Health and Social Care Regulation in Wales: An Integrated System of Political, Corporate and Professional Governance for Improving Public Health

By Jewel, Tony MBBChir, Ma, Frcgp, Ffph; Wilkinson, Jane Mbbs, Mrcgp, Ffph | The Journal of the Royal Society for the Promotion of Health, November 2008 | Go to article overview

Health and Social Care Regulation in Wales: An Integrated System of Political, Corporate and Professional Governance for Improving Public Health


Jewel, Tony MBBChir, Ma, Frcgp, Ffph, Wilkinson, Jane Mbbs, Mrcgp, Ffph, The Journal of the Royal Society for the Promotion of Health


Abstract

Wales is developing a unique integrated system of governance to improve public health, which is diverging from some recent developments in the rest of the UK but shares many common features. There is a focus on strengthening collaborative working and co-ordination between bodies inspecting, regulating and auditing health and social care. Systems are being developed that are proportionate to the level of risk, eliminate unnecessary burdens of external review and support the improvement of services for patients, service users and carers. This is consistent with the Assembly Government's aim to improve the way that public services are delivered in Wales, including strengthening input from the public in the planning, delivery and reporting of regulation and inspection work. The test in the future will be how far we can demonstrate quantitatively and qualitatively the added value from our uniquely Welsh approach, built as it is on devolution and the aspirations for small-country governance.

Key words

regulation; health; social care; public health; integrated

INTRODUCTION

Wales achieved devolution in 1999, after nearly 500 years since Wales was incorporated into 'England and Wales' by Henry VIII. Since the establishment of the National Assembly for Wales, the Welsh Assembly Government (WAG) has obtained more legislative powers from parliament following the Government of Wales Act 2006. The direction of travel is towards greater rather than less autonomy. Within Wales there is now a clearer distinction in this third, post- 1999 government between the representative, legislative and scrutiny roles of the National Assembly. There are 60 assembly members (AMs), and Welsh ministers perform the executive function through a cabinet of nine under the leadership of the First Minister. The Welsh ministers are supported in their political leadership and executive role by the WAG civil service, of which we form a part.

This article will set out how the various parts of public health and health and social care governance work in Wales. Some of these derive from the England and Wales reforms during the 1980s and 1990s, while others show how in Wales we are treading a path that is diverging from England and that seeks to demonstrate the benefit of 'smallcountry governance'.

Following the 2007 elections the WAG is led by a coalition between the Labour Party and Plaid Cymru, with a shared commitment to deliver the 'One Wales'1 commitments. The political context described is relevant to any debate about public health governance. In the particular context of Wales, as a nation within the UK, public health governance needs to take account of public and political accountabilities and systems of scrutiny. The devolution settlement for Wales involves areas where the responsibilities are largely devolved, such as health and education, and others where powers are retained by the UK government, such as the treasury and defence. The greatest area of expenditure in utilizing the overall budget of about £14bn is health and social services, which use approximately 40% of the overall resource. Therefore the cabinet, ministers and WAG members and the Welsh media attend closely to the strategic direction and performance in public health, health and social care.

At the WAG level there is less excuse than in Whitehall for silo working either between or within departments, and great opportunities for cross-departmental initiatives. All departmental heads meet weekly as part of the Permanent Secretary's Business Group and also make corporate decisions through a Strategic Delivery and Performance Board. The scale of the small nation is such that external colleagues such as local authority chief executives or NHS chief executives can be called together for face-to-face meetings and for leaders to get to know each other.

Politically the coalition government leans towards democratic participation by the citizen, relying less on market mechanisms and the part consumers play. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Health and Social Care Regulation in Wales: An Integrated System of Political, Corporate and Professional Governance for Improving Public Health
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.