Partnerships in Health and Social Care
| Author | Tom Forbes,Debbie Evans |
| Published date | 01 January 2009 |
| Date | 01 January 2009 |
| DOI | http://doi.org/10.1177/0952076708097909 |
| Subject Matter | Articles |
Partnerships in Health and
Social Care
England and Scotland Compared
Debbie Evans
Wolverhampton University, UK
Tom Forbes
University of Stirling, UK
Abstract Since 1997 partnership working across the public sector has been a key theme
of UK Government and Scottish Executive policy. Both Governments’ policy
approaches initially converged on this theme. However, while the UK
Government has become lukewarm to the use of partnership working to
deliver public services, the Scottish Executive has remained true to the
partnership ethos. This article compares approaches to partnership working in
health and social care between the UK Government and the Scottish
Executive using a qualitative methodology based on semi-structured
interviews two English and two Scottish health and social care partnerships
are examined with regard to policy implementation of both Government’s
partnership agenda. The UK Government appears to have been confused over
its aims and objectives for health and social care, while the Scottish Executive
on the other hand has followed a more consistent approach beginning with the
integration of primary and secondary health services and desire to integrate
health and social services. However, in what appears to be a major flaw in
policy, both the UK Government and the Scottish Executive have privileged
the NHS as the main player in their health and social care partnership designs
at times alienating the Local Authorities. As a result, there has been a missed
the opportunity to develop true health and social care partnerships in the UK
that are fully inclusive of all partners and instead we have seen the retention
of many historical antecedents to effective joint working between the NHS
and Local Authorities.
Keywords England, health, partnership working, Scotland, social care
DOI: 10.1177/0952076708097909
Debbie Evans, The School of Health, University of Wolverhampton, Wolverhampton, WV1 1SB, UK.
Tom Forbes, The Department of Management, The University of Stirling, Stirling, FK9 4LA, UK.
[t.m.forbes@stir.ac.uk] 67
© Public Policy and Administration
SAGE Publications Ltd
Los Angeles, London, New Delhi
and Singapore
0952-0767
200901 24(1) 67–83
Introduction
Since 1997 the development of partnership working across the public sector has
been one of the key themes of UK government policy (Balloch and Taylor, 2001).
Partnership working is not in itself an innovative concept, with several studies out-
lining its potential prior to 1997 (Audit Commission, 1989; Wildridge et al.,
2004). Partnership working appears in a number of contexts (Oliver and Ebers,
1998). The strategy literature emphasizes the importance of firms cooperating
rather than competing with each other (Bresser, 1988) through, for example, joint
ventures (Harrigan, 1985) and strategic alliances (Lorenzoni and Baden-Fuller,
1995). The network literature suggests that partnership working leads to greater
resource impact, improved clientele support and favour with political elites
(Granovetter, 1985; Meier and O’Toole, 2001). Partnership working can also be
associated with inter-organizational domains. Organizations exist in environ-
ments that are uncertain, turbulent and changing (Trist, 1983). The problems they
face are complex, have no clearly identified boundaries and are often beyond the
scale or scope of any single organization to effectively manage (Sullivan and
Skelcher, 2002). There is therefore a need to pool expertise and resources in an
attempt to overcome these difficulties (Gray, 1989). Mackintosh (1992) and
Hastings (1996) also suggest that partnerships are created to generate synergy,
transform the goals and cultures of one or more organizations or to enlarge the
budget available to tackle a particular policy or welfare problem. The rationale for
partnership working is therefore clear and unambiguous.
One area where partnership working has been extensively developed has been
in health and social care. While a diverse range of partnership mechanisms have
emerged between health and social care (Dowling et al., 2004), equally diverse is
the policy approaches taken by each of the Regions that constitute the UK
(Exworthy, 2001). Varying modes of decentralization have allowed Scotland,
Wales and Northern Ireland to promote the modernization of health and social in
order to meet the needs of their respective communities (Greer, 2004). A key area
of policy divergence has occurred between the UK Government and the Scottish
Executive. This has been as a result of devolution in Scotland and the setting up of
a Scottish Parliament with health and social care becoming a devolved matter for
the then Scottish Executive. This article analyses some of the key policy differ-
ences that have arisen in relation to health and social care between England and
Scotland between 1997 and 2006. The article is structured as follows. Sections two
and three outline health and social care policy developments in England and
Scotland between 1997 and 2006. Section four provides an analysis of these key
policy differences. Section five provides the papers discussion and section six the
conclusion.
Public Policy and Administration 24(1)
68
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