Plaid Cymru call to scrap or boost local health boards
Plans to scrap or boost the role of the seven local health boards in Wales have been launched by Plaid Cymru.
It is inviting comments on a paper calling for a "radical restructure of Health and Social Services".
Seven local health boards look after GPs, community care and hospitals in Wales while the 22 local authorities are in charge of social care.
Plaid Cymru argues that having two separate systems creates unnecessary bureaucracy and delays for patients.
The party is inviting comments on two different models, one of which is to scrap local health boards and replace them with one national health board to deliver hospital and specialist care.
Local authorities would be given the responsibility to deliver primary care and community health services.
The other option presented in the paper is to bring adult social care services under the control of the seven local health boards.
This option, the party says, would need to involve making health boards "more democratic and accountable".
Plaid Cymru's health spokesperson Elin Jones said: "These proposals are about streamlining the system so that we have a much more dynamic service.
"It's clear that the current model of health and social care is too cumbersome.
"There are too many boundaries in the system that cause unnecessary bureaucracy which delays the transfer of patients throughout their recovery process.
"As a result, there are blockages in the system that cost us time and money."
She added: "Piecemeal reform, as is proposed by the Welsh government, is short-sighted and will, ultimately, end in failure.
"The time has come to work more smartly, more collaboratively and put the needs of patients first. This can only be achieved through the creation of a new National Health and Social Care service.
"We would invite anyone with an interest in our health service and its future to contribute to the debate."
But some professional bodies that represent NHS staff have expressed concerns about the idea of scrapping local health boards.
Dr Philip Banfield, chair of the British Medical Association's Welsh Council, is against the plans.
He said they would be "especially concerned about local authorities running primary care which deals with over 19 million consultations" against the background of falling investment and concerns "that local authorities would not have the necessary resources and infrastructure to deliver primary and community care".
"Furthermore, a single health board for the whole of Wales would take away local accountability and bring with it the likelihood of widening inequalities of provision for the old and vulnerable," he added.
"Closer collaboration between health and social care has always made sense and was the prime motivation of the First Secretary appointing a Health and Social Services Minister in the first Assembly in 1999.
"However, the option of bringing adult social care services under the responsibility of the seven local health boards must be accompanied by the financial resources to do so."
But Nicola Davies-Job, associate director for professional practice at the Royal College of Nursing (RCN) in Wales believes the idea is not such a radical move.
She said: "We'd have the same situation we're in now - you'd still have bureaucracy between two departments.
"You'd still have patients with delays in transfer of care as the finance would still be in two different departments. The service would be more disjointed.
"The RCN thinks the proposal to transfer control of adult social services to local health boards is the preferred option."
A spokesman for Health Minister Mark Drakeford said Plaid's policy document would be read "with interest".
"We hope this signals an attempt to think seriously about the future of the NHS and social services in Wales and, if it does, the ministers will look carefully at what the party is saying," he added.