Welsh care integration strategy fails to deliver, according to new report

    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 found, writes Derren

    Despite spending more per head on health services in Wales than in
    England, researchers reported that waiting lists for outpatient
    appointments had risen sharply between 1997-2002, compared to a
    general reduction in other parts of the UK.

    Part of the blame for this poor performance is put down to the more
    difficult than envisaged integration of health and social care, the
    research suggests, and particularly the poor performance of social
    services departments – all 12 inspected between 2000-2002
    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,” it states.

    It also suggests these problems could be caused by giving more
    power to decision makers in local authorities and community health
    councils with the aim to shape services around a more preventative
    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. The more
    traditional power centres favoured by other reforms (managers or
    professionals) also have their problems, but at least they are
    relatively tried and reasonably well understood,” it

    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 getting wider.

    “Wales is facing an uphill struggle to achieve comparable
    performance and social care is very much part of that,” he

    However, Beverlea Frowen, head of health and well being at the
    Welsh Local Government Association, still believed close working
    between health and social services benefited local services.

    “In Wales we are trying to address many years of chronic
    under-funding 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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