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In the daily update on Friday 15th May, Matt Hancock said that the current crisis had demonstrated how closely health and social care need to work together and had acted as a catalyst to reform, referring to “integration”. Care homes are not, and were never intended to be, hospitals. The residents are just as entitled to hospital care, if that is what is needed, as are the rest of us. That so many have been left to die in Care Homes, rather than being admitted to hospital, and thereby denied the benefit of oxygen, ventilators and intensive care which might have saved their lives, is the real concern. The discharge of older people from hospital to care homes, without testing, in order to free up beds for coronavirus patients, may also have spread the virus.
However, that Baroness Ros Altmann also referred to “integration” on “Good Morning Britain”, and Matt Hancock reiterated it on the 21st May, would suggest the matter is under consideration.
Countless enquiries into “child abuse” and “adult abuse and neglect” have criticised agencies for not working together. And successive Governments have tried to get Health and Social Services, in particular, to work more closely together from “joint funding” in the 1970s to the “pooling of budgets”. But no Government has grasped the nettle of the lack of common geographical boundaries, different funding streams and different lines of accountability which have been the real impediments. This does not mean a merger of health and social services, as that would further marginalise Social Work and a different combination of agencies are required depending upon the problem and desired outcome. For example: Child Protection requires children’s services, health, education, the police and foster care to work together. Older People require Adult Services, Health, Housing, Leisure Services and Income Support to work together. – But not all of them all the time. It is quite a complex multi-dimensional organisational issue across countless scenarios.