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I'm delighted to be here at Community Care Live. 

This is but day 8 for me in the new job and although the brief is new, I was keen to take advantage of this - one of the key events in the social care calender - to drop by and really just open what I hope will be a rich and rewarding dialogue unfolding over the months and years to come. So by way of introduction I want to talk about three things and then spend 10-15 minutes at the end hearing from you about issues that will be important over the next few months: 

But, let me start with the election, because as a new minister that was my starting point. When I was writing this speech I was reminded of the words of one Lord Tweedsmuir who said that 'public life is the crown of a career'. I think the difference between a crown and a noose is about 7 inches! Now sometimes in an election, that's easy to lose sight of. I'm particularly thinking of the constituent who said to me - "Liam, why is it that politicians just stand for whatever people are prepared to fall for?" But actually the manifesto that the Government ran on - the most detailed in our party's history - and expressed in its first legislative form on Tuesday - has some big things to say about social care.

 These are important because they are commitments that take forward precisely the agenda that Stephen Ladyman set out on this platform last year.

 He saw the future as needing to deliver these things:

That was his vision for the future. That is exactly what I want adult social care to deliver.

And, like Stephen,  I want to see those services delivered by committed, skilled and enthusiastic workers who listen and respond to those they work with and who pass on those messages to commissioners and managers to effect change.

Now, you're entitled to ask, 'where is the logic in this agenda' - these are fine words, but when is this going to happen.

And so my second point is to share the analysis and logic behind this approach - the point I would like to argue is that the historic borders between the NHS and social care are going to blur considerably. And what's driving this blurring of the line are three revolutions - in demographics, in expectations, and exponential changes in technology. I'll go through these in order.

I know that many of you feel that there has been a lot of change in social care in the last few years. In my view, that is nothing compared to what is to come in the next 18 years - which will be a revolution. 

I want to take you to Britain in 2020.  By then 30% of the population will be over 60, up by 20% from now. By 2011 there are likely to be another 700,000 disabled older people, up to 5.2 million people requiring significant healthcare. 

And it's not just numbers that are rising, its also expectations. Those people in their 60s in 2020 will be the first generation to have grown up with an NHS over all of their life and they are are likely to take it for granted. Also people expect high quality public services that offer choice. An interesting figure for example is, in 2000 42% of people said that they would be likely to complain about poor services, up 15% on the 27% in only 3 years since 1997. People also have a different relationship with authority, including health and social care agencies. They are much less likely to be deferential and more likely to lobby for what they want and against things that they don't. People are much better informed with access to the internet and already there are over 200 patient groups with regular websites. This is going to be quite a challenge for those of us in public service. 

On the plus side, we are seeing a phenomenal pace of change in medical care. Genetic therapy is likely to mean that we can do much more work on predicting and preventing debilitating and life threatening conditions, improving the quality of life for literally millions of people.  By 2015 it is likely that gene therapy will be extended to the treatment of 30 life threatening conditions. Biotechnology will see us able to grow new arteries in people, bionics will reverse sight and hearing defects. They are not some sci-fi fantasy - this is our future reality. 

It is exciting in so many ways, not least the scope for self-diagnosis, self-screening, self-treatment. We will see fridges ordering food via the internet and much expanded home-based health and social care as the result of high tech solutions combined with portability of equipment. In other words we will transform our first tentative approaches with telecare and telemedicine in the next couple of decades. 

Now, in a world of change, you need a good compass. I think our compass we and you have is the values that we - you - bring to work every single day. 

The job is going to become more complex, more challenging, and yet in some ways more simple. I know that sounds like a contradiction. Let me unpack it. Many of you here will say that you feel the same about the public sector ethos of serving the community, building a caring community, as I do. You will say that you came into the work to help people. Yet I know that many people in audiences like this feel we have lost something important. I think satisfaction and pride in a job well-done is achievable but in the future it will involve working in different ways.  I believe it will offer you more job satisfaction, be better for the people needing support and ultimately help us to build a better society for all of us. 

Now people often mistake social care and social work as inter-changeable terms. Although they are part of the same big picture, they are not the same. Partly this is about the different qualifying and training routes but also partly because of its origins in the Poor Law, we developed social care more as a way of helping people, full stop. When what it really should be about, and certainly what social work's roots were more about, was about helping people to do things, achieve ambitions, take control over their lives as much as possible, build relationships and networks that help rather than harm individuals and their families. 

Now I know that is a bit of a gross generalisation. All of you will be able to give me examples of the support workers that help people with learning disabilities acquire daily living skills, the person with the mental health problem or other disability be supported into employment, the older person who relearns old skills following a stroke.  All of you will have examples like that. 

