Welsh leaders fear Wanless agenda will herald era of structural change

Local government leaders have raised major concerns about the
implications of the Wanless review of health and social care in
Wales.

They fear the recommendations may be the precursors to structural
change despite ministerial assurances to the contrary.

The comments come in the Welsh Local Government Association’s
initial response to the review’s recommendations on redesigning
services and the links between health and social care.

Derek Wanless’s review, published earlier this month, found that
increasing demand for care could overwhelm providers unless health
and social care services were modernised and brought closer
together (news, page 7, 17 July).

The association’s disquiet comes despite Welsh ministers insisting
that the report’s emphasis is on integrated thinking, not
structural change.

The association says it is important that action to break down the
barriers between health and social care “does not weaken the links
and capacity for a seamless service between social care and other
local government services such as education, housing, environmental
services and leisure, which can deliver prevention and earlier
intervention and a holistic approach to individual needs”.

It raises concerns about an over-emphasis on a seamless approach
that may encourage local health boards and authorities to focus on
a narrow agenda for change.

“If the objectives from the recent health reforms are to be
achieved and the pressures on acute hospital services reduced, we
must ensure that health and well-being strategies are more than
health and social care plans,” it warns.

However, the report broadly welcomes many of the review’s
recommendations, and calls for the association to be fully involved
in the operational detail of the Welsh assembly’s long-term
intentions on how best to implement the review’s findings. A formal
response from the Welsh assembly is expected in the autumn.