Funding methods prevent integration

The way health and social care is funded is
the central problem in ensuring services are integrated, a health
policy analyst from the Royal College of Nursing said last
week.

Because health was funded via taxation while
social care was means-tested, bringing the two together was going
to be a critical challenge in integrating health and social care,
Helen Caulfield told a London conference.

She added that it was “unclear” how bringing
together health and social care would make a difference to the
public.

Moving towards integration with social care
was “problematic” for staff on top of other structural changes, and
it was difficult to see how a true partnership between health,
social care and independent providers could be achieved, she
claimed.

Care trusts had not taken off in the way that
the government had hoped, she added, with enormous transaction
costs involved in producing a care trust, and no additional
government funding.

– Also at the conference the chairperson of
Disability Action in Islington told delegates that the health
service had “a lot to do” in order to implement the Disability
Discrimination Act 1995.

Alan Desborough said that disabled people
dreaded negative language and being patronised when they came into
contact with health professionals. These were major barriers for
accessing health care on equal terms, he said.

“We have got to re-educate the medical
profession,” said Desborough. “I hope therefore that staff training
in disability equality is high on the agenda, as well as access
audits on buildings, and training must be run by disabled people
who are qualified in disability equality training.” Disability
Action recently finished a year-long pilot project on health
advocacy which identified physical barriers, such as counters in GP
surgeries that are too high for wheelchair users, and too few sign
language interpreters.

The conference was organised by Harrogate
Centre for Excellence in Health and Social Care.