Website of the Department of Health

I was given a long briefing note this morning telling me to extol Skills for Care's partnership with the Department of Health, to extol Michael Leadbetter's stewardship of the Practice Learning Task Force and to extol Donald's chairmanship of Skills for Care since he took over last October.

But really this national two-day conference says it all.

Donald, I think it is clear to everyone attending that this organisation is flourishing and its message on standards is spreading far and wide - even to the back of this room.

The last thing you need is my speechwriter's dull hand to deaden that achievement.

So let me launch into what I came here to say. 

I want to professionalize social care.

Not just social workers. But everyone.

So I've made a decision.

John Hutton, one of my predecessors put in place the General Social Care Council and I'm going to use it.

I think we need to be honest with each other as friends need to be. Our social care workforce care for the people we either haven't got the time, or the skills, or yes sometimes the love and affection to care for ourselves.

I think that dedication is reason enough to justify a move towards professional registration.

The people who do this work are the kind-hearted, long-suffering, forgotten workers in English society. People very often who have not just a vocation but the values that we cherish most in British life.

But what they are not, yet, is a world class workforce equipped for the challenges that we posed in our ambition for the future - set out in our white paper "Our health, our care, our say" last week. An ambition to give every citizen and every community a new share in the opportunity society we have worked so hard to create.

World class is what they need to be.

And undoubtedly, world class is what they want to be.

This country should be the centre for best practice in social care. In my first major speech I said I wanted to see a workforce that was both professional and proud. And I meant it. I believe professional registration in the years to come will be a major driving force towards that goal.

Why? Because a quiet cultural revolution needs to take place in this country, driven by the ambitions of social care workers but sparked by the decision to recognise them as professionals.

Two years ago, The Health Select Committee recommended registration of domiciliary and other social care workers as a matter of the "utmost urgency" after chronicling the extent of elder abuse in the UK.

Help the aged says that the media report 35 stories on elder abuse each month and we have all heard stories of unacceptable standards of care, including some terrible instances where even basic nutritional needs have not been met.

Whatever the ins and outs of these cases and reports, one thing is clear.

That one bad case is one case too many.

We are still in places failing to protect the dignity of some of the most vulnerable people in our society. To me that says something simple, it says that the system is still not sophisticated or flexible enough to deal with these fundamental issues.

Now the White Paper published last week, poses a major new direction for care: a shift into prevention; stronger teams across local government and the NHS and a strategic shift that locates more services in local communities and closer to peoples' homes and sometimes in their own homes.

The vision in the White Paper is to make the health and social care services as flexible as possible to individual needs. Our 13 pilot schemes for Individual Budgets will blaze the trail.

But we can't ask the most vulnerable in our society to make choices unless they can trust the people giving advice on services and providing the care.

Registration will provide clarity - and perhaps the most valuable gift of all - peace of mind.

It will enable pensioners, parents and children to have confidence in the people who care for them or their loved ones, opening the door to the future we set out last week.

But registration is about more than just this; its about public safety as well.

Registration will allow us to set standards for people seeking social care jobs and it will allow us to take sanctions against people if they fall below those standards of registration.

Now, don't underestimate what a massive undertaking this is or what impact it is going to have on the workforce.

So today we start with a consultation simply about how to do it and what the aims of registration should be. Actually registering the workforce is still a little bit down the line.

But, it is going to happen and as employers and trainers I want you to embrace the spirit of this change as well as the practical implications for you and your staff.

So there can't be any more of social care as the Cinderella service. The social care workforce is going to the ball.

We want the people who take care of England to have the same status in society as doctors and nurses and lawyers.

They will be professional people, with professional standards and the corresponding duties and responsibilities that go with being a professional.

To me this simply represents one of the best chances this government has of driving up standards of training and qualifications in social care.

This does not mean every care worker will need a degree. But it may mean they have to show they've been on CPR courses or have learnt how to lift and carry people properly.

Practical, professional skills for practical professional carers.

The social care workforce in this country is bigger than the NHS workforce - 1.2m people working for 30,000 different companies, councils and charities.

Eighty per cent of the £17bn that we spend a year on social care goes on staff.

