Health and Social Care Integration, Integrated Services, Integration, Live Debates, Service Integration

Integrate or disintegrate? – Opinion piece by Nick Berbiers


Oh the horror….the horror….I only have to hear the merest muted whisper of the word ‘integration’ and the toe-curling, seat-wriggling, cold-sweat-inducing memory just bursts back in all its shameful splendour. We shall call it ‘the integration episode’.

It is 1998, a scorching hot day, and I am on a Q&A platform at the culmination of a national children’s service conference. Quite how I ended up on a panel of such luminaries is utterly beyond me – clearly a surreal administrative error of the highest order – none the less, there I was.

Amongst this veritable Who’s Who of children’s social work notaries (plus me), sits to my left a bona fide social work great. A man who has achieved and been honoured for his decades of truly brilliant work, and who happens be an extremely nice person and a huge hero of mine. He is a perfect example of what used to be termed a real gent’: more on him later.

Fortunately for the large audience, all the questions so far had been directed to or been answered by one of the wiser panel members: i.e. everyone on the panel who wasn’t me. Then someone stood up and asked, ‘What future innovation or development do you think could most improve child protection?’ And for reasons I cannot begin to fathom – pity, I suspect – our Chair decided that that one should go to me.

Well, you will begin to see where this is going if I reveal that I began my ‘speech’ by standing up and proclaiming in a booming declamatory tone, ‘Integration, integration, integration!’ (Yes reader, I am afraid I really did do the repeat three times for effect thing…..and I am now sitting here making very loud groaning noises.)

Perhaps the lunchtime prawn sandwiches were dodgy, or perhaps it was the heat, but for reasons I cannot begin to explain I then launched into a lengthy laudatory oration of this stunning new concept in children’s services that was being termed ‘integration’. And I mean oration. On and on I went, increasingly thrilled by my own voice, vision and soaring rhetoric. This new fella Blair was a great supporter of the idea, I told them, and it would change the world I told them, and a new day was dawning in children’s services I told them (oh dear lord, I actually used that phrase too – but at least left off ‘Is it not?’, because I still knew in my fevered mind that ‘Is it not?’ is a really, really naff adjunct).

To give you some further insight, I gather – as I have understandably repressed as much of this as possible – that within this stunning tour de force, I also managed to squeeze-in an historical overview of all UK social work history since 1900 in order to fully reinforce my most excellent points.

And so it went on….and on….and on….and on…..

Now you would think – and sincerely hope for my sake – that this is as bad as this story gets, but oh no, no, no. Much like the poor audience that day, there is no respite. You have only had heard the half of it!

As I proceeded with this wild-eyed monologue, my previously mentioned esteemed panel colleague quietly begins to chuckle, softly and intermittently at first, then more frequently: I can hear this off to my left! Then he begins to laugh, again quietly and intermittently at first, then more, then more, to the point when he is just plain laughing every few seconds.

Just to break stride for a moment – unlike I did that day – two points. One, this lovely bloke would never intentionally do anything so discourteous on purpose, but by dint of the dodgy prawn sandwiches and/or the heat and/or whatever it was in the air that day, had obviously been infected with the same affliction as me. And two, far more bizarrely, I just kept going and going and going taking absolutely no notice.

Finally, when I had completely run out of steam, I then turned to my esteemed panel colleague and in the most huffy, haughty (and hoarse by this point) voice I could muster, said, ‘And you so OBVIOUSLY disagree!’

‘No,’ he said, ‘it’s not that it shouldn’t happen, it’s that it never will.’ And with those simple words, in that very odd, inexplicable metaphysical way that occurs sometimes, he grounded everything.

So whilst a cringingly embarrassing story about me it does serve as a good metaphor. Though he and I will still have to agree to disagree on his definitive ‘never’, events of the past fifteen years do prove that he was and is a fair wiser owl than me: not that that was ever in any doubt. Because for all the rhetoric, the genuine commitment, the effort by so many, and the legislation, polices, and guidance, even a children’s services integration advocate like me would have to concede that we have only inched a little further along the road. It is a very easy subject to wax lyrical about, but it is very hard to deliver.

That said, I continue to believe that there remain innumerable untried, untapped ways of bringing the component parts of children’s services together, to work ever more closely to better protect, meet the needs of, and provide care when required, for all children and young people. You can call that integration or you can call that alignment – the terms are far less important than the actions. I look forward to debating such issues with both other UK colleagues about our experiences, and with international colleagues about theirs – for our countries have not all taken exactly the same approach toward integration in children’s and adult services (far from it) and there are many lessons to learn from each other – at the next @SWSCMedia Twitter debate. I very much look forward to seeing you there.

Nick Berbiers (@NickBerbiers) is a Social Care Interim Manager and Consultant at Neist Point Limited.

Join us every Tuesday at 20:00 GMT / 15:00 EST for an exciting and enriching Twitter Debate @SWSCmedia.

Also read Nick Berbiers’ great article in Community Care: Which debate tells us more about social work today; NCAS of Twitter?

 

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