Some IAs leaving cash allocated for tackling mental health and drug and alcohol problems unspent
The leadership of key organisations charged with transforming care in Scotland has been questioned by the country’s third sector.
Charities spoke out after a bombshell report by the Scottish Parliament’s health committee found the conduct and progress made by the 31 Integration Authorities (IAs) to be “unacceptable”
IAs were established in 2016 to bring NHS and local council social care services together into a single, integrated health and social care system.
But MSPs on the committee said IAs – which spend £8 billion a year of public cash – were failing to deliver the change required, and that the best practice in some areas was not being replicated in others.
Some were even leaving cash allocated for tackling mental health and drug and alcohol problems unspent.
Scotland’s charities say the current system needs radical change – with a greater role for the third sector built-in.
Anna Fowlie, chief executive of the Scottish Council for Voluntary Organisations (SCVO), said: “This report is a wake-up call for the Scottish Government.
“SCVO is in total agreement with the Health & Sport Committee that three years into a new health and social care system it is totally unacceptable that the IAs, which are responsible for spending around £8bn in public funds, are taking decisions on spend without any link to health and social care outcomes or assessing the effectiveness of their spend.
“After three years the IAs are clearly not challenging the status quo, and integration is in reality not that much further forward.
“If the Scottish Government want health care services that are fit for purpose in the future then radical change and a greater role for a directly funded third sector in health and social care is essential.
“We are now beyond the stage where more of the same approach won’t work.”
Annie Gunner Logan, director of the Coalition of Care and Support Providers in Scotland, added: “The recommendations in the report certainly get to the heart of the matter, in particular the call for integration authorities to get much better at demonstrating the impact of their spending decisions with reference to the agreed national outcomes for health and social care.
“The investment here is enormous, and it’s reasonable to expect those involved to be able to say what difference it’s making. I’m representing the third sector on the ongoing Scottish Government/Cosla review of integration, and I can confirm that the review is focusing on many of the areas highlighted in the report.
“Audit Scotland will also be reporting on integration shortly and I wouldn’t be surprised if some of the same themes come up.”
Health committee convener Lewis Macdonald MSP said: "The successful integration of health and social care is one of the biggest challenges facing us. It is clear that transformational change is required in the sector in order for us to meet long term challenges such as our aging population. This requires those in charge to use the powers Parliament has given them and drive change.
"It is vital that the significant budget for health and social care is spent efficiently and effectively. It is unacceptable that this is not happening and the Committee is calling on this to change.”
The Scottish Government said it is reviewing the progress of IAs, and a spokesperson added: “Integration is the most significant change to health and social care services in Scotland since the NHS was established, and ensuring its success is a priority for the Scottish Government.
“That is why in 2018/19 the Scottish Government is investing almost half a billion pounds of frontline NHS spending in social care services and integration, as well as an additional £66 million to local government in support of social care.”