Social care is almost entirely made up of one-to-one relationships.

Carers look after 1.7m people but barely a quarter - one in four - have any form of professional training.

Registration is going to change this.

And I believe it will do more - like giving new strength to recruitment and retention.

At the moment there's too little certainty that the same person will knock on your elderly mother's door from one week to the next.

The turn over of staff in social care is enormous. At any given time there is normally at least a 10 per cent vacancy rate.

Now there's a national outcry when the vacancy rate in teaching goes up. But not a murmur when it happens in social care.

Now we are going to change that.

And we know that social care workers take the most sick leave of all workers in the public sector.

We need to address this. This really affects people. We know that because when people are given a choice one of the first things they do is pay for consistency.

Joseph Tomlinson is a 17-year-old lad with severe learning disabilities who I met the other day.

He has the same aspirations as any other 17 year-old but, before he was put on a pilot scheme called In Control in Wigan, he faced barriers in achieving them. He got the social care he was given, not what he wanted.

He was faced by a round-a-bout of different carers provided by Wigan borough council. So many carers that he never knew who was coming or when. He found this lack of continuity difficult.

In Control has given Joseph back the control, certainty and companionship. The first thing he did when he was put on this pilot called "In Control" was choose his carers.

They now come at regular times and it has meant that Joseph can go to his local college, go to the gym, and quite simply enjoy the quite miracle of an ordinary life.

So my drive for higher standards in the social care workforce is not stopping with professional registration.

Last July, I and Beverley Hughes at the Department for Education and Skills, set up the Options for Excellence taskforce.

It has representatives on it from every strata of social care and in the Spring it will give me an interim report describing the current state of social care in England and how it can be improved through better training, standards and regulation.

I have also asked the board of Options for Excellence to draw up a blueprint of how social care will be provided in 15 years' time.

Their job will be to try to imagine what people who use services will be asking for once we have embedded this idea that the individual user should decide what care they need not the state.

Now we already envisage greater demand for personal assistants, experts to help older people "navigate" their way around buying services and far greater use of technology that allows people to live independently at home for longer.

And once we've started building a world class social care workforce which is well paid, well trained, well qualified and better motivated to provide the best quality service... there is still more we can do- still more we can do to put this culture of care centre stage.

We've already set national minimum standards for care homes, given the Commission for Social Care Inspection statutory powers to uncover abuse and we've introduced the protection of vulnerable adults scheme that has so far banned 1,500 people from working in social care settings.  But we want to go further.

Now we want CSCI to have new freedoms to focus like a laser on the operators that concern the most and soon we will present the Bichard Bill to Parliament.

But there is still more we can do.

By championing the concept of dignity for life in every corner of this country.

And I'm going to do this personally.

So, over the next three months, I plan to visit almost every region to talk with older people, people who work with them and their carers.

Asking them what they require to live their lives with "dignity". What they require to live their lives actively, because if you retire at 60 today you could easily now still have a third of your life ahead of you.

What I find will inform two next steps. First, Professor Ian Philp's Next Steps report on the National Service Framework which we will publish in April.

I have already asked him to come up with ideas of how to reinvigorate the network of Older People's Champions first set up by five years ago and this agenda will be led by a new group at the Department of Health, which I will co-chair with Professor Philp and the Chief Nursing Officer, Chris Beasley.

But we need to go further, I want to provide these champions with tools which will help them push for better standards of care in their local community.

These tools will contain information on best practice for providers, European comparisons, references to legislation, web addresses and helpful phone numbers.

The Home Office has already tried this approach with anti-social behaviour and has had impressive results.

Its "Together" campaign "Toolkit" has been given to thousands of people to help them tackle anti-social behaviour instead of tolerating it.

The Home Office has also trained six-and-a-half thousand people to deal with local anti-social problems. Its Together website had received 170,000 hits and its Action Line has received 14,664 calls. And I think that we can learn a lot from this.

Elderly people should receive care that respects their dignity. I came into this job with clear priorities.

And the reason that dignity for life is not simply important for the individual but for our country is because dignity is a reciprocal arrangement; the measure of any individual's dignity directly related to the conduct of the society around them.

