Latest news stories and opinions about the Dental, GP and Care Industries. For your ease of use, we have established categories under which you can source the relevant articles and news items.
Eurocare 2: A Welsh perspective on equity for minority EU groups
1) aging populations
2) restricted finances due to austerity
and 3) a reduction in the number of working adults to pay into the state coffers.
I also touched on the increasing importance of evidence-based planning and provision. At the heart of this is the need to undertake detailed community profiling in order to discern the level and specific types of need presented by a given population.
Now consider the following cameos:
- In Wales, as in other areas of the UK, we have had problems providing for the travelling/Romany community. This has been seen in a shortage of sites for travellers, partly resulting from intolerance of ‘host’ communities, and subsequent failure to accommodate them within primary health, education and social care services.
- Like many other countries, Wales and the rest of the UK has also historically excluded (discriminated against?) prisoners from mainstream social care regulations. This has often resulted in last-minute and hurried assessments of complex personal circumstances immediately post-release, resulting in oversights in provision of even basic services such as providing accommodation or mental health care.
- In Spain there is evidence that British and other northern European pensioners are not receiving services on the same basis as indigenous Spaniards. These expats once formed a temporary population who would return back to their home country in anticipation of very old age. However the current generation are trapped due to a reduction in spending power following the economic collapse of the late 2000's.
This kind of planning is a statutory requirement in the UK, but not within all EU states, with service providers and local authorities in Wales required by the Well-being Act to collect and report data in order that services can be tailored accordingly. However, this does not mean that Wales or the rest of the UK has a clean bill of health when it comes to providing equitably for all communities (see first two cameos). As a further example consider that in Wales it remains the case that native Welsh speakers are often unable to receive services in their preferred language, despite Welsh Government attempts to increase Welsh language provision.
Shortfalls in provision
A move across the EU towards evidence-based planning and provision promises best possible efficacy and targeting of resources. Standardisation of assessment and provision based upon population profiling and epidemiological incidence appear to be spreading across member states as a result of research, sharing of best practice and EU policy designed to foster such initiatives. Whilst moves between member states towards harmonisation are occurring, considerable discrepancies still remain. Even within states there can be variance in how regions interpret, fund and implement policy, leading to a lottery of provision. As the three cameos show, shortfalls in provision can result from unhelpful historical attitudes (see those concerning Romany and prisoners) or weaknesses in profiling and evidence gathering (Spain), or elements of both.
Evidence-based planning is intended to ensure comprehensive cover across the full range of services, accessible by all citizens on the basis of need. Of course this is intended to address the needs of say immigrant, temporary citizens, subcultures or socially-excluded groups. Whilst the EU tolerates discrepancies between member states and even between regions as to how services are organised and administered, it is less forgiving of what might amount to discrimination under its Social Chapter/Human Rights directives.
The new Social Services and Well-being Wales (2014) Act mandates measures to consider the circumstances of prisoners, whilst still incarcerated, illustrating how legislatures can take a lead in addressing structural problems in provision. However EU states must work hard to ensure that provision is equitable and fair so as not to contravene social-chapter directives.
In my next article I will consider the challenges posed to member states by the huge influx of migrants over the past 12 months.