Health secretary Alan Milburn is keen to assure social services that they are equal partners with the NHS. But he warned that means signing up to a similar strict regime of regulation. Pat Healy reports

Health secretary Alan Milburn could do no wrong when he addressed the annual social services conference in Torquay last week.

He started by informing the 800 delegates that he was treating them to his first major speech since taking over the job from his former boss, London mayoral candidate Frank Dobson.

And then he wowed them with the emphatic statement that his decision to be there 'signifies my determination that social care should become an equal partner to the NHS instead of being its poor relation'.

This was all they needed to dismiss from their minds the reported remarks of 'a government source' that too many social workers were 'bloody crap', which Mr Milburn told a press conference later was not a comment that had been made on his behalf.

But it was said to be the reason for his idea that social services should come under a quality body similar to the NHS's National Institute for Clinical Excellence.

Not that Mr Milburn was going to let social services off the hook. He told the conference that they had to raise their game because there 'can be no hiding place for failure' and 'it is time to end the excuses'.

That was not an idea many of the social services directors or committee chairs attending the conference could quarrel with, when of 29 departments examined last year by the Social Services Inspectorate only eight were found to be 'serving people well'.

Mr Milburn called for 'a new ethos of excellence not excuses' to 'drive standards up and drive failure out'.

The best social services authorities were capable of excellence, he said, but there was too much inconsistency.

'Unacceptable variations either in quality or in efficiency between social services authorities are unfair both to taxpayers and to service users, ' Mr Milburn said.

'I am as determined to end inconsistency in social services care as I am to end it in health service care. The postcode lottery of quality in care must end.'

The mechanism will be a national strategy for excellence in social services, which will be spelled out in a green paper on quality early next year.

It will include proposals for a 'national social care institute of excellence' to parallel NICE.

Throughout, Mr Milburn emphasised the need for social services to work with the NHS 'to provide a truly integrated system of care' across traditional boundaries. And he demanded that they give local communities a guarantee this winter that 'health and social services will be functioning at full capacity over the holiday period'.

It was not quite clear what he meant by 'full capacity' - he said afterwards that he wanted to avoid the problems of last winter when 'parts of the operation were not working at full tilt', and there had been problems over primary care and hospital discharge.

But he told the conference: 'I expect every council, every trust and all those involved in the winter planning to sign up to a local winter guarantee. Once this promise has been made, it must be honoured.'

And he added: 'There must be no excuses this winter. Local social services will be under the spotlight just as much as local health authorities. That is my challenge to all those involved with winter planning.'

He declined afterwards to say how he intended to enforce the guarantee. 'I look to local authorities to do what we require, ' he said, adding darkly: 'I have a range of powers available. You know what those powers are.'

Essex director of social services Michael Leadbetter was impressed at the speed with which Mr Milburn had picked up his new brief, although other delegates seemed to think he was back in his old job when they asked for more money for social services.

'Three weeks ago, I was chief secretary to the Treasury, ' he said. 'But don't worry, I am better now. I have become a human being again.'

And then he gave the standard response about the comprehensive spending review having given everyone a three-year plan, with more money for social services, and that was what the government was going to stick with.

That was good enough for Rita Stringfellow, chair of social affairs and health at the Local Government Association, and, as a councillor with North Tyneside council, a former boss of Mr Milburn before he became an MP.

'We have a three-year spending pattern, and we have never had the security of that in the past, and more money is coming through, ' she said.

'The amount of money spent on social services does not guarantee quality.'

Which contrasted with the expressed concerns of social services directors and chairs that much of the new money was committed to new initiatives, reducing their overall discretion to ensure that their funds were used to meet the greatest need.

It was a point raised by Conservative health spokesman Dr Liam Fox in a well-received speech the previous day.

He said too much money was being spent on ministers' pet projects, which forced local government to make unpopular decisions.

He said it was 'unacceptable' in a democracy for accountability and power to reside in different places. 'Far too much is being ring-fenced, far too little discretion is being given to those who are going to be accountable to the electorate for carrying out the policies, ' he said.

Dr Fox said he agreed with many of the government's proposals on social care, including promoting independence of individuals and improving standards. But it was not just the aims that mattered, but how they were implemented.

The government wanted to end postcode care through national service frameworks, but that would not happen while clinical priorities were subordinated to waiting lists, he said.

Dr Fox announced that he is setting up a joint policy group on learning disability with his Conservative colleagues from education and environment because 'we must have a more integrated approach'. It could not be right, for example, that many children in care suffered from dyspraxia or autism, Dr Fox said.

But he was not giving away much of the Conservative agenda on social care . He said as a doctor he believed in evidence-based medicine. Policy should also be evidence-based, which was why he was setting up various groups to examine the evidence.

He was clear on one thing, though - that young people today should be told to start saving now for their own long term care.

No-one could blame the present generation of elderly people if they had not done so because they had been told they did not need to. But when asked what his response was to the Royal Commission on Long-Term Care, Dr Fox said he had set up another group to look at it.

He agreed with parts of the royal commission report, but was not yet clear on what sort of long-term care model might be possible. 'Until we have that information it would be premature to make any policy pronouncements.'

On that, at least, Mr Milburn seemed to agree. Asked when the government was going to respond, he said it was a 'very serious report', but he was a new health secretary. He was going to give it his 'full consideration' and when he was able to make a response he would do so.

New president's offer: 15 minutes of fame Jo Williams, the incoming president of the Association of Directors of Social Services, is said by Rita Stringfellow, chair of social affairs and health at the Local Government Association, to be known for her 'sincerity, commitment and being in touch'.

Which may explain why she went down so well when she gave her inaugural speech at the conference - even though she exhorted her colleagues to abandon the habits of a lifetime by allowing their clients to talk to the press.

'We have to start to take some risks, ' she said. 'We must allow people to make their own decisions. People like to tell their story, to have their picture in the paper, to be famous for 15 minutes.'

The idea was part of a leadership challenge she held out to improve the image of social services, a concept she thinks would be greatly helped if people were allowed to tell positive stories about their experiences with social workers.

Her optimism is fuelled by 28 years in social services, starting in Shropshire as a social worker and culminating two years ago in her return as director to Cheshire, where she spent 19 years before going to Wigan for five years.

Her main interests have been children and mental health, but she is excited at the opportunities opening up to work with the NHS. She has just had a meeting with the chairs of her six local primary care groups which had been 'really positive about the contribution of social services staff '.

In her spare time, she keeps fit, plays tennis and supports her management consultant husband who sings with the Liverpool Philharmonic Choir.