But still I see too much of the attitude that social care is delivered to someone, that it is about doing to rather than doing with. Its easier to disempower someone, reduce their coping skills than take the time to build confidence and motivation - in fact, unfortunately, easier. But that doesn't help the individual or ultimately the wider network and community the individual is part of. The social care system cannot simply keep taking more people in without "discharging" some or some parts of support, it doesn't have the capacity. But those people "discharged" need to be equipped to manage, with or without support. 

We have to invest up-front in people to give them the best chance to control their lives and reach their potential. 

And I suppose this brings me to my third point - about the sort of journey we have ahead of us. 

We have big changes to make. It is our burden to live in interesting times. 

But what we need to change are some of the attitudes, systems, some of the organisational culture and processes that get in the way of you doing your job in the ways that you would like to. I will give you an example of what I mean. Direct Payments are a huge success story - for the fortunate few that can actually get them. Yes, the numbers are growing but not at the rate that disabled and older people tell us that they should. This is a policy and legal framework that was a driven by disabled people - so it is telling that it is both popular with them but seemingly not very attractive to local councils and their staffs. 

I know that there are a number of factors at play, many of which will frustrate you as much as me. These include the lack of political will and senior leadership that exists in some quarters. In some places, the bureaucracy surrounding direct payments make the most motivated social worker or disabled individual despair and give up. There are many, many individuals who disagree with direct payments on principle. I have to say though that hiding behind the "risk" factor is sometimes a bit of a cop-out. I know that there are risks, but these have to be discussed, have to be assessed and they have to be managed rather than being used as an excuse. Some of what lies behind this is just a reluctance to give up power to the individual or a patronising view that people don't want to be bothered with the hassle or simply believing people are incapable of managing their own affairs, even with assistance.  This is a quote, one of many, from an older Somali woman who has direct payments, what she said was: " Now I have more independence...in control of my life. I can control everything although I still have no energy...but yes I can control everything". This is something that's really really important - this person may be physically "dependent" on someone else but she feels in control of her life. I think we have to stop perpetuating the myth that independence is the opposite of dependence. The truth is we are all interdependent and our reliance on machinery or people in our everyday lives is no reason to relinquish control of how we want to live. 

Some social workers see it as too time-consuming, easier and quicker to give a direct service and move on to the next person.  But the research shows that initially it can be more time-consuming but "When it works well, yes I'd say it's much less (time)" is a quote that we hear. Other social workers say "I just feel keeping people more in control gives them a better quality of life" and "there's a massive sense of satisfaction" and crucially "You need to feel enabled, if you're anxious about it you need someone to encourage you". So the organisation as a whole, councillors and managers, need to motivate and enable staff because without this they simply cannot bring those qualities to the work they do with individuals.  These are all very big hurdles. 

But when change gets difficult, we need to keep our eyes on the prize. 

I know of a young man with cerebral palsy that makes much of everyday living difficult for him, including communicating with others and getting around in his wheelchair. Nevertheless, he was determined to leave home to go to university and have his own flat. Using a combination of resources including direct payments he has achieved this, despite all the well-meant advice from professionals and family. He employs male carers about his own age that help him both in class and in having a social life with his friends. Technology has transformed his life where he can organise most of his environment by nudging buttons on a control box with his chin. 

So, when people tell me about the "demographic time bomb" we are facing - more older people, more disabled people - I tell them that people will have options and choices inconceivable today. 

So, that's a little bit about the way I think. Direct payments, individual budgets, telecare are steps on the way and important ones but we must prepare for a very different future and environment that will transform the way social care responds to people needing care and support. We have to start preparing for that now by returning as much control as possible to people using services. For some, exercise of that control might be something as simple as the clothes they wear each day, for others it will be about what staff they choose using a direct payment. 

Conclusion 

So I thought I'd finish by sharing the overall impression that's struck me in the last 8 days in conversations I've had with all the people in the sector, in the DH, and across government and local government. 

Because what strikes you is the sense of quiet excitement about the future of social care. 

Shimon Peres once said, 'just because there is a problem it doesn't mean there is a solution'. I think our world is very different. When we look at the challenges ahead we can see the solutions as well as the problems. 

There is a palpable sense not just that our sector is at a vital stage in its history but that there is a real opportunity to make some decisive moves forward. But to get those moves right I need help from all of you. I need you to contribute to the process Stephen Ladyman began last year. 

There is just over two months left before the consultation on the Green Paper closes. Its absolutely vital that you have your say, the Green Paper is about something simple and important - its your chance to shape the future. Your chance to help us build a future of which each and everyone of us is truly proud.