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Finding Answers To The "If Only..." Challenge

Finding Answers To The "If Only..." Challenge


Dr Rory Truell
December 2007

All of us are familiar with the horror stories of child abuse, neglect and poverty-related illness that could have been prevented, if only…

This year the government has focused a large amount of resource on stemming family violence. The unacceptable statistics and the message “It’s not OK!” are being widely broadcast for everyone to see, from passengers arriving at Auckland Airport to TV viewers.

From the perspective of the social services sector this type of programme signals a positive commitment to addressing serious social issues at a higher level. What it also points to is a need for the government to be taking a more comprehensive lead on building cooperation where it is most needed: at the points of pressure between our social services and health services.

Whenever there is a crisis with New Zealand children, calls for cooperation between the health and social services sectors are voiced far and wide.

The reality is that we are swamped with a multitude of NGOs, PHOs, commissions, charities and government departments dedicated to supporting families and community wellbeing. Are they all working to the same set of goals? No.

Most agencies develop their agendas in isolation from any overarching requirements for integrated services. This creates not only the gaps that lead to the horror stories of child abuse and poor health, it also shapes the sector into a competitive and boundary driven mindset where all too often agencies compete for funding.

In the UK major advances have been made in its child health and wellbeing outcomes by ensuring that agencies work together. Legislation such as the Children Act (2004) explicitly requires social and health services to cooperate to ensure the physical, educational, emotional, social and mental wellbeing of children is protected. Similar requirements are made in health and local council legislation. In the UK failure to follow these intersectoral demands would be a breach of the law. If only that was the case here.

In New Zealand the task of trying to unite our fragmented health and social services is an uphill challenge. It’s left to the compassionate leaders and professionals of those services; people who do not have sector-wide authority or mandate.

Perhaps a commonsense starting point for New Zealand is for the government to set clear requirements for intersectoral work in agencies that are found in every community. This would entail all PHOs, hospitals, CYFS, Iwi and schools to meet regularly and alongside other local agencies to develop comprehensive plans that provide full and integrated support to their communities.

Leading an integrated health and social services strategy is the government’s responsibility. It’s not OK to be doing anything less than that.

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Dr Rory Truell is Head of the national industry training organisation for social services, Te Kaiāwhina Ahumahi, responsible for training people in social services. He holds a Doctorate of Health Sciences as well as qualifications in Social Work, Community Welfare, Clinical Supervision and Psychotherapy.

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