The Scottish Government must focus on transforming health and social care services to address the growing cost of the NHS and its recovery from Covid-19.
Improving the NHS will be very difficult against the competing demands of the pandemic and an increasing number of other policy initiatives, including plans for a National Care Service.
The health service in Scotland is on an emergency footing and remains under severe pressure. There is a growing backlog of patients waiting much longer for treatment because of the response needed to Covid-19. That has made workforce planning and delivering on ambitious recruitment plans all the more important. But the Scottish Government has historically struggled to recruit enough people with the right skills.
The NHS’s ability to plan remains hindered by a lack of robust and reliable data, including workforce, primary care, community, social care, and health inequalities data.
Meanwhile the pandemic has increased the fiscal pressures on the NHS, which remains financially unsustainable. This is despite the Scottish Government allocating £2.9 billion for pandemic-related costs in 2020/21 and committing more funding in 2021/22 and beyond.
Stephen Boyle, Auditor General for Scotland, said: “Reforming the NHS is key to the Scottish Government’s pandemic recovery plan and needs to remain a priority. Putting Covid costs to one side, health spending is rising every year, meaning less money for other public services.
“There’s now a clear opportunity to do things differently by building on the innovation and collaboration we’ve seen across the NHS in the last few years.
“For that to happen, our leaders must take the public with them and involve them in the shift from care being delivered in hospitals to much closer to people’s homes. But better-informed policy decisions and services won’t be possible without better collection and use of data.”
First Minister lays out her Programme for Government 2021/22
Leading Scotland safely out of the pandemic, urgently confronting climate change, driving a green, fair economic recovery, and boosting opportunities for children and young people are among the core priorities in this year’s Programme for Government (PfG), published yesterday.Oh … and there’s a referendum in there, too …
The programme sets out plans for a record increase in frontline health spending, new legislation for a National Care Service, a system providing low-income families with free childcare before and after school and during holidays, and actions to drive forward Scotland’s national mission to end child poverty.
The programme also includes plans to help secure a just transition to net zero – creating opportunities for new, good and green jobs, making homes easier and greener to heat, and encouraging people to walk, wheel or cycle instead of driving.
Speaking in Parliament, the First Minister said: “This programme addresses the key challenges Scotland faces, and aims to shape a better future.
“It sets out how we will tackle the challenge of Covid, and rebuild from it. It outlines how we will address the deep-seated inequalities in our society. It shows how we will confront with urgency the climate emergency, in a way that captures maximum economic benefit. And it details the steps we will take to mitigate, as far as we can, the damaging consequences of Brexit while offering a better alternative.
“In the face of these challenges, our ambition must be bold. This programme sets out clear plans to lead Scotland out of the greatest health crisis in a century and transform our nation and the lives of those who live here.
“We will deliver a National Care Service; double the Scottish Child Payment; and invest in affordable, energy efficient homes and green travel. We will ensure that businesses have the support, and people have the skills, to succeed in the low carbon economy of the future. We will show global leadership in tackling the climate crisis. And we will offer people an informed choice on Scotland’s future.
“To that end, I can confirm that the Scottish Government will now restart work on the detailed prospectus that will guide the decision. The case for independence is a strong one and we will present it openly, frankly and with confidence and ambition.
“This programme addresses our current reality, but it also looks forward with confidence and ambition to a brighter future. It recognises that out of the many challenges we currently face, a better Scotland – as part of a better world – is waiting to be built.”
Building on the progress from the first 100 days of this government, with the co-operation agreement with the Scottish Green Party at its heart, the PfG sets the scene for the next five years.
Key commitments for over the course of this Parliament include:
increasing frontline health spending by 20%, leading to an increase of at least £2.5 billion by 2026-27
undertaking the biggest public service reform since the founding of the NHS – the creation of a National Care Service – with legislation brought forward by June next year
improving national wellbeing with increased direct mental health investment of at least 25%, with £120 million this year to support the recovery and transformation of services
investing £250 million to tackle the drugs deaths emergency over the next five years
expanding the Scottish Child Payment to under-16s by the end of next year and doubling it to £20 a week as soon as possible after that, with a £520 bridging payment given to every child in receipt of free school meals this year
investing a further £1 billion to tackle the poverty-related attainment gap and providing councils with funding to recruit 3,500 additional teachers and 500 classroom assistants
providing free childcare to low income families before and after school and during holidays, and expanding free early learning and childcare to one and two year olds
investing £100 million over the next three years to support frontline services for preventing violence against women and girls
providing £1.8 billion to make homes easier and greener to heat, as part of a commitment to decarbonise 1 million homes by 2030
ensuring that at least 10% of the total transport budget goes on active travel by 2024-25, helping more people to cycle, wheel or walk instead of drive
delivering a revolution in children’s rights, including across the justice system
supporting a just transition to a low-carbon economy for people and businesses, including a £500 million Just Transition Fund for the North East and Moray
investing an additional £500 million to support the new, good and green jobs of the future, including by helping people access training
delivering 110,000 affordable homes by 2032 and investing an additional £50 million to tackle homelessness and rough sleeping
taking forward the democratic mandate for a referendum on independence to be held within this Parliament and, if the Covid crisis is over, within the first half of this Parliament, while providing the people of Scotland with the information they need to make an informed choice on their future.
