A version of this article by Keith Fletcher first appeared in "Community Care" 12-18 November 1998 under the title "Get around the table". It is reproduced here with the agreement of the Editor.

A Negotiated Settlement

It is sometimes suggested that it is impossible for social services and health to collaborate more effectively until there is legislation to enable joint funding. Nonsense! If you wait until conditions  are exactly right hell will have frozen over.

It’s not easy to reach agency level agreement on issues like continuing care; even less to reach case agreement in its absence. Joint funding would certainly help. Clearer boundary definitions from the Department of Health, with occasional arbitration if necessary, would help even more. But agreements between social services and health about boundaries, joint strategies and individual care packages are not merely desirable. They are a professional imperative for both. Failure is not acceptable.

In the spirit of helpful support therefore let me suggest a few thoughts to consider when these things are under negotiation.

Health and social services have each other by the tail. If they pull away they cause themselves great pain and both fail their clients/patients. It is, by and large, the same people who need both to work together to get a decent service from either. Fear of failure might not be the basis of a love match but it should keep you at the table until you have found a mutually acceptable way of avoiding it. In the memorable words of someone or other, “If you have them by the balls their hearts and minds will follow.”

The potential benefits of success are enormous. Think how much better your service would be if only you could iron out the obstacles to progress created by their failure to respond to the needs of your clients/patients as you see them.

Recognising that failure is impossible is the first step to success. Identifying the components of success is the second. What do you want, specifically, from this particular negotiation? Answers like, “We want to find better ways of working together,” are the equivalent of, “We want to be happy and have lots of fun.” What exactly is the problem you want to solve? How does it manifest itself? What do you want the other side to do to alleviate it? What can you do to alleviate it?

Now turn the question round. What do you think they want from this negotiation? Why not ask them before you begin? It will probably be something from you. It may be more than you can give. What else can you offer which they may find acceptable?

Keep remembering that both sides are (or should be) negotiating for the same beneficiary. So all sides win or all sides lose in this particular game. It isn’t a competition. But that doesn’t mean you are both on the same side either. They are trying to do the best for their people just like you. If you don’t treat them like people of goodwill why do you expect it of them?

This negotiation is not quite like buying a car. You can’t move on to the next showroom  if you don’t get the deal you want. You have to get what you can here - but then, so do they!

Keith Fletcher is the author of “Negotiation for Health and Social Services Professionals” published by Jessica Kingsley.

Created 24 January 1999