8 Oct 2012
Restructure of health and social care services: what do you think?
Integration of health and social care services is an idea that has been in circulation for some time but it is now closer to becoming a reality here in Edinburgh as the Scottish Government prepare to legislate for the creation of Health and Social Care Partnerships.
In theory the combining of health and social care budgets and staffing under a single management and governance structure should ensure better value for money and more joined up services for the growing number of people who require care type services in the community or other non-hospital health facilities. Integration will happen, but will have to be properly managed if it is to deliver the potential benefits to society.
It’s now well accepted that people are living longer but with ever more complex, multiple health conditions that require management and the support of care services. Most people would prefer to be cared for at home or in their community and services are being shaped to reflect that need.
Integration presents political opportunities and challenges for us in Edinburgh Labour. For the first time elements of local health services will be subject to more democratic scrutiny and input than has previously been possible. And the opportunity to work with health professionals at a local community level must surely present new ways of joint working to tackle health inequalities and delivering healthy living messages.
The draft governance proposals are that the new Health and Social Care Partnership for Edinburgh will be chaired for the first two years of its existence by the Council, a unique opportunity to shape the new arrangements as they are being established. The chair of the new organisation then rotates equally between NHS Lothian and the Council. There will be 14 voting members of the new Partnership Board, 7 each from Edinburgh Council and NHS Lothian. The 7 Councillors will provide proportional as well as all party representation at this strategic level. Equally important though will be the local arrangements where communities, Councillors and health professionals such as GPs can work together on a shared health and social care agenda.
Of course, it won’t all be plain sailing. The new arrangements won’t be blessed with lots of new resources. Budgets will remain the same or may reduce depending on future government cuts. Current organisational barriers won’t be swept away overnight and working cultures are always slow to change. Add to that the reality that people are living longer with more complex health needs and it’s easy to see that there are plenty of challenges to be met.
Health and social care services aren’t particularly newsworthy, unless something goes wrong of course, as recently happened in tragic circumstances. Throughout the integration evolution, not making the headlines will be a sure sign of success
If the transition is properly managed the thousands of staff who work in these services in Edinburgh shouldn’t see much difference initially but will hopefully become aware of a more streamlined and joined up method of working across different services. It’s important to note too that workers will not have their terms and conditions altered by this, they will not be TUPE’d, there is no new legal entity being created, just a more sensible set of management arrangements to deal with the well documented demographic changes around us.
This is an exciting opportunity to drive change and improve services for our most vulnerable citizens and we should celebrate the fact that Edinburgh Labour is at the heart of the initiative.
The Council’s response to the recent Scottish Government consultation on Health and Social Care Integration can be read here.
The report outlining interim governance arrangements as outlined above can be read here.
While not pretending to know all the answers at this stage I’d be happy to address Labour Party Branches or CLPs on this issue and would very much welcome feedback and views from Party members.
Convenor for Health, Social Care and Housing
tel 0771 549 0859