I must say that I did not fully understand this until last year when I was sitting on the Bill Committee examining what is now the Mental Capacity Act. And I might say that that Act was a big step forward for this agenda.

And like everyone on that committee I was snowed under with briefings and petitions mostly about two highly controversial issues; withdrawal of Artificial Nutrition Hydration (ANH) and the supposed weakening of euthanasia rules and so I decided to go and visit some of the groups petitioning me in my constituency in Birmingham.

The most powerful message I heard was from a long retired nurse who spoke up in the priest's front room - who was chairing this meeting - and she moved the rest of us to tears about the way she had in the past seen terminally ill patients treated. It was at this point that I understood that what moved her to anger was not simply the experience of that individual, but the violation of a more profound and deeper sense of our shared humanity and obligations to each other.

So whether that is elder abuse, care home neglect, or simply separating a couple who have been together for sixty-five years, we have to change standards and improve them.

I want to invest communities around England with people - in the NHS, local councils and patient groups - who are trained to prompt best practice, know how to identify the potential for poor practice and formally bring complaints when abuse is brought to their attention.

And this mission needs to be backed by the best research. So I am glad to be able to announce today our partnership with Comic Relief and Action on Elder Research to fund a project seeking to shine a spot light on elder abuse.

This team will tell us how common elder abuse and mistreatment are and will help us develop new measures to stamp them out because they simply cannot and will not be tolerated.

By the end of this process, I hope the next care standards minister will have three clear levers in place: first a registered professional workforce - driving standards up; second, champions in the community - driving up standards; and third a vision of the future services - driving standards for the future.

I just want to say that this country's treatment of the elderly has come a long way since the publication of the National Service Framework for older people almost five years ago. My argument is this: our retired population is a gold reserve, which we need the alchemy of good care to unlock.

But when the NSF was published we wanted to stop the NHS discriminating against people because they were old.

Now we are thinking about taking this one step further and legislating against age discrimination in services.

We already have evidence that GPs and consultants are actually now far less likely to arbitrarily deny a person over 70 treatment because of their age.

If you look at the figures: heart surgery in the over-75s has risen from two per cent to 10 per cent.

Death rates for heart disease, stroke and cancer are down. Life expectancy in men and women over 65 is rising.

As well as tackling discrimination, we've cut by two thirds the number of delayed discharges - which has released 1.7m bed days per year and had a substantial knock-on effect in our battle to reduce waiting lists.

We've hit our target for the number of people being taken care of at home two years early.

These are great and good changes. We are creating a more equal society for older people. One where their age is not an impediment to living or the services the state is willing to provide.

The measures in the White Paper will take that equality a step further.

They will ensure everyone understands what they are entitled to and the power to ask for them personally with their own voice.

We are trying to bring consumer power to the aid of public services and by using public services to empower consumers, we have a real chance of making equality the hallmark of our social care system.

A system where people accessing services expect the very best and where the provider meets that expectation.

In the age of the internet, instant world-wide comparison shopping, telling someone, even an 80 year-old, this is what you're getting, like it or lump it, is simply not acceptable.

What this government is talking about is the first, historical realignment of our health and social care services since 1948.

Now you've been in this business for longer than me, and you will know that we've tried this before.

One of my great heroines, Barbara Castle, tried it in 1976 with Priorities for Health and Social Services.

She may not have envisaged individual budgets and choice but she knew this: the closer you took services to people the more likely they were to meet their needs.

But four years later, The Black Report into health inequalities in 1980, found that health inequalities had not changed, it judged that the government had failed because of a lack of clear objectives and a failure to assign responsibility to ensure the shift took place.

Well I'm clear about where the responsibility for the changes I've outlined today lies.

It lies with me. It lies with my colleagues at DH. It lies with you the employers and trainers in this hall today. It lies with England's well over one million social care staff and the people they look after.

It is our duty to make sure these historic opportunities make real changes to people lives.

It is our duty to leave this room today and take individual responsibility for driving up standards and providing world class social care not just to a lucky few, but to all.

Thank you.