An investigation into inter-ministerial collaboration for the provision of a seamless service delivery for persons with disability

Abstract

In Malta, the needs of persons with disabilities are fragmented across three main welfare institutions, the Ministry for Health (MfH), the Ministry for Education and Employment (MEDE) and the Ministry for the Family, Children’s Rights and Social Solidarity (MFCS), each tasked with providing either health, education or social related services. While fragmentation can provide increased specialisation, it can also give rise to wasteful duplication, costly gaps and an inefficient service system that effectively supports Persons with Disability (PwD). This situation is further reinforced with the continuing dominance of siloed service systems that are entrenched at all levels of government. In fact, the National Audit Office (NAO), highlighted that a “ministerial silo” approach contributed to overlaps of services and cross funding, hindering the provision for client-centric holistic services. A collaborative approach across Ministries, was recognised as necessary to achieve a seamless service provision and holistic policy goals for PwD. Nevertheless, managing and achieving effective collaborations can be challenging and may not produce the desired outcomes. Based on a case study design, this study investigated the nature and level of collaboration of the newly established structures, namely the Inter-Ministerial Administrative Committee (IACD) and the Inter-Ministerial Interdisciplinary Professional Board on Disability (IIPBD). It also highlights the challenges experienced during the Inter- Ministerial Collaboration (IMC), as well as the perceived benefits that can be derived from the collaboration for PwD. This study has also examined how the IMC could be improved with a view to service delivery. Using a qualitative approach, data was collected through 17 semi-structured interviews, after which it was thematically analysed. Key findings indicate that the IMC was developmental in nature and that certain elements contributed to the achievement of a collaborative environment particularly trust, commitment, a legal framework and political commitment. On the other hand, insufficient communication, lack of resources and a siloed culture, were perceived as obstructing the collaboration process and the achievement of collaborative advantage. Nevertheless, the IMC was highly commendable by the participants for the benefits it confers to both public organisations and serviceusers. Finally, this study provided recommendations, based on evidence-based research, to enhance or contribute to the development of promising practices for IMCs, conducive to the provision of integrated services for PwD and for IMCs in general.