John Swinney admits SNP's integration of health and social care services has 'failed' as reform talks to begin
John Swinney has opened the door to social care services being managed by a newly-structured NHS.
John Swinney has admitted that the SNP government’s strategy of integrating health and social care services has been a failure.
Last week, the First Minister announced a widespread intention to reform NHS management and local councils, in part, motivated to help bridge the almost £5 billion gap in the Scottish government’s revenue and capital budgets.
As part of the plans, Scotland’s 14 mainland health boards are set to be axed, with two east and west bodies established to manage NHS services. Meanwhile, Mr Swinney is set to open talks on Friday to allow local councils to merge with other authorities.
Since 2015, health and social care services have been integrated between NHS boards and local councils, run by so-called integration joint boards (IJBs).
But a stark report from the Accounts Commission in February revealed that Scotland’s IJBs “are in a critical financial position” with budget gaps this year reaching £449m.
The First Minister has now suggested that a “single line of accountability” would better deliver social care services, acknowledging that the integrated model has not been a success.
Speaking at First Minister’s Questions, Mr Swinney admitted that the SNP government’s experiment of integrating health and social care services has not been a success.
Scottish Labour local government spokesperson, Joe Fagan, asked Mr Swinney if social care services will return to local councils as part of the reforms amid speculation that the new NHS management could oversee services.
He said: “What more can he tell us about the shape of his health and social care reforms?
“In particular, which of the powers that currently rest with integrated joint boards does he believe should fall within the remit of NHS? Is that simply adult social care or does he believe that the NHS should run care homes and social work offices?
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“If that’s not his intention, will those IJB powers return to local government?”
Mr Swinney told MSPs that “the arrangements for health and social care in Scotland need to be reformed and that has to be the starting point of those conversations”.
But he warned: “I am not going to prescribe the approach that we are going to take.”
Mr Swinney added: "The single line of accountability on the delivery of health and social care would help us to deliver a more effective system that meets the needs of individuals.
“Just now, there is shared accountability and I don't think it works as effectively as it should."
The First Minister confirmed he will begin talks with council leaders on Friday over his proposed reforms.
He said: “I will be engaging in discussions with the Deputy First Minister and the Cabinet Secretary for Public Service Reform with the Convention of Scottish Local Authorities (Cosla) on Friday and that will open up the conversation about where the most appropriate delineation of responsibilities should rest.”
Scottish Conservative health and care spokesman, Miles Briggs, said: “This tacit admission from John Swinney begs the question why has it taken him so long to admit his party’s strategy has failed?
“For years, the SNP have defended a system that has too often meant buck-passing, cuts and patients falling through the cracks.
“Now they claim to want to deliver reforms that are desperately needed, but after 19 years of SNP failure, nobody will trust them to get it right this time.”
Scottish Labour health spokesperson, Jackie Baillie, said: “IJBs face funding gaps of hundreds of millions, yet SNP ministers have failed to heed the warnings for years.
“We need strong and effective leadership on health and social care, not further incompetence from this SNP government.”
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