The first Government of Wales Acts (1998) legislated for the establishment of the Welsh Assembly (a year later), and health, social care and education were among the twenty policy areas devolved to Wales. The second Act (2006) brought about the separation of the executive body (the government) from the legislative body, and provided enhanced legislative powers for the Welsh Assembly Government (now more commonly known as the Welsh Government). This Act also legislated for the future acquisition of full law-making powers for Wales, without the need for further legislation. In 2011, following a referendum, the Welsh population voted to bring primary law-making powers to Wales. Wales now, therefore, has its own law-making process in twenty devolved areas, including health and social care (Welsh Government, 2012).
Since 1998, therefore, legislation and policy in relation to health and social care in Wales has developed a distinctive Welsh perspective. Wales has always had a tradition of participation and working in partnership in health and social care policy development, but devolution created an environment in which the ‘Welsh Way’ could move forward, providing Welsh solutions to Welsh problems (Williams, 2011). Services in Wales have consequently moved away from a market model of care provision, instead aspiring to a model of ‘Progressive Universalism’ (Drakeford, 2007) – services for all (in which all citizens are stakeholders), but with a particular emphasis where there is greatest need. This has brought (and will continue to bring) inevitable changes for social workers in Wales as they support Welsh citizens, including vulnerable adults and children, young people, families and communities. Such changes will include legislation and policy, social work practice and service delivery, linguistic and cultural needs, and of course an ever-changing landscape in terms of the citizens of Wales and their needs, wishes and aspirations.
The ‘Welsh Way’ is reflected across Welsh policy and legislation in health and social care, and the need to address the needs of the citizens of Wales is woven into all policy and legislation produced by the Welsh Government. With regard to children, young people and families, for example, there is a greater commitment to incorporating the principles of the United Nations Convention on the Rights of the Child into all policies and legislation. The Children’s Commissioner for Wales [Tip: hold Ctrl and click a link to open it in a new tab. (Hide tip)] was the UK’s first independent human rights institution specifically for children. Two further Commissioners have since been appointed – the Older Peoples’ Commissioner for Wales and the Welsh Language Commissioner. The role of all three commissioners includes promotion of citizens’ rights in Wales.
A commitment to local service delivery which ‘emphasises cooperation over competition, and partnership over contestability’ (Williams, 2011, p. 26), means that social work, delivered through social services departments based in the Local Authorities, will continue to have a major role to play in in the delivery of citizen-focused services in Wales. Social work will play a key role in providing Welsh solutions to Welsh problems.
The White Paper Sustainable Social Services: A Framework for Action (Welsh Assembly Government, 2011) clearly set out the Welsh Government’s priorities for action to bring about ‘high quality responsive, citizen-centred social services’ (Welsh Assembly Government, 2011, p. 3), taking into account demographic and financial changes, and ‘placing the professional contribution of social workers and social care workers even more at the heart of services’ (p. 24). Furthermore, the aspiration is that working in partnership with service users and carers in the design and delivery of services will ensure their voice is heard at this stage of service provision. In this way, service users and carers are seen as partners with local government, engaged in co-production, rather than being mere consumers of what is provided. The Social Services and Wellbeing Act (2014) aims to address the issues raised in the White Paper, and will transform care and support in Wales. This will be achieved through working in partnership with service users to identify their needs and decide what kind of services will best maintain and enhance their wellbeing and promote their independence (Welsh Local Government Association, 2012) This outcomes-focused, partnership approach, concerned with wellbeing for people as individuals, as part of their family, and as part of their community, is a distinctive feature of the policy and legislative agenda in Wales.
A visit to the Welsh Government health and social care website will allow you to find Welsh strategies, reports and other documents specific to a range of service user groups, while the National Archives website provides links to Measures (legislation created prior to 2011) and Acts of the National Assembly for Wales. In the next activity, you will investigate what Welsh policy and legislation has to say about service provision for a particular service user group.
Activity 3: Reflecting the ‘Welsh Way’ in policies
You are going to look briefly at the mental health and wellbeing strategy for Wales, which you will find on the webpage: ‘Together for Mental Health’.
This page outlines the main themes of the strategy. Scroll to the bottom of the page and download the strategy itself. Read through the executive summary (pages 5 – 10) and make some brief notes on how you think these reflect the ‘Welsh Way’, particularly in relation to citizen-centred services and service user/carer involvement. How might the strategy affect both the general public AND target particular needs?
Together for Mental Health sets out the Welsh Government’s ‘vision for 21st century mental health services’. It builds on the Mental Health (Wales) Measure (2010), which places legal duties on Health Boards and Local Authorities to improve support for people with mental ill-health, and should be viewed alongside Together for Health (2011), the strategy for the NHS in Wales, and Sustainable Social Services, (Welsh Assembly Government, 2011), mentioned above.
The strategy is the first mental health and wellbeing strategy for Wales, covering both adults and children, and focuses on promotion of good mental health, prevention of mental health problems, and improvement of mental health services. Taking an outcomes-focused approach (with a delivery plan), the strategy endeavours to view developments from the service user perspective, and to ensure its objectives are measurable,
The citizens of Wales also have an important role in the drive to tackle stigma and discrimination, and service users and carers must be involved in the planning and delivery of mental health services. Health and social services will be expected to work together in new ways in order to address factors in peoples’ lives that may affect their mental health and wellbeing.
However, these bold intentions will have to be met within existing resources that in the current context of budget cuts will prove challenging. Nonetheless, it might be argued that the underlying values of citizen rights, listening to the service user voice, and moving away from the market model of care provision in Wales, provide a refreshing return to the values of the social work profession. As you reflect on this, you might like to consider whether or not you agree with this view.
The legislative programme in Wales will continue apace, with an increasingly divergent agenda from the other nations of the UK. The responsibility of intervening in people’s lives, sometimes against their wishes, makes it imperative that social workers become familiar with the legislative and policy context in Wales, as this is what underpins and informs their practice, and ultimately has an impact on the lives of service users and carers.