to play in the provision of care including family and informal support.
From Social Welfare to Social Justice
By 2000, we had come a long way from the standard of state-provided welfare care of 1945 with its emphasis on institutional care. Expectations of basic rights to be assisted were much more evident, legislation had been extensively introduced, but examples of good practice in transparent management and provision of equitable services had perhaps become fewer as issues over responsibilities and the finance to do the job emerged in the new world of the Scottish Assembly and the territory of local government. It was clearly a problem period and yet, as the boarded up former institutions show, a revolutionary change had been achieved. The real significance of this revolution should have been a change in the quality of life for those with care needs. Within Scotland, East Lothian compared well with its social work initiatives in the era of major change and expansion; by 1996, the political agenda was putting more emphasis on delivering social justice rather than welfare. The milestones then are there for history to evaluate; the greater challenge is in the future, with predictions that the resources devoted to community care will need to be nearly doubled as a result of the projected demographic change.
Further reading & references
- Commission on Social Justice (1994) Social Justice Strategies for National Renewal, Vintage London
- Department of Social Work (1970-1975) Minutes of the Social Work Committee of Midlothian, East Lothian and Peebles
- East Lothian Council (various) Annual Housing Plans
- HMSO (1964) Parliamentary Paper: Children and Young Persons Scotland (The Kilbrandon Report) Cmnd. 2306
- HMSO (1966) Parliamentary Paper: Social Work and the Community Cmnd. 3065
- HMSO (1975) Housing and Social Work – a joint approach (Report of the Morris Committee)
- HMSO (1978) Parliamentary Paper: Report of the Committee of Enquiry into the Education of Handicapped Children and Young People Cmnd. 7212
- HMSO (1985) Parliamentary Paper: Second Report of the Social Services Committee on Community Care Session 1984-85
- Lothian Regional Council (1975-1995) Minutes of the Social Work Committee
- National Institute for Social Work, (1982) Social Workers Their Role and Tasks (The Barclay Report) London.
- Rowe, Jane & Lambert, Lydia (1973) Children Who Wait, A.B.B.A.
- The Scottish Consortium on Crime and Criminal Justice (2000) Rethinking Criminal Justice in Scotland, Edinburgh
- Children Act 1948
- Mental Health (Scotland) Act 1960
- Social Work (Scotland) Act 1968
- Chronic Sick and Disabled Persons Act 1970
- Chronic Sick and Disabled Persons (Scotland) Act 1972
- National Health and Community Care Act 1990