The proposed creation of an integrated health and social care board “has to happen”, according to NHS Shetland chairman Ian Kinniburgh.
Councillors earlier this month voted against the proposal for a “health and social care partnership committee” composed of seven councillors and seven NHS board members, plus other non-voting members because of fears it would reduce the level of democratic control.
However, NHS Shetland board members at their meeting today unanimously supported setting up the committee and Mr Kinniburgh insisted it was “too good an opportunity to miss”.
The committee would take responsibility for areas previously dealt with separately by SIC and NHS, such as adult social work, criminal justice, mental health, dental services, and various medical and nursing services.
The Scottish government is considering a bill requiring all local authorities to set up such partnerships. Until that bill is enacted in April 2015, the new committee would act as a “shadow” committee.
But councillors treated the proposal with a great deal of suspicion and voted against it earlier this month. Although they had no objection in principle to closer ties with NHS, they felt the fact that the NHS contingent was not elected by the Shetland public would mean democracy would be undermined. To establish anything so far ahead of April 2015 would be “jumping the gun”, according to councillor Billy Fox.
NHS chief executive Ralph Roberts said he did not accept things were moving too fast as joint working had been going on for a decade, for example in the care centres. “People need to understand we’re moving forward on this,” he said.
Mr Kinniburgh said establishing the joint committee would be a “real opportunity to make a difference” and the shadow committee would be a way of learning to work together.
There was a need to make SIC more familiar with the workings of NHS, he said, to strengthen the relationship between the organisations. He said: “We’re absolutely committed to making joint working work, we’ve been leading the way in Scotland for nearly 10 years.”
NHS board member, Cecil Smith, who is also SIC social services chairman, said he was “disappointed” at the SIC’s decision. He said the members had not seen written evidence of the benefits of setting up the committee, but “we’ve got to keep going and make it work”.
NHS board member Keith Massey spoke of his “extreme disappointment” over the council’s vote, as Shetland had always been a “shining example” of joint working over the last decade.
He added that there could be duplication and waste if the services did not work together.
Member Malcolm Bell, who is also SIC convener, said: “There is a history of joint working in Shetland, it’s clearly the direction of travel in Scotland, it’s going to happen, it’s as simple as that. The customer doesn’t care if it’s the council or the health board delivering services.”
He said that the council had not actually rejected the idea of integration but had been concerned about the “different cultures” working together.
It had been “a bit of a blip”, but he said, “we will move forward.”
He added: “We are still up there with the best of them [in Scotland] on service delivery.”
Director of public health Sarah Taylor said the council’s stance was “not a major setback” and the health board was working to iron out some of the “challenges”.
Mr Smith agreed the council’s vote was a “minor blip”. He said: “It’s not the end of the journey. We will continue to work together, we have to work together.”
Recruiting for the joint post of head of community care would be a “huge opportunity to make sure this works”, he added.