Behind the headlines

Our regular panel comments on a topic in the
news.

Should there be a joint inspectorate for
health and social care? The British Medical Association says there
should be. But inevitably questions will be raised about whether
such a move would bring genuine benefits for social care clients or
merely accelerate the absorption of social care into the health
service. At present, NHS facilities are scrutinised by the
Commission for Health Improvement, while from April next year
social care will fall under the gaze of the National Care Standards
Commission. The BMA thinks the two bodies should be merged to
create a single over-arching authority. It argues that this would
ensure consistent standards across both sectors, avoiding
duplication as both inspection bodies will be empowered, for
example, to inspect nursing homes. But it is hard to suppress the
fear that integration of the two inspection bodies could lead to an
“identity crisis” in social care, as values which set social care
apart from health are marginalised. An integrated inspection
service may be more concerned with what health and social care hold
in common than their individual strengths.

Julia Ross, social services director
and primary care trust chief executive, London Borough of Barking
and Dagenham
“It would be good if we could stop worrying about
takeovers and really think about what’s in the best interests of
service users. We can afford to be a lot more confident than we
sometimes behave. If not a total merger, then for goodness sake
let’s work hard at working together. I like the idea.”

Martin Green, chief executive, Counsel
and Care for the Elderly
“On the face of it, the British Medical Association
suggestion of one inspection body makes sense. However, I believe
that there is a danger that health issues would dominate over
social care issues. For me the important thing is not how many
bodies there are, but how effective they will be. There are
enormous challenges ahead for both the Commission for Health
Improvement and the National Care Standards Commission, and I hope
we will judge them on their outcomes, not their structures.”

Robert Whelan, deputy director of
Civitas, the Institute for the Study of Civil Society
“It’s not going to be possible to raise standards until
there is competition between suppliers. The idea that regulatory
bodies can make a difference is doomed; they have no impact
whatsoever. We need a situation in which, for instance, if one
hospital or GP is giving an indifferent service, people can take
themselves off to the next one. Only then will services
improve.”

Karen Warwick, senior practitioner,
Barnardo’s
“The integration of the two inspection bodies would
create a more ‘joined up’ approach to inspections. The proposed
difficulties ensuing from a possible identity crisis should be on
the agenda from day one. The development of core values is
essential but it is equally important to recognise and respond to
the fundamental differences between health and social care.
Embracing difference from the outset will assist the inspection
body in effective functioning.”

Bill Badham, programme manager,
Children’s Society
“Integrated care can only be of benefit. The challenge is
to ensure high quality provision and monitoring arrangements are
not compromised. Merging the two inspection bodies could help
partnership working and a more seamless service. But inspection
standards must not be diluted. Specialist understanding must be
retained. It would be up to the new over-arching authority to
monitor and push for tangible improvements in services and care in
all areas.”