Hospitals should be last resort for treatment

The votes have been counted and the seats decided, but now comes the tough business of government. Welsh Labour’s decision to govern alone certainly suggests a degree of self-confidence in their programme for the next five years – but it is inconceivable that they will not at some stage need to reach out to the other parties. Carwyn Jones tacitly acknowledged as much in his speech on Tuesday.

One thing, however, is clear – the pressure will be on the new Welsh Government to deliver for Wales. The combination of new powers for Wales, a clear mandate and a still sizeable budget mean that the Welsh Government will have to provide tangible improvements on unemployment, poverty, low educational achievement and ill health by 2016.

Nowhere is that more true than in health and social care – and, in particular, in improving care for older people. A report from the Older People’s Commissioner for Wales, released in March, painted a bleak picture of the care older people receive in hospitals in Wales. The lack of dignity afforded to older patients must be a priority for the new Assembly Government, and its response to the Commissioner’s report will be telling.

Moreover, with Wales’ demographic time bomb, the scale of the challenge is not set to diminish. By 2030, the number of over-65s in Wales will rise to 1,044,000 (32 per cent of the total population) from 719,000 in 2007 (24 per cent of total population).

Prevention must become the watchword if older people’s services are to improve. The simple fact is, investment into low-level interventions (such as good neighbour schemes, lunch clubs, and community transport) allows older people to remain healthy and active in their own homes. These interventions save money further down the line through reduced hospital admissions and lower levels of dependency on formal social services. To not invest in prevention is a false economy.

But with so many pressures on the Welsh Government, will preventative care get the priority it deserves? The signs from the party manifestos are encouraging, and there appears to be considerable room for common ground.

To take one obvious example, both Labour and Plaid have talked of the benefits of so-called ‘Health MOTs’. In Labour’s case, they pledged annual health checks for over-50s. Not wanting to be out-done, Plaid went a step further and pledged them for everyone. This strong political consensus should make the issue one of the first to be taken forward by the new Assembly Government.

Labour might also find Plaid to be supportive of an agenda to join up health and social care. In their manifesto, Labour talked of working

“… with local authorities to ensure new, integrated cross-boundary arrangements for the commissioning, procurement and delivery of social services”.

if anything Plaid’s approach was even more emphatic – talking of requiring (rather than encouraging) service providers to work together. The Welsh Conservatives have also talked a good game on the issue, promising in their manifesto to bring forward a White Paper on achieving better collaboration between health and social care. They may even choose to go further now, and follow the lead of their Scottish counterparts by calling for a merger of health and social care budgets.

Elsewhere, Labour talked enthusiastically about home-from-hospital support – ‘reablement’, pledging to put it “at the heart of our approach to providing services to older people”. They also re-emphasised the direction of February’s social services White Paper by saying that such a programme would focus on local services rather than a more standardised framework for Wales as a whole.

Here, Labour may well find an ally in the Welsh Liberal Democrats, who committed themselves to improving preventative projects such as reablement by:

“…spending money on preventing the need for hospitalisation… [and] making sure that hospitals are seen as the last resort”.

The Welsh Conservatives and Plaid may also be sympathetic.

These are just a few of the areas where Welsh Labour could now reach out to the other Assembly parties and develop a consensus on preventative healthcare and helping older people. Doing so would offer a win-win for government. It would improve wellbeing amongst older people, but also save money on costly hospital admissions.

Achieving all this will take political expediency and economic foresight. However, the opportunity is there to be taken if the parties can find the common ground. For the older people of Wales, progress cannot come soon enough.

Ed Bridges is Public Affairs Manager with the WRVS, he can be contacted at ed.bridges@wrvs.org.uk

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