Poor social services and flaws in integrated working dog Wales

    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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