Greater integration of health and social services in Wales – one
of the major policies of devolution – has failed to deliver better
health for the population, a report by Nottingham University has
Despite spending more per head on health services in Wales than in
England, researchers reported that waiting lists for outpatient
appointments rose sharply between 1997 and 2002 compared with a
general fall elsewhere in the UK.
Part of the reason for this failure to improve health is that the
integration of health and social care has been more difficult to
achieve than envisaged, suggests the research, and the performance
of social services departments has been so poor.All 12 departments
inspected between 2000 and 2002 were judged to be failing to serve
most people well.
“The part of the strategy which relied on better integration
between health and social services may have been somewhat
over-optimistic in the situation where Welsh social services were
performing very poorly,” the report states.
It also suggests these problems could be the result of placing more
power in the hands of decision-makers in local authorities and
community health councils in a bid to shape services around a more
preventive agenda, such as creating plans to tackle bed-blocking
and post-hospital social care.
“Attempting to place power in the hands of a fairly disparate group
of stakeholders may have been overly ambitious,” it states.
Hugh Gardner, social services director at Swansea, said the results
did not make good reading and that the gap between the performance
of services in England and Wales was widening. “Wales is facing an
uphill struggle to achieve comparable performance and social care
is very much part of that,” he added.
However, Beverlea Frowen, head of health and well-being at the
Welsh Local Government Association, insisted that close working
between health and social services did benefit local
“In Wales, we are trying to address many years of chronic
underfunding to both health and social care, which cannot be
overcome in one term of devolution. However, the policy approach by
the assembly to develop local strategic partnerships is to be
commended,” she added.
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