Integration of social services in Belgium,

in particular in Flanders

European Conference on Integrated Social Services

Council of EuropeWarsaw, Poland, 14-15 June 2007

J. Mostinckx, former director of Social Services Ministry of Flanders Department Social Services, Public Health and

Family. Belgium

Why goverment decided to integrate social services?

1. To avoid the overlapping and multiple use of social services

2. To deal more effectively with complex social problems

3. To facilitate access to social services and social rights, in particular for the most vulnerable social groups

4. To simplify and accelerate service delivery5. To improve efficiency, effectiveness and client-

friendliness of service provision

Social serviceswere in Belgium initially developed

by:

1. The Ministry of Justice

2. The Ministry of Public Health

3. The Ministry of Education

4. The Ministry of Employment

5. The Ministry of Culture

=> 15 different recognition systems and grant shemes

Three most important integration movements

1. 1980: Federal administrative reform

2. 1990-2004: The regions promoted mergers and co-operative ventures of social services by:

recognition procedures subsidy decrees

3. 2004: Decentralisation of social services to the local level

1. Federal administrative reform and integration

The social services which depended till 1980 on different national ministries

Were granted to the Flemish, French and German communities authority In Flanders the granted Welfare, Health and Family matters were brought together in one department: Department of Social Services, Public Health and Family

By bringing together different social services

in one ministerial department

It became easier to compare different welfare provisions and see the problems

it was not clear to the clients what they could expect and where they could expect it => users couldn’t see the wood for the trees!overlaps and duplicated use became apparent problems with professionalism and quality

2. Integration process after the state reform of 1980

1. [Federal: the 1980 Federal State reform law bringing together the welfare, health and family matters within one department of the two regions]

2. Regional:1. 1991: Integration Acts on general social work2. 1998: Integration Act of the school medical

inspection and psycho-medical-social centres3. 1999: Integration Act of mental health care4. 2004: Act on integrated youth support

3. [Local: : Act of 2004 on integrated local policy => social house]

2.1. The first Flemish Parliament Integration Act on general social

work

brought different forms of non-residential andresidential social work

together in 1991

Effect of integration plan

1980-90: general social work: 38 different decrees15 different subsidy regulations or grant systems

1994:355 different centres 1,025 FT social workers (sw) => an average of 2,8 social workers per centre

2003:1 recognition system and 1 grant scheme 27 independent centres for social work1,075 FT SW => an average of 40 sw per centre

The Parliament Integration Act of 1991 had four objectives:

1. Greater legal security for the private social work centres

2. A better position and profile for the sector within overall welfare and care.

3. Creating a coherent and integrated network of balanced, spread and accessible provisions.

4. Harmonisation of the regulatory framework for all the recognised provisions in general social work

2.2.Integrated youth supportThe 7 May 2004 Flemish Parliament Act on integrated youth support

provides a framework for intersectorial co-operation and co-ordinationdetermines the aim and operating principles of integrated youth support determines which sectors participateproposes a number of concrete forms of co-operation and co-ordinationestablishes an intersectorial policy

The following “sectors” form part of

integrated youth support Public agencies:

Agency for Special Youth Assistance Agency for the Social Integration of

Disabled Persons Agency for Child and Family

Private centres General social work centres Family Care Centres Mental Health Care Centres Pupil Guidance Centres

The operating principles : Accessibility: well known, available,

comprehensible and affordable Demand-oriented Subsidiarity: a preference for the least

interventionist alternative Client participation: dialogue Acceptance: support is only provided if

the client agrees, unless the juvenile court decides differently

Emancipation: aimed at increasing the possibilities to act independently.

2.3. Integration of the school medical inspection

and the psycho-medical-social centres

Merging of: 104 school medical inspection centres and 201 psycho-medical-social centres

to 75 pupil guidance centres school doctors and nurses started to co-

operate with psychologists, pedagogues and other experts

supporting schools and parents.

The pupil guidance centres (Act of Dec. 1998) started to work as on 1 Sept. 2000.

2.4. Integration of mental health care

Parliament Act of May 1999 was implemented in Dec. 1999

The objectives a broadening of scopemore room for managementa clear second line positionemphasis on weaker groups, children and the elderly

Integration: 84 centres in 1988 merged to 21 centres in 1998, evenly spread throughout FlandersThe budget increased from 28.9 million euros in 1998 to 41 million euros in 2004. In 1998: 620 FT care workers were subsidised, and in 2003: 880.

3. The social house

Integration of social and care services by local social

policy

The Local Social Policy project aims at:

assigning a stronger coordinating role to the local authoritiesachieving more integration in a fragmented field of service provisioncontinuing to work on an accessible, client-friendly social service provisionproviding more concrete possibilities for organisations, target groups and citizens to participate.

The following initiatives were introduced July 2001:

The creation of a framework for local social policyThe drawing up and implementation of a concrete action plan regarding local social policyThe start-up of a number of pilot projects related to the social projects

Result: Social houseIs a one-stop shop for citizens with regard to social service provision in their municipalityProvides “integrated access” to the social service provision of both

the municipalityand the local public centre for social welfare

Allows citizens to gain easier access to their social rightsto be helped in an effective way

4. Summary and conclusionsThe integration of social services was a reform that lasted 25 years Policy makers, managers of social services and social workers were initially demanding parties for integrationOnce the integration process was in full swing dissatisfaction aroseToday there is a general contentment about the different integration processes.

Administrative reforms and integration of social services

Administrative reforms, (e.g. State reform in Belgium) are ideal moments for starting integration processes=> are preceded by social consultation and parliamentary

debates

The need to work together on a permanent or structural basis can be more easily achieved at lower administrative levels => decentralisation (Social House)It is necessary to work with different procedures at the different levels (federal, regional, and local) It is necessary to adopt both a ‘bottom-up’ and a ‘top-down’ approach.

Economies (cuts) and integration of social services

Co-operative ventures (joint-working, partnership, collaboration, networking) are:

sometimes a necessary transition to integration but are expensive and time consuming.

Permanent and functional mergers: are more invasive but also more efficient are more client-friendlycost money in the short termare economical in the long term

e.g. envelope-system (fixed amount) in the general social work

The budget increasing factors in the case of integration

Harmonising salaries Mergers result in larger companies:

A large company => more hierarchy higher salary costs more administrative and management costs

In all sectors where integration was introduced there was a considerable increase in the budget in the first years

Access to social rights and integration of social services

The most important results of integration in our experiences are:

quality policyresult-oriented managementclient-friendliness improving access to social rights=> in particular for the most vulnerable

groups

adoption of a more holistic approach in meeting the needs of service users.