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Peter Black and South Wales West Liberal DemocratsRepresenting Aberavon, Bridgend, Gower, Neath, Ogmore, Port Talbot, and Swansea |
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The future of care
February 8, 2010 12:00 AM
By Peter Black in Western Mail
By Peter Black in Western Mail
Just over a week ago at the Welsh Liberal Democrat Conference, I launched a consultation paper asking how we can secure a sustainable and affordable structure to deliver care in our communities.
This paper does not add any concrete policies to our general election manifesto, and I have no intention of rushing to meet that deadline. What I am seeking to do is to start to develop a fully thought-out vision for social care in Wales to add to our Assembly election manifesto next year.
Primary and community care, such as the services provided by GPs, health visitors and District nurses has a lot in common with social care, which covers services provided by local authorities. Both seek to provide the support and help needed to enable an individual to live independently in their own home or that of a relative or carer as long as possible. However, both have separate management and budgets, which means that sometimes we get duplication of effort, whilst public resources are not always spent in the most efficient way.
There can also be competition such as when a Health Board or local council, attempts to reduce the demand on their own budgets by shifting the responsibility and the cost to the other. Patients can be caught in the middle of this wrangling and may receive the wrong type of care or a delay in getting the service they need. Often they are stuck in a hospital bed awaiting a care package to be put in place.
It is for these reasons that in some areas Councils and health boards have tried to find ways to work together better. The aim is to provide higher quality services and experiences for both employees and patients. By cutting out the debate over who is paying for the care, the only discussion is one of how we provide a better service.
Pooled budgets have been talked about for years and in some limited fields they work. However, as a rule they are more talked about than acted upon. What is left is the need for a more formalised structure to encourage joint working, or even mergers of services cutting across the health local government divide.
One option would be to look at how health and social care provision can be delivered through partnerships between local Authorities and Health Boards. A Local Authority in England became the first place in the country to appoint a single Chief Executive for both the Council and the PCT and I understand similar proposals are being developed in Powys. Under this model, the PCT and the social care functions of the Local Authority are run by a Joint Management Team, employed by both the Local Authority and the Trust.
Alternatively, some Local Authorities have gone beyond a partnership model and established a separate independent organisation to which to transfer some of its functions. This model is less complex than other models but it doesn't address all the conflicts though it may be possible to adapt this model to include primary care functions.
But these are not the only options. If we want to amalgamate social care and health care, do we necessarily need a brand new structure to do so? Instead of combining the two under a new body, why not give additional responsibilities to an organisation that already exists? Why not give the responsibilities held by councils to Health Boards or democratise health by letting local Councillors run it? Or should we just stick with the status quo and try to improve it?
Any model of delivery will have strong points and weak points. That is why I want to hear from service users and those who work in the sector as to what they want. Our consultation paper has been put on our website at www.freedomcentral.org.uk/future-of-social-care and I welcome responses from anyone who has ideas or experience within these services.
What would you like to do next?
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