tor June 17, 1972
ety Ster lfare Smith
N°rthern Ireland, as is often the case, ironically proceeded quite differently , ,'oninally Ulster has had integrated ervices administered through local „LY welfare departments since the the 'forties; except for some s,011slY complex ministerial responsi,,the principles of the situation qinlost have been a model for 1141; In practice several of the eight were too small to provide a eservice and suffered from being ihaf,r°111 centres of new thinking. The tr aining. courses were slow to get tn the Province meant that workers r, " England to qualify, many not to AnY discussion of the future of . needed therefore to be linked with er question of local government d a debate which has raged in 0r has less than elsewhere in the UK. 04(11 has two cities, Belfast and errY, each exercising virtually 50Wers, and six counties with a tier of districts under them. Several actors distinguished Northern IrelicInn the British situation — the e in Stormont of a ' regional ' parliament, the discredit into which certain sections of the local government system had fallen, the decision in 1969 to remove housing powers from local authorities to a central agency, and the influential position of the Ministry of Health and Social Services. The latter produced a Green Paper early in 1969 on the administrative structure of health and personal social services which proposed their integration under a single board responsible directly to the minister, in effect their removal from the present structure of local government. Stormont conceded the Green Paper's case before appointing a review body under the chairmanship of Patrick MacRory, and the MacRory Report, published in 1970, has become more or less Ireland's Maud. The major difference from arrangements elsewhere in the UK will be the joint running of health and social services. The Seebohm Report made a point of the need to separate the two clearly, largely it seems because only alone could social work develop the professionalism required for its development. It is therefore surprising that social workers in Ulster have welcomed their local plans. They have managed, however, to build into the proposals a measure of independence that will guarantee for 'example that a proportion of resources will be earmarked for social service development rather than being swallowed in the much larger medical budget. Each area board must appoint separate committees for the health and personal social services. The social workers' identity is preserved 955 throughout the staffing structure, achieving for them a more distinct status in management than that of the dentists, technicians, pharmacists and other paramedical officers. The plan offers social services progress towards parity of power with nursing and medical staff far more clearly than the comparable British operation; and the structure builds in opportunities for professional consultation which have long been accepted by doctors — which were in fact a sine qua non of their co-operation — but which are a marked advance for social workers.
There can be no denying that the Ulster plan will provide for far more effective integration of the interlocking spheres of medicine and social work than the total separation of powers that is occurring in the rest of the UK. The British situation was brought about on the one hand by social workers' insistence on not being dominated by doctors and on the other by the doctors' long maintained hostility to local authority control. Given those apparently unmovable blocks, it was inevitable that services should be separated between central and local government. When next year both area health boards and the new counties and metropolitan districts are established, there will at least be co-terminous boundaries as a basis for co-operation. If the Northern Ireland experiment works well, is it too much to hope that the British arrangements might eventually be reviewed? Trend-spotters for the reorganisation after next will do well to watch Ulster
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