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Are Caring Professions Restricting Employment of Disabled People?

Are Caring Professions Restricting Employment of Disabled People? Peter Thistlethwaite EDITOR The Government is demanding improvement of public will be shared by his former local authority commissioning in health and social care. The latest colleagues. Also in question is how GPs and local NHS re-organisation is predicated on the need for authorities will look at the innovative suggestion stronger commissioning by primary care trusts, co- that ‘GPs will be able to prescribe social care’. Cat ordinated somehow with GP-led practice-based among the pigeons, or damp squib? commissioning. This sounds like a tall order. GPs I have to conclude that these initiatives may be are not universally behind the move and progress is doomed to have limited impact at local level and on patchy, PCTs still have to develop the skills to be service outcomes. For this I would not expect to expert commissioners; the provider market, although blame the harassed NHS commissioners in changing, is not a paragon of competition; users localities, who bear a huge burden of change and seem to prefer easy access and quality to choice; and expectation, nor the directors of adult social services the hospitals are still a force to be reckoned with. who may fear encroaching NHS control and loss of Then there is the complicating influence of the shift local democratic influence. It is the lack of courage of social care commissioning to service users with from the top to change the nature of the NHS/local individual budgets (see Simon Duffy’s argument in authority relationship that will create a soggy blur this Issue). Life on the sunny uplands of the DoH is of indecision, and ultimately fail the public. very definitely simpler than down in the swampy David Behan believes that there is good enough lowlands where real lives are lived. Have a look at evidence to demonstrate the all-round benefits of the articles in this Issue from PSSRU, the NHS integrated care, and I agree with him. So why not Improvement Foundation and RiPfA for require integrated care? It is about time health confirmation. These new commissioning tasks commissioning was part of a local authority’s are very difficult, and are laced with contradiction. responsibility, tied in to the local democratic system The latest initiative from the DoH is a and part of the local strategic effort. This is bound to Commissioning framework for health and well-being. be more efficient in management terms, and would This has been issued in White Paper form for end the division of powers which so dilutes strategic consultation, but will require a level of partnership impact right now. Crucially, it would improve the between local authorities and PCTs superior to chances of the development of integrated care in the anything that has existed in most places so far. It community: social care, community health services seeks a shift to prevention, as if convinced that the and primary care together, not looking at different ‘national illness service’ can switch priorities easily, masters, and with a single line of accountability. and similarly social services. The policy is being I was told by a director of adult social services supported unequivocally by the Director General for recently that she receives at least one message a week Social Care, David Behan, a former social services from bodies looking for data about ‘cost shunting’. director. This raises the question of whether his What a mind-set that reveals. How will collective enthusiasm about the potential benefits for the responsibility for ‘care’ ever come into being? 2 Journal of Integrated Care Volume 15 • Issue 2 • April 2007 © Pavilion Journals (Brighton) Ltd http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Integrated Care Emerald Publishing

Are Caring Professions Restricting Employment of Disabled People?

Chih Sin; Janice Fong
Journal of Integrated Care , Volume 15 (6): 5 – Dec 1, 2007
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Publisher
Emerald Publishing
Copyright
Copyright © 2007 Emerald Group Publishing Limited. All rights reserved.
ISSN
1476-9018
DOI
10.1108/14769018200700009
Publisher site
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Abstract

Peter Thistlethwaite EDITOR The Government is demanding improvement of public will be shared by his former local authority commissioning in health and social care. The latest colleagues. Also in question is how GPs and local NHS re-organisation is predicated on the need for authorities will look at the innovative suggestion stronger commissioning by primary care trusts, co- that ‘GPs will be able to prescribe social care’. Cat ordinated somehow with GP-led practice-based among the pigeons, or damp squib? commissioning. This sounds like a tall order. GPs I have to conclude that these initiatives may be are not universally behind the move and progress is doomed to have limited impact at local level and on patchy, PCTs still have to develop the skills to be service outcomes. For this I would not expect to expert commissioners; the provider market, although blame the harassed NHS commissioners in changing, is not a paragon of competition; users localities, who bear a huge burden of change and seem to prefer easy access and quality to choice; and expectation, nor the directors of adult social services the hospitals are still a force to be reckoned with. who may fear encroaching NHS control and loss of Then there is the complicating influence of the shift local democratic influence. It is the lack of courage of social care commissioning to service users with from the top to change the nature of the NHS/local individual budgets (see Simon Duffy’s argument in authority relationship that will create a soggy blur this Issue). Life on the sunny uplands of the DoH is of indecision, and ultimately fail the public. very definitely simpler than down in the swampy David Behan believes that there is good enough lowlands where real lives are lived. Have a look at evidence to demonstrate the all-round benefits of the articles in this Issue from PSSRU, the NHS integrated care, and I agree with him. So why not Improvement Foundation and RiPfA for require integrated care? It is about time health confirmation. These new commissioning tasks commissioning was part of a local authority’s are very difficult, and are laced with contradiction. responsibility, tied in to the local democratic system The latest initiative from the DoH is a and part of the local strategic effort. This is bound to Commissioning framework for health and well-being. be more efficient in management terms, and would This has been issued in White Paper form for end the division of powers which so dilutes strategic consultation, but will require a level of partnership impact right now. Crucially, it would improve the between local authorities and PCTs superior to chances of the development of integrated care in the anything that has existed in most places so far. It community: social care, community health services seeks a shift to prevention, as if convinced that the and primary care together, not looking at different ‘national illness service’ can switch priorities easily, masters, and with a single line of accountability. and similarly social services. The policy is being I was told by a director of adult social services supported unequivocally by the Director General for recently that she receives at least one message a week Social Care, David Behan, a former social services from bodies looking for data about ‘cost shunting’. director. This raises the question of whether his What a mind-set that reveals. How will collective enthusiasm about the potential benefits for the responsibility for ‘care’ ever come into being? 2 Journal of Integrated Care Volume 15 • Issue 2 • April 2007 © Pavilion Journals (Brighton) Ltd

Journal

Journal of Integrated Care – Emerald Publishing

Published: Dec 1, 2007

Keywords: Disability; Professional Regulation; Diverse Workforce

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