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Holyrood committee backs measure to integrate health and care

18 November 2013

A Scottish Government bill to integrate the delivery of health and adult social care has been backed by a committee of MSPs at stage 1 of its progress through Holyrood.

The Health & Sport Committee has supported the general principles of the Public Bodies (Joint Working) (Scotland) Bill, while raising a number of issues that it says need clarification.

Under the bill, new governance arrangements will be created to support joint working between local authorities and the NHS. National outcomes will be set by Scottish ministers, and an integration plan delivered on a joint board or lead agency model, the agency having a significant budget and responsibility for commissioning services.

The committee's concerns include the reach of ministerial powers, the role of GPs and also the extent to which the Scottish Government expects both health board and local authorities to commit towards financing the delivery of joint health and social care.

Ministers would be given wide ranging powers to make provision by order about the membership, proceedings and general powers of joint boards, and the supply of services or facilities to boards. The committee calls for detail as to the kinds of circumstances in which the Cabinet Secretary considers that it would be appropriate to use these powers.

It further calls on the minister to consider strengthening the involvement of the third and independent sectors in the integration process; and whether the involvement of carers and carers’ organisations in the design and production of integrated services can be underpinned.

Consideration should also be given to what role the revised GP contract can play in encouraging or helping GPs to play a full role in the integration process.

The committee has noted concerns about "cost creep" issues arising from integrating free universal NHS services with means tested social care, and invites the Government to indicate what measures it proposes to reassure groups who might be most likely to be affected by cost creep.

And with significant budget expected to be transferred to the joint boards, it wants clarification of the extent to which there is expected to be variation between health boards. Integration of different staffs from different professional backgrounds and working for different employers also raises issues.

Committee convener Duncan McNeil MSP said: “We already know that where integrated health and social care is successful it results in better outcomes for patients. The quality of care for patients improves, people are not unnecessarily delayed in hospital and patients are supported to live a comfortable life in their own home.

“However, integrating different organisations with different cultures and principles is never going to be simple. Whilst this committee supports the principle behind this legislation, there are clearly a number of issues that need to be addressed for this legislation to deliver the better outcomes it promises.”

Click here to view the committee's report.


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