Defending social and health services under threat: questions and strategies

Two of the authors of this article were key participants in the planning and implementation of IMPACT 97, an interdisciplinary conference whose aim was the collection and dissemination of data documenting the harm being done by cutbacks in health and social services. IMPACT 97 took place in 1997 in New York City. It was partly inspired by an international conference held earlier in Great Britain on the Crisis in the Human Services (Adams, 1997). Both conferences demonstrated that interdisciplinary collaboration was possible, that it could result in the collection and dissemination of key social data and that it could receive the support of practitioners, key organizations as well as funding assistance (Adams, 1997; Beckerman & Levitt, 1997). This article builds on this experience by considering how to defend social and health services under threat. While all sectors of social services have been threatened, social services in health care have experienced some of the greatest challenges. Developments in this field of practice provide the focus for the article. The following questions will be addressed: Why is the social work profession and its services under attack? What can we do about these attacks? What are the forces which shape our future and how can we help shape that future? In presenting this article on the United States' experience, the intent is to look for parallels which can inspire mutual support in dealing with the increasingly intolerable situation of the social work profession in the United States and Great Britain.