Commenting on yesterday’s Programme for Government announcement, Chris Birt, Associate Director for Scotland at the Joseph Rowntree Foundation said:“Alarm bells should already be ringing in both the Scottish Government and Parliament that we are currently set to miss our child poverty targets, with no clear plan on how to achieve them.
“The Programme for Government published today pushes that plan further down the road, both to the budget later in the year and next year’s Tackling Child Poverty Delivery Plan.
“Time is running out on the targets. Families on low incomes across Scotland are experiencing growing financial pressure and uncertainty . They will hope the commitment to double the child payment “sooner rather than later” happens very soon and that our national mission to end child poverty gathers urgency and scale.”
The STUC welcomed the Scottish Government’s Programme for Government, specifically highlighting the commitments from the First Minister to implement national bargaining in the care sector, additional funding for the health service, gender recognition reform and justice for Scotland’s miners wrongfully arrested in the 1980s.
STUC General Secretary, Roz Foyer said: “Reform of our care sector cannot come quick enough and the STUC will engage fully in this legislation, campaigning for a National Care Service based on sectoral collective bargaining and not for profit delivery.
“The commitment of the First Minister to National Bargaining is therefore very welcome. However, the £800 million additional funding announced over the course of the Parliament is less than a quarter of the expenditure which the Feeley Review said was necessary for the social care sector.
“Yet we still have concerns that the Programme of Government tries too hard be all things to all people. It is simply not credible to raise the levels of investment required to tackle climate change, reduce inequality and create jobs while at the same time boasting about the lowest business taxes in UK and freezing income tax rates for the duration of the Parliament.
“The same lack of ambition is reflected in today’s Scottish Government response to the report of the Just Transition Commission which leaves much to be desired on future job creation and ensuring the burden of climate change is not carried by workers and the less well off.
“Fighting discrimination and inequality is at the heart of trade unions, we know trans people are some of the most disadvantaged and discriminated people in Scotland and the gender recognition bill is therefore extremely welcome in enabling trans people to access their human rights.
“Finally, I welcome the proposed Miners’ Strike Pardon Bill. It has been all too clear for decades that the miners were the victims of a politically inspired political attack and that organs of the state, including the police, were used to repress their legitimate industrial action.
“This Bill will help provide some relief to the thousands of lives were wrecked by wrongful arrest and is a testament to years of campaigning by working class families who refused to give up.”
GMB Scotland Secretary Louise Gilmour said:“The need to tackle the crisis in care is accepted, but the challenge is to end years of exploitation by giving care workers substantial pay increases. That’s how we’ll confront the understaffing crisis and transform the sector.
“It’s why GMB is campaigning for £15 an hour minimum for care workers. The prospect of staff remaining mired in wages of just under or over £10 an hour isn’t credible.
“And there is a growing consensus supporting that view, including among Cabinet Secretaries as the Greens committed to a £15 minimum in their recent manifesto, so we need to make it happen.
“If we are prepared to be bold and deliver proper value for workers across the social care sector then there is a huge opportunity to be grasped, everyone will benefit and Scotland will be fairer for it.”
Joanne Smith, policy and public affairs manager for NSPCC Scotland, said: “Recovery and reform are very much needed as we move forward from the pandemic, and this year’s Programme for Government is the first step in this journey.
“For children in Scotland to have the best start in life, it is vital that all families can access holistic support, where and when they need it, and so we are heartened by the Scottish Government’s announcement of a Whole Family Wellbeing Fund.
“In line with the Promise’s recommendations we would like to see that national spending prioritises early, preventative support for families, therefore stripping out demand for crisis-led services.
“We are also greatly encouraged by the Scottish Government’s commitment to review and redesign the Children’s Hearing System. Through our work with very young children and families in Glasgow, we see the limitations of current justice processes in meeting the distinct needs of infants and their families.
“Given that around a third of children who come into care in Scotland are under the age of five, we need to ensure justice processes are better aligned with infants’ developmental timescales. We look forward to working alongside the Review team to ensure that the rights of infants are upheld throughout the process.”
Mary Glasgow Chief Executive of the charity Children 1st said: “Today’s Programme for Government has rightly prioritised the right of children and their families to know they can access the help and support they need whenever they need it.
“Children 1st have long called for a transformation in the support available to families, which must be based on learning from the – often difficult – experiences of children and their families when they have needed practical, emotional or financial help.
