The Congress,

1. Having regard to the report presented by Mr Markku Andersson on behalf of the Working Group on the "Responsibilities of Local and Regional Authorities in the Social Services Field";

Considering that:

2. There is no universal vocabulary of social welfare, since perceived needs and the ability to address them determines each society's range of social services. The processes of economic and social change create new prospects and new hazards for every generation, which requires constant adjustment on the part of the social services;

3. Political considerations and levels of resources largely determine how social services are organised. Ethnicity and urban deprivation have added new dimensions to needs that cut across the traditional client categories of families, children, youth, the sick and handicapped, the unemployed, the aged, and the delinquent;

4. Improving the health and well-being of the population and cutting social inequalities are nevertheless top priorities for all democratic governments;

5. Good social services are vital to people's quality of life, since they are aimed at:

a. reducing the incidence of avoidable illness, disease and injury in the population,

b. enabling people who are unable to perform essential activities of daily living, including those with disability or chronic illness to live as full and normal lives as possible,

c. maximising the social development of children within stable family settings, and

d. reducing disparity between population groups, for example people on lower incomes, minorities, the elderly and residents of rural areas;

6. Proposes that the 12^th Conference of European Ministers Responsible for Local Government take into consideration the following aspects when discussing the role of local and regional authorities in the provision of local social services:

Diversity

7. There are marked national variations in the organisation and funding of social services:

a. there are differences in the relative importance of central, regional and local governments with respect to statutory funding, policy-making and service delivery,

b. there are differences in the relative importance of the statutory, voluntary and private sectors. Even if governments are the major contributors, the proportional allocation of funds for the statutory and non-statutory sectors varies from country to country;

c. there are also variations in the degree of administrative autonomy granted to the personal social services;

8. There is also a great diversity of local government systems: local and regional authorities have different legislative and electoral mandate to develop policies, plan and provide for the local needs of their communities. The resources available to, and the level of needs of local communities also vary significantly across Europe;

9. It is difficult to succinctly outline the role that local and regional authorities play in the provision of health and community services due to variations and types of communities, as well as the reforms that are occurring in local government functions and management across Europe;

10 Programmes provided by all spheres of government need to recognise and take account of these variations: No one model is applicable for planning, co-ordinating and delivering health and social services in all parts of Europe. Different approaches to service planning and provision in different municipalities or regions, in line with local needs and service systems are perfectly acceptable;

Decentralisation

11. In accordance with Article 4.3 of the European Charter of Local Self-Government “public responsibilities shall generally be exercised, in preference, by those authorities which are closest to the citizen”;

12. As the level of government which is closest to the people, local government appreciates the links between components of health and community services such as public health, recreation and leisure, housing, services for families and services for the aged. Since these services are delivered locally, they need to be shaped locally to meet local needs and the wishes of users;

13. It is the sphere of government which gives its special expertise and responsibilities in ensuring that the wide, and often conflicting, variety of needs of the community are met in a co-ordinated way. It has significant experience in balancing the claims of often conflicting interest groups. It can also co-ordinate various efforts to provide more effective services able to better address local needs;

14. Local and regional authorities have a key role in needs identification and prioritising, user consultation, planning and implementation of infrastructure and services. Their focus on the community interest means they can play a unique role in promoting community and public health. Virtually all functions performed by local and regional government have some direct or indirect impact on the health and well-being of the local population;

15. Local and regional governments legitimately claim a significant role in planning and provision of co-ordinated local social services (including both community and health services) as part of their role in providing governance of local communities. Besides their major role in many countries in planning and service provision, local and regional authorities are able to take a holistic, integrated view of issues in personal human services, population health and community well-being;

16. Local and regional authorities should be empowered to promote the economic, social and environmental well-being of their areas: Improvement in health will require the engagement of these authorities acting corporately across all their functions, since action on the causes of ill health spans the range of their responsibilities;

17. This duty should be underpinned with a discretionary power enabling councils to take steps which in their view will promote the well-being of their area and those who live and work there: Local and regional authorities should be able to decide on the range of health and social services that is to be made available to their communities;

18. Central governments should aim at defining the best role that local and regional authorities can play in promoting the health of people at a community level. They should develop and test a broad, all-encompassing framework to guide the role that local and regional authorities will play in planning, monitoring and ensuring the delivery of local health and social services;

