Because change is an inevitable part of human existence, it is also timeless and unavoidable. This concept is insensitive to the current events in the UK’s social and health care sectors. The current state of health and social services is undergoing another painful restructuring, which is creating psychological as well as physical stress for the whole workforce and consumers. Due to constant reorganizations, changes in emphasis and redirections of care delivery for the general public, this trajectory is creating uncertainty about the future. People aren’t sure of their future or loyalty as the system changes cause great worry for all.
Retrospectively, the 1990s saw a significant conscientious transformation in health and social services (The NHS and Community Care Act), which restructured welfare systems to create what many managers and practitioners thought would be an advanced institution. The New Labour government from 1997 to 2010 altered the outlook and introduced new services such as personalization (direct payments, cash for care and personal budgets), which transformed the delivery of services within each sector. Mishaps in industrial relations policies and protocols can cause staff to lose commitment and make it difficult for them to maximize their services or be profitable.
Effective governance and scrutiny are required to ensure that social and health care reforms work for everyone. This includes changing organizational cultures, philosophy, and terms of reference. To make the reforms successful, it is essential to ensure that all new policies and structures are properly analysed. It is unclear whether the “New Ways of Working”, as it is called, is capable of altering the structures and fabric of the UK welfare services. The overhauls will focus on reducing costs/budgets and staffing, as well as improving the quality and standards of services.
Because costs are rising, standards are declining and waiting lists to assess are increasing across many social service departments, some of the decisions made in certain departments or services are being questioned as irrational. Quality newspapers agree that the coalition may not have done enough to implement social and health care modifications. However, they should have been properly evaluated. The plans could be a disaster without careful planning and governance. Despite this, most managers and health/social care workers have found it difficult to cope with the rapid restructuring and reallocations of services. Experts have found it difficult to understand the government’s plan to continue reforms, and their inability to make time to study and win professional support for these radical plans.
Given the outcry among clinicians and practitioners, one might wonder if the government’s defiance could be considered democratic or dictetorism. Democracy, on the other hand, is defined as “government for and by the people”. If this is true, then the coalition would be held responsible for any criticisms of their actions. Political vandalism of tax payers’ money and good governance could be described as the dismantling the (PCT-) Primary Care Trusts across the country over the next two to three years.
Similar concerns have been expressed by most local and strategic health authorities. This could have serious implications for services for older people, as well as other vulnerable groups like people with mental and physical disabilities. A large number of professional bodies, including the Nursing and Midwifery Council and British Medical Association, have also highlighted this issue. Criticisms of the government are now unseasonable because social and health care organizations need to double their expected cuts to stay afloat.
The rising number of older people is posing a serious threat to welfare services and public services. This is despite the extraordinary support of informal caregivers, who are estimated to have saved the government more than eleven billion pounds (PS11bn). However, it is necessary to make changes in order to reduce duplication within the system. Therefore, it is important that all stakeholders (national and local governments, social care, and health care) form a long-term strategic alliance. This would ensure and strengthen collaboration services, and minimize costs and waste within the relevant sectors. It is clear that the economic state, both macro and micro, is not stable. This is because of the volatility in the financial markets and the escalating cost of maintaining health and social services.
The UK’s ageing universal services have been difficult to plan, manage and administer due to the disproportionately large cuts made by local authorities. According to the Big Society agenda, the government should delegate responsibilities to the community and individuals as well as families, the third sector, and other groups. This would allow service users to continue receiving care while the restructuring process is underway, according to all assumptions. The key to the success of the reforms would be to ensure effective control and oversight over all workflow patterns and service delivery. This has been a huge problem for organizations and managers as the details of the shake up are superficial in terms economics and sociopolitics, in line with UK social policy.
The government appears unconcerned about the proposal by the House of Commons’ health select committee that councillors be appointed to the boards of GPs consortiums. Reflection shows that the quality and capability of representatives from some voluntary bodies, such as the patients/service user liaison body or the local involvement network agencies, could be inconsistent due to clinical and financial expertise. As a scrutiny committee it would be difficult to work closely with Health Watch and the health-and-wellbeing boards.