“The proposed £500m investment in a ‘Whole Family Wellbeing Fund’ is a hugely welcome step forward and we are committed to working alongside children and their families, and the Scottish Government, to turn this significant investment into practical action.”
Tracy Black, CBI Scotland Director, said:“With Glasgow hosting COP26 later this year, the Scottish Government is right to focus on its plans for a net zero economy. Yet given the need to cement Scotland’s economic recovery post-pandemic, businesses will feel there ought to have been a greater focus on boosting growth. While there were encouraging mentions of greater access to finance, the devil will be in the detail.
“Firms are already decarbonising their operations, and, by working alongside government, can help urgently transform net zero ambitions into action. Reforming the planning and business rates systems – enabling much needed in investment in low carbon infrastructure – would help achieve ambitious climate targets.
“The First Minister is also right to highlight that COVID hasn’t gone away. Scottish firms have worked tirelessly throughout the crisis to keep staff and customers safe. Businesses are not calling for a rushed return to the workplace, though employers will rightly be speaking with their employees about a gradual return in line with the latest guidance.
“As the economy reopens, skills shortages remain a key concern, so employers will be frustrated not to hear more about plans for upskilling and retraining.
“Business investment is absolutely vital to Scotland’s economic recovery, and the government should do everything in its power to attract – not repel – investment and the very best talent. Ultimately, by working more closely with business to create sustainable economic growth, ministers will be able to achieve their goals of improving people’s living standards and public services.”
A National Care Service for Scotland – but COSLA condemns proposals
A consultation has been launched to seek the public’s views ahead of the creation of a National Care Service, which will ensure everyone who needs it can expect the same standards of care, wherever they live in Scotland.
Local government umbrella organisation Cosla has criticised the government’s plan as another move to undermine local democracy.
The National Care Service will deliver person-centred care that supports people in a way that suits their needs, providing real benefits for those who are being cared for and the people who care for them. It will introduce ethical commissioning, based on fair work principles, for the benefit of everyone involved.
The consultation sets out some of the options for delivering social care in a way which changes the system from one that supports people to survive to one that empowers them to thrive. It recognises that this will involve significant cultural and system change that will need to be supported by new laws, and new ways of working.
In order to deliver these recommendations there will continue to be strong local accountability. The consultation proposes Community Health and Social Care Boards to strengthen the voice of the local population, with people with lived experience and local elected members sitting alongside professionals.
Consulting on the proposals was one of the commitments for the first 100 days of this government. Implementation of the recommendations of the Independent Review of Adult Social Care, and the establishment of a National Care Service, will be one of the most significant tasks of the current parliament.
At a minimum the new National Care Service will cover adult social care services. However, the consultation document also recognises that if we want to build a comprehensive community health and social care system, we should consider extending its scope to other groups such as children and young people, community justice, alcohol and drug services, and social work.
Minister for Social Care Kevin Stewart said: “The importance of our social care services has never been clearer. We owe an enormous debt of gratitude to our nation’s carers, paid and unpaid, for the commitment and compassion we have seen throughout the pandemic.
“The Scottish Government commissioned the Independent Review of Adult Social Care during the pandemic, because it was clear we needed to do things better in future.
“We have already made significant improvements, with reforms such as the integration of health and social care, and implementation of the Real Living Wage Policy for Adult Social Care workers and this year the Scottish Government pledged £64.5m to fully fund the pay increase. But we can go further. What we are now proposing is the biggest public sector reform for decades, since the creation of the National Health Service.
“I am committed to implementing the recommendations of the Independent Review and staying true to the spirit of that report by building a system with human rights at the heart of it.
“The Review recommended the creation of a National Care Service, with Scottish Ministers being accountable for adult social care support. I believe however that it is right for this consultation to look beyond simply the creation of a national service for adult social care. The ambition of this government is to go much further, and to create a comprehensive community health and social care service that supports people of all ages. We are also committed to a ensuring there is strong local accountability in the system.
“Absolutely vital to this is ensuring that our invaluable social care workforce feel happy, respected and fulfilled in their role.
“We are at the beginning of a journey to improve social care in Scotland. We will only get this right with your support. I want to hear from as many people and organisations as possible over the next couple of months, so we can build a better system together.”
In a statement, the Social Covenant Steering Group which will advise on the creation of a National Care Service, said: “Most of us have waited many years to see plans for major improvements in the way social care support is delivered and we welcome the publication of this consultation.
“Many people may feel they have been consulted before and are keen to see some action. But this time it is an important legal step in in order that a bill can be put to Parliament.
“So, it is important that as many people as possible including; current users of social care support, unpaid carers, the workforce and everyone else who cares about this vital support will take this opportunity to express their views on the kind of system we need to enable everyone to reach their potential.”
