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Caring is sharing

People need to be less precious about their own little empires - because residents lose out

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More than 20 years ago I used to attend conferences with colleagues from the health service, as well as those from local authority social work departments, on how best to integrate social care.

Introducing ourselves around the table, I would say that I worked in housing, at which point my fellow attendees would ask ‘what are you doing here?’.

How disappointing then to attend another conference on integrating social care last year to be asked where I was from, and on being told housing, to be asked the same old question. What’s that adage about some things change yet remain the same?

Trust Housing Association celebrates its 40th anniversary next year and the following year I will reach my own personal landmark of having worked in the Scottish housing sector for 40 years.

So how much has changed over the past 40 years, and to what extent are we still hidebound by accepted and established procedures and protocols? How integrated is social care now compared with the early seventies?

The history of collaborative working is at best piecemeal. The change fund partnerships, set up to help stimulate innovative and joint approaches between health, housing and social work departments, have a chequered early history with continual criticism of the third sector’s inability to participate as equals in the process.

The joint commissioning of services between health and social work and the moves towards greater integration of services between the parties seems to make eminent sense. So why is it not happening more?

For me, it is not an ‘old age’ problem but rather an ‘age old’ problem of power and culture. Despite our best efforts over 40 years, we still have fragmented services where people receive separate visits from well-meaning health professionals, social workers and housing staff. How can this be the best use of scarce public resources?

A recently widowed pensioner living at home with no family support doesn’t care what organisation their visitor represents; all they want is the most appropriate form of support to allow them to live a good quality of life with assistance for their needs, proportionate to their circumstances.

If we are serious about integration we need to be prepared to give away power and budgets in the best interests of the customer. People need to be less precious about protecting empires and be more willing to accept cultural change with an entirely new ethos of comprehensive, co-ordinated and collective customer service.

After 40 years, the voluntary drive towards this new Eden has not worked - perhaps it’s time for the government to legislate for its delivery?

Bob McDougall is chief executive at Trust Housing Association

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