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.