Just over a year ago in this journal I shared my hope that the Competition and Markets Authority (CMA)’s examination of the marketplace for children’s care provision would call out the systemic problems with treating care as a market at all, and that it might metaphorically ‘throw our ball back over the garden wall’ to sector leaders and politicians (and the Care Review running in parallel at the time), telling us to find a better, non-competitive way to meet their duties to protect and care for children.
Now that we’ve seen both the CMA’s final report, and the Care Review’s recommendations, I do think that both have unequivocally admitted that the care market is failing in a myriad of profoundly problematic ways, most importantly, failing thousands of children. The CMA went as far as it could within its statutory remit as a market regulator, to underline that banning profit or moving away from markets altogether is a perfectly legitimate political decision elected governments (but not the CMA itself) are free to make and to implement, just as the governments of Wales and Scotland have decided to try to do. That comes pretty close, in my book, to ‘throwing the ball back over the wall’ to the Care Review and the Department for Education (DfE), to take full responsibility for deciding and designing what to do with the deep-rooted failures of the English care market.
The Care Review’s proposed solution is the creation of Regional Care Cooperatives (RCCs), clustering LAs together as the ‘owners’ of new regional commissioning bodies, while those LAs’ commissioning duties and budgets for all foster and residential care would be ‘removed’ from them and handed over to their RCC. LAs would then be ‘charged back’ by the RCC for each and every care placement their children need. The theory of this proposal is that the combined purchasing power of councils will be greater than each of them separately in trying to push back against the largest private care companies and their ‘excessive’ profit-making from taxpayer funds.
It's hard to find any published submissions to the Review that suggest anything resembling RCCs, and frankly I’ve really struggled to see they could offer any solution at all. At best, it simply reorganises public procurement by adding a new layer of procurement decision-making and a wealth of new bureaucracy, making the RCC a fee-charging supplier of care to each council, as well as hoping it could strike tougher financial deals with the care companies they would still be relying on. This idea places even more faith in market forces (and ‘customer power’) to deliver a solution to a public service disaster created by relying on market forces in the first place.
Collaboration is exactly the right ‘antidote’ to competition. But a ‘cooperative’ in which the partners have been forced to join together whether they want to or not, by having yet more finances and responsibility taken away from them, is not really cooperation, or collaboration, worthy of the name. As the long, difficult, and still often problematic experience of establishing Regional Adoption Agencies (RAAS) has shown, you can force a cluster of councils to sit round a table together, but you can’t make them collaborate if they didn’t already want to. We’re seven years down the road with RAAs, and only now really seeing some (certainly not all) RAAs living up to their stated intention of pooling their resources, effort and creativity.
We haven’t got another seven years to save children and children’s social care from the destructive marketplace of today, even if RCCs could do it, and even if the DfE agrees to that recommendation. The CMA may have kicked the ball back over to children’s policy-makers, but I’m afraid RCCs are an idea that kicks it straight back over to the market garden again - in the hope of finding that elusive ‘level playing field’, but instead kicking it firmly into the long grass.
Kathy Evans is CEO at Children England
@Kathy_CEO_CE