Activists with disabilities have given a cautious response to the government’s new White Paper on Health and Welfare, with particular concern about the ongoing crisis in welfare funding and ministers’ failure to pledge proper co-production and engagement with service users .
Much of the White Paper on Integration and Innovation focuses on the NHS and on plans to ensure that England’s health and social security systems are “truly integrated”.
The themes of the White Paper will be “Supporting Integration, Reducing Bureaucracy and Improving Accountability”. A bill based on its content is due to be published later this year.
The main structural changes will be the establishment of regional integrated care systems (ICS) to operate the NHS in all parts of England, as well as separate ICS health and care partnerships bringing together the NHS, local government and other partners.
The White Paper states: “Instead of working independently in each part of the NHS, the public health and welfare system should continue to seek ways to connect, communicate and work together to meet people’s health and care needs.”
Although there are many references to social welfare in the White Paper, important issues – particularly funding – remain in the background. Instead, the White Paper promises that the government will present its long-awaited welfare reforms later this year.
The social welfare proposals that the White Paper offers include measures to improve accountability of local authorities and service providers, with new ways to monitor the quality of services and improve data collection, and changes to enable “person-centered models” for patient discharge Hospital.
There is also a new duty for the Care Quality Commission to assess how local authorities are performing their adult welfare duties and that the Health and Welfare Secretary may “step in” when a local authority does those duties not fulfilled.
Matt Hancock, the secretary for health and social affairs, said the proposals would allow professionals “to work seamlessly across health and care without being broken down into man-made silos that separate them”.
Due to the focus on the NHS and other pressures, few organizations for disabled people have so far issued a position on the White Paper, but the Reclaiming Our Futures Alliance (ROFA) and Disability Rights UK (DR UK) have provided initial responses to the Disability News Service.
ROFA’s Mark Harrison (pictured right) said he had “real concerns” about integration as these are two systems “run by non-disabled professionals who are not committed to putting disabled people first.” “.
He said: “There are no disabled voices in the NHS because there is no room for them.”
He said welfare is “lip service” for hearing disabled voices and then ignores what they say.
He said: “This is partly because of the austerity measures imposed by the central government, but also because the concept of service user and voice involvement is stuck in the 20th century. It’s not a meaningful co-production. “
He pointed to two examples of local authorities engaged in meaningful engagement and co-production with disabled people: Hammersmith and Fulham Council in London and the Greater Manchester Disabled People’s Panel.
But Harrison said, “I can’t see an example of this in the NHS and 99 percent of local authorities across the country.”
He also pointed to the human rights abuses over the past decade caused by the re-institutionalization of thousands of people with learning disabilities and people with autism.
He said he didn’t think the White Paper would reverse this as one of the main causes has been the loss of local, community-based and preventive services that offer options to help people live independently in the community.
Fazilet Hadi (pictured left), Head of Policy for DR UK, said: “It is a laudable goal to bring health and local authorities together to plan services in local areas and eradicate inequalities, but without real co-production with disabled people at heart With reform and without increased investment in social welfare, the danger is that it will be just a shuffle of deck chairs. “
She added, “It is positive to have partnership bodies in place that will enable health authorities and local governments to plan services across their area and bring together health facilities to shape health care.
“The exchange of customer data could also lead to more personalized services.
“As we all know, structural change is not enough.
“We currently have a social care system that is chronically underfunded and is not free at the time of delivery.
“We also have incredibly long waiting lists for NHS treatment and NHS staff who have been redirected to carry out the ambitious vaccination program.
“With no suggestions on the table to address welfare underfunding or to clear the NHS treatment backlog, it is difficult to enjoy the health and care white paper.
“It’s also hard to believe that simply bringing legal bodies together will inevitably lead to better public health planning, increased co-production and engagement with discriminated groups, or a greater focus on reducing health inequalities.”
The government originally promised that a social welfare Green Paper would be published by the end of 2017 and then by July 2018, before being postponed to autumn and then to the end of 2018.
After missing the December 2018 deadline, it was pushed back to the “earliest opportunity” in 2019 before Health and Welfare Secretary Matt Hancock told MPs that it would be released by April 2019.
In July 2019, when he became Prime Minister, Boris Johnson announced on Downing Street that the government would “resolve the welfare crisis once and for all with a clear plan that we have prepared”.
The party’s general election manifesto for 2019, however, only offered future discussions with other parties to reach “bipartisan consensus” on reforms.
Now the White Paper says that the government has “committed to making proposals this year”.
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