19. The devolution of responsibility must be matched by accountability for standards. Local services must be judged against general standards, so that people, wherever they live, have access to at least a standard quality of care;

20 Local government in many countries has significantly less revenue raising power than there is need for services in its area. It is therefore dependant on general or specific purpose grants from other spheres of government for many of the services it provides;

21. Where powers and responsibilities are transferred to local or regional authorities, it is necessary to ensure that these authorities have the necessary financial or other resources to perform the tasks assigned to them;

Co-operation

22. Patients and users of social and health services should have access to an integrated system of care. This could be achieved through joint planning and a greater emphasis on partnership working and service delivery; between national or regional health and social services and local government, with local communities and with the voluntary sector, ensuring that varied activities are effectively integrated and directed towards enhancing the overall well-being of local communities;

23. Central governments should provide councils with clear discretionary powers to engage in partnership arrangements with other bodies, organisations or agencies that operate locally for any purpose which supports their functions, including the function of promoting the social well-being of the area. These will assist the application of a planned and integrated approach by all spheres of government and private and non-government services to local health and community services rather than an ad hoc, fragmented approach;

24. Intergovernmental co-operation and co-ordination should involve a clear definition of roles, responsibilities and relationships between each sphere of government, as well as avoidance of restrictive and regulatory approaches and controls imposed on local government;

25. Councils' powers to work in partnerships should be strengthened. It is often necessary for local and regional authorities to co-operate in order to provide an efficient service, for instance when the size of an authority and/or its financial capacity are limited in relation to the scale and cost of the services required;

26. There is an overwhelming need for greater cohesion and coherence at the local level of all those - public sector, business, voluntary bodies - whose activities and efforts can affect the well-being of local communities;

27. Even in prosperous societies the scale and diversity of needs is such that the formal social services are obliged to utilise and support informal systems of social care and mutual aid, which provide care on the basis of personal relationships, in the context of families, neighbourhoods and other loosely structured community-based associations. Without informal supporting networks the formal social services would be overwhelmed by demand;

28. It is evident that there is no clear boundary between the formal and informal sectors of social welfare, the two sectors being mutually supportive rather than alternative sources of social welfare. The increasing orientation toward community care calls for social policies that strengthen the association between formal social services and informal networks of social care, without losing sight of their differences;

Modernisation

29. A drive to improve standards, tackle inequality and speed up services requires a new approach for health and social services. There should be a new emphasis on performance management to ensure that services everywhere deliver what is required for patients, users and carers. Public authorities should pave the way for radical improvements in the quality, reliability and cost-effectiveness of social services; put a new emphasis on rehabilitation and reducing dependence wherever possible;

30. Modernisation of social and health services will require the proper involvement of the public, patients and users in the decision-making process both nationally and at local level. Public authorities should set out clearly what users can expect from social services, health and housing agencies;

31. Progress should be made in the key areas which underpin all service development, i.e.: properly resourcing services, developing and involving staff, introducing modern information systems and developing a modern infrastructure of buildings and equipment. Making significant progress in these areas will depend on effective local leadership, as the implementation of these strategies will require cultural change and organisational development;

32. Public authorities should be committed to measuring and assessing performance against outcomes that matter. In particular, the following dimensions should be considered: health improvement, fair access, effective delivery of appropriate health care, efficiency, patient/user experience and health outcomes of care. These indicators could provide diagnostic tools to help improve local performance by benchmarking and sharing best practice. Taken together, they will enable performance locally to be assessed, reviewed and improved;

33. Modernisation should be backed by substantial additional resources, not only in terms of buildings and equipment, but also for health and social services staff, who are key to delivering the programme of modernisation. The contribution they have to make in planning and delivering health and social care must be recognised;

34. The potential of new information and communication technologies should be used not only to provide the most effective care possible, but in a way that maximises public satisfaction and convenience;

35. The modernisation of facilities, equipment and systems can be achieved by increased public investment, by improving public service management methods and by developing public-private partnerships. An increased recourse to private service providers can be a way to bring the advantages of competition and flexibility to the delivery of social services. These advantages include greater efficiency, increased responsiveness to the needs of customers and encouraging innovation. On the other hand, privatisation also involves risks and requires careful management on the part of the public authorities, especially in terms of setting clear performance criteria and ensuring accountability.