Issue 2: March 2012

THE CHRISTIE REPORT AND CARE - TIME TO STAND AND DELIVER?

By Ian Welsh, Chief Executive, Long Term Conditions Alliance Scotland

Few, if any of us, in Scotland would deny the challenges we now face. An ageing population, the economic climate and welfare reforms are fuelling increasing levels of need whilst public authorities work within ever tightening fiscal constraints.

We need to produce better outcomes with smaller budgets and to achieve that requires investment in prevention – taking demand out of the system where possible. In seeking this shift, the Christie Commission has offered both a road map, and a substantial challenge.

We need to produce better outcomes with smaller budgets and to achieve that requires investment in prevention - taking demand out of the system where possible.

The big question for all of us – Scottish Government, local authorities, the health service, third sector, individuals and communities – is how to achieve the transformative change envisaged by Christie.

ADSW (Association of Directors of Social Work) has talked of the need for “a new ‘compact’… with the people who need support, both now and in the future”. At the heart of this is a move towards asset-based approaches in which the capacity – and voice – of individuals and communities is valued and maximised.

Asset-based approaches such as self management, peer support and independent living must be at the heart of how we implement Christie. However, there are two distinct notes of caution here: firstly, such approaches must not represent an excuse to simply cut, rather than redesign, services, with the assumption that individuals, community groups and unpaid carers will take up the slack; and secondly, while asset-based approaches offer high value for relatively low-cost, they do not come at no-cost.

Asset-based approaches such as self management, peer support and independent living must be at the heart of how we implement Christie.

Third sector organisations – small and large – provide the foundation upon which asset-based approaches flourish. In reality we are already seeing many of these organisations lost for the want of modest funding as local authorities and their partners pull back budgets. Delivering on Christie requires a move away from the ad hoc approach to third sector funding, replaced by local strategic investment frameworks that support the sector as a core element of the care and support landscape.

As the Scottish Parliament’s Local Government and Regeneration Committee begins its year-long inquiry into Public Service Reform, and we look towards the local government elections in May, the focus on the ‘how’ of public service reform will only be sharpened. The road towards Christie will definitely not be an easy one – there will be significant challenges along the way, which we will all need to do our best to grapple with.

However, as we embark on this journey, we should remember that this is about far more than financial or demographic pressures. The economic climate has helped focus minds on prevention and asset-based approaches, but these have been around for a long time in Scotland and reflect a growing desire from people to have a different relationship with support and services.

People do not want to be viewed as problems, or passive recipients of services. They want to be treated as active citizens

People do not want to be viewed as problems, or passive recipients of services. Nor do they want to make do with simply having their most basic needs met (would any of us?). They want to be treated as active citizens who contribute and enjoy the right to live high quality, independent lives in which they are in control. It is that energy and motivation that will provide the real driving force behind this agenda.

A copy of the recently published report on the Long Term Conditions and Social Care Dialogue event can be found here: Long Term Conditions and Social Care Dialogue event report.

By Ian Welsh, Chief Executive, Long Term Conditions Alliance Scotland

Issue 2: March 2012

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