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09 Dec 2021

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Public/private integration of social care is the first challenge

By Caring Times editor GEOFF HODGSON

I think the phrase ‘put your own house in order first’ comes from the Bible; whatever its provenance, it certainly comes to my mind whenever I hear talk of health and social care integration.

Being one big household would bring a lot of benefits but each side, health and social care, should try to avoid bringing problems with them.

The NHS is not entirely without problems, some of which are only likely to go away once it begins to look at social care as an equal partner, but I think it is yet to cotton-on to the idea of systems with flexibility to meet people’s needs, rather than people having to fit in with a rigid system.

Social care is in no better position, but with us it’s more about commissioning and public funding, with private providers pragmatically focusing on the self-pay market and local authorities (who passed the baton to the private sector in the first place) playing ducks and drakes by setting-up their own provision, often in the form of “arm’s length trading companies”. Then, using our money to pay over the odds, they drive yet more private providers to either throw in the towel or concentrate solely on private-pay.

Last week, Renaissance Care (Scotland) chief executive Robert Kilgour called on he Accounts Commission, the public spending watchdog for local government in Scotland, to carry out an investigation into how much local councils spend on their care homes. Mr Kilgour made FOI requests to all 32 local authorities in Scotland for a detailed breakdown of their care home operations. The responses are available online at www.scottishcare.info

It is clear from the responses that some Scottish councils are paying more for their own provision than they pay private providers for the same services. Care England has carried out a similar exercise in England with essentially the same result. And here was me thinking local authorities didn’t have two pennies to rub together.

One has to hope that the promised green paper, whenever it emerges, will take a long look at the role of local authorities as purchasers, commissioners and (laugh out loud) market managers. Until this kind of rubbish is sorted out, it’s pretty pointless to talk about health and social care integration.

  • The CT Blog is written in a personal capacity – comments and opinions expressed are not necessarily endorsed or supported by Caring Times.
Robert Kilgour

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