Consultation on the Social Services (Wales) Bill is now over and has no doubt generated the usual broad mix of opinion. The Bill represents an historic moment for the Welsh Government as enactment is its first major piece of legislation since gaining its enhanced powers. Deciding to legislate on any subject is invariably tricky often motivated by Government needing to demonstrate to the public that it means business prevailing over logic that change can occur without yet another Act of Parliament. In this instance, Welsh Government seems to be recognising progress has been made but that improving and sustaining effective social services requires stronger central direction and leadership. In essence, the Bill represents a rebalancing of power between central and local government in the delivery of personal social services.
The Deputy Minister states that the challenges facing social care are: changing public expectations; increasing demand for services; demographic change; and increasingly tight resources. Understandably, given Whitehall’s reluctance, or inability, to move forward on the funding issue following the Dilnot Report, the Bill makes no attempt to resolve these issues via funding solutions. Instead it puts forward a challenge for the deliverers of social services to choose renewal over retrenchment as the way forward. Encouragingly in this context, the limitations of the continued pursuit of efficiency measures as the main plank of balancing supply and demand are exposed.
WIHSC’s response to the consultation welcomed the Bill’s confirmation of social services as an integral local government function and the emphasis on continuing the strong partnership ethos which has been evident in recent years. However, in view of the mixed success in respect of achieving integrated health and social care, we see the case for more prescription about how local government and the NHS should work together. It is clear that the general public expect public services to resolve communication difficulties internally without detriment to effectiveness and we believe it is time for debate about the value of integrating services to end and action begin. The Bill presents an opportunity for this transformation, particularly the references in the consultation document to placing a duty on partners to cooperate and collaborate.
Having a ‘common core’ to the assessment process seems to be a useful idea to address the inadequacies of the unified assessment system provided that it is not accompanied by an over bureaucratic process now focuses on outcomes. The twin proposals of portable assessments and the development of a national eligibility framework have created some of the greatest debate on the Bill yet viewed from a user/carer perspective, they are inherently the right way forward to meet people’s needs and go some way to convincing the public that there is a coordinated view of how social care should be provided. Is diversity within the Welsh population really so great to warrant the degree of variation currently evident?
However, setting a single eligibility threshold of assessment carries significant challenges both in terms of getting the level right and potentially increased demands on resources. It is important not to replace one flawed system with another in this regard and the new arrangements would benefit from considerable ongoing discussion and consultation with all stakeholders.
WIHSC particularly welcomed the proposals to simplify rights for carers. Work we have undertaken around the contribution of carers continues to emphasise their value to society as a whole. Amending the definition of carers to include paid carers is the right way forward and consistent with the principles of self directed care, as are the proposals to extend direct payments. However, the new definitions need to be carefully framed as we would not wish this to lead to confusion with those more formally paid care workers employed on a commercial basis.
The safeguarding agenda features strongly in the Bill and establishing new boards broadly in line with local health board boundaries is a sensible way forward which should benefit the collaborative approach so necessary to achieve successful outcomes. The notion that there should be joint responsibility on Board partners, albeit that social services would retain lead coordination responsibilities, is a sound one and it is good to see the WIHSC review of “In Safe Hands“, which found evidence of differing levels of commitment to adult protection from partners, clearly being used as a basis for consideration of many of the developments proposed.
Overall, there is cause to be positive about the proposals and direction of the Bill. Notwithstanding its diversity, Wales is small enough to be governed in a way which makes the consistency of service delivery the norm rather than the exception. We believe that is what the Welsh public want and expect and the Bill offers an opportunity to achieve this. Written by Tony Garthwaite, WIHSC Senior Fellow