The Parliamentary Review of Health and Social Care in Wales: A New Health Policy Landscape for Wales?

30 January 2018

The community and family orientated approaches outlined in the independent review of Health and Social Care in Wales provides a great sense of optimism: that individuals will stop being viewed in isolation, with a community public mental health approach underpinning the recommendations.

The independent panel outlined how "bold new models" of care are required to meet the needs of individuals, families and communities alike, with a keen emphasis the on prevention throughout. Each of the four mutually supportive goals – "the Quadruple Aim" – presented in the review recognise the importance of looking upstream to address the root causes of mental health challenges. They are continually to: 

  1. improve population health and wellbeing through a focus on prevention
  2. improve the experience and quality of care for individuals and families
  3. enrich the wellbeing, capability and engagement of the health and social care workforce
  4. increase the value achieved from funding of health and care through improvement, innovation, use of best practice, and eliminating waste.

Strategic, system-wide activity is necessary to take advantage of the opportunities to improve mental health at all stages of life, particularly at times when individuals, families and communities experience adversity, and during times of transition from one life stage to another.

If we are to rise to the challenge of reducing the prevalence of mental health problems, we will need to revise the way we view mental health and where it is owned. We will need to move from a dominant mental health 'deficit' model to one which views mental health as a universal asset to be strengthened and protected.

It is particularly encouraging to see the report identify children’s mental health and wellbeing as priority; in working to reduce the prevalence and the distress caused by mental health problems we recognise that to make the biggest difference, we need to start at the earliest point, focusing a good deal on child development in the early years. The delay in identifying children at risk and providing effective early intervention means that many young people enter adulthood with untreated conditions, while other symptoms may only develop once they have reached adulthood.

Socio-economic disadvantages such as poverty, but also exposure to abuse and other adverse experiences, place people at greater risk of developing mental health problems. Children and young people living in these circumstances are two to three times more likely to develop mental health problems. This sets the scene for a spiral of disadvantage that all too often accumulates across life. When mental health problems are established, these can lead to a series of detrimental effects on people's life chances.

The reports sense of urgency to achieve its vision of 'the Quadruple Aim' presents a real opportunity to address the stark health inequalities identified across Wales. We urge the Welsh government mirror this appetite for change and to accept the recommendations from this review in full and to provide detail on how the recommendations will be funding and how progress will be measured to ensure they are delivered in full.