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Wednesday, September 16, 1998 Published at 13:49 GMT 14:49 UK


Bringing down the 'Berlin Wall'

Health minister Alan Milburn unveils plans to bridge the care gap

Social services and the NHS are to be allowed to pool their budgets in a bid to demolish the "Berlin Wall" that exists between them and improve care.

The proposal is one of a series of "radical options" announced by the Department of Health on Wednesday.

They include an extension of the one-stop shop idea for some care services, such as physiotherapy, and putting one agency in charge of the care partnership.

Health officials say the proposals will bridge the gap between health and social services which can lead to costly delays in people receiving care, vulnerable people missing out on necessary support and squabbles about who picks up the care bill.

Some of the most well-known cases involve mental health patients who have been released into the community without a care package being agreed between health and social services.


Health ministers Alan Milburn and Paul Boateng announced the proposals, on which health and social services workers will be consulted.

Called the Partnership in Action, the plans includes:

  • allowing one agency - an NHS trust, primary care trust or social services department - to provide a range of community health services, such as physiotherapy
  • asking health and social services departments to pool their budgets to make it easier to provide comprehensive care packages
  • appointing a single agency - a health authority, primary care trust or local authority - as lead commissioner to be responsible for overall decisions about commissioning health and social care
  • providing other incentives to encourage more joint working and flexibility, such as extending health authorities' powers to transfer money to support social services' projects.

The government is also looking at how health and social services inspectorates can jointly inspect services.

Turf wars

Alan Milburn said: "Too often the complex needs of many vulnerable people have taken second place to a system plagued by boundaries, barriers and turf wars."

He added: "These proposals will help put the needs of vulnerable people centre stage. This partnership approach will end wasteful duplication, make more effective use of public funds and give people the benefit of an integrated system of care."

Paul Boateng said what was important was "what works". The proposals are out for consultation until the end of October.

Health service managers have welcomed the proposals.

Better for patients

Karen Caines, director of the Institute of Health Services Management, said: "A whole system approach is better for patients and more cost effective."

[ image: The partnership plan must be implemented at a
The partnership plan must be implemented at a "workable" pace, says Karen Caines
She added: "At present, there is great variation in partnership working. Where good practice occurs, it is often due to individual leadership and vision.

"A new joint approach could allow wider benefits to reach the people who need them most, such as elderly people and children."

However, she said the proposals would have to be implemented at a "workable" pace and national guidance would be necessary to align eligibility criteria for services which carry charges.

There are fears one-stop shops run by social services could lead to people paying for services they used to get for free on the NHS.

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