The Consultation on the National Care Service which was launched today cuts straight through the heart of the way Scotland is governed, says COSLA President Councillor Alison Evison:
“The Consultation launched today cuts through the heart of governance in Scotland – not only does it have serious implications for Local Government – it is an attack on localism and on the rights of local people to make decisions democratically for their Place. It once again brings a centralising approach to how decisions which should be taken locally are made.
“We welcomed large parts of the Independent Review of Adult Social Care and have been keen to get on and deliver, however the vision this consultation sets out goes beyond the Feeley Report. It isn’t evidence based and will take years to deliver – years when we should be making improvements which will benefit all users of social care services.
“Councils know their communities and all the evidence suggests that local democratic decision making works. Councils have shown time and time again during the last 18 months of the pandemic that we can deliver for the communities we serve when we are trusted and resourced to do so.
“It is deeply concerning that the consultation is also a considerable departure from the recommendations of the independent review set up to look at Adult Social Care.
“The lack of prior engagement with Local Government is not new – the partnership between the Scottish Government and Local Government which we have been seeking to build, continues to elude us in practice and it is the communities we serve who are losing out.
“Let’s be clear – this is not a “thinly veiled” attack on Local Government – there is no subtlety to it and, sadly for local communities, the ‘onion peel’ of Local Government services by this Government shows no sign of letting up.
“On behalf of the communities we serve, COSLA and Local Government will engage constructively with the Consultation process. People may be surprised by the extent of services covered by this Consultation and I would urge as many as possible to respond to it, as this could really be the end for anything other than central control in Scotland.
“We all want better services for our communities, nobody more so than Local Government and that is what Local and National Government should be working on collectively for our communities.”
‘Real life experts’ to help focus on what really matters to people receiving social care
Health Secretary Humza Yousaf and Minister for Social Care Kevin Stewart have welcomed the first meeting of a Social Covenant Steering Group, set up to help guide the development of a National Care Service.
Establishing the group, made up of people with day-to-day experience of social care, was a key recommendation of Derek Feeley’s Independent Review of Adult Social Care and marks the fulfilment of one of the commitments for the first 100 days of this government.
Initial membership of the group, which met for the first time yesterday, includes unpaid carers, disability rights activists, a care home resident, a campaigner for the needs of relatives of those in care homes, a social care worker and others with significant experience of the way services are currently delivered.
The diverse group includes people from across Scotland with a spread of ages, and social, cultural and ethnic backgrounds.
The group is expected to help establish a common set of values and beliefs – a social covenant – which will underpin the National Care Service, including treating people with dignity, prioritising the common good and ensuring there is strong oversight of the new service. It will establish underlying and unifying principles to help guide decision-making.
Mr Stewart, who will chair the group’s meetings, said: “We know there were problems in the social care system before COVID arrived and we had already started to think about ways of reforming it, but the pandemic has shone a spotlight on the system and really highlighted the importance of making changes.
“Many members of this group have already heavily influenced the recommendations in Derek Feeley’s report and I am keen to ensure that we continue to listen to their expert views and act on what they tell us.
“A social covenant will enable us to develop a common set of values around social care; and see those systems as not merely a safety net, but a springboard to allow people to flourish.
“It is extremely important that we listen to people with lived experience – the real experts – to hear about the highs and lows of social care services. It is by doing this that we will really find out what’s good about the services people receive, more importantly, what needs to improve for those who use and deliver social care.”
“Only by listening to people with real-life experiences , and acting on what we hear, can we create a system that ensures that everyone in Scotland has the opportunity to live fulfilling and rewarding lives.”
Marion McArdle, who has a daughter with complex needs said: “I feel privileged to be part of this group, since I’m fully expecting it to be a partnership between the government and the experts, people with real stories and real suggestions on how to change things for the better based on their lived experience of social care in Scotland.
“I’m optimistic that this can only be good thing and a great step forward in getting it right for Scotland’s citizens who are entitled to a social care system which at the very least meets their human rights.”
Collision course with COSLA over National Care Service?
Health Secretary Jeane Freeman has accepted the findings of the Independent Review of Adult Social Care, and the Scottish Government is already working to implement key recommendations.
Ms Freeman told Parliament yesterday that Derek Feeley’s Independent Review, commissioned five months ago in response to the COVID-19 pandemic, was an “important opportunity” to be bold in reshaping how social care is planned, funded and delivered.
Speaking in a debate on the review, Ms Freeman set out a number of immediate measures in response, including a new £20 million Community Living Change Fund to redesign services for people with complex needs including intellectual disabilities and autism, and for people who have enduring mental health problems.
This will address some of the issues raised by the 2018 Coming Home report, about the need to avoid out of area placements and delayed discharge for people with learning disabilities and complex needs.
She said she accepted the principle of introducing a National Care Service but would continue to talk to the Convention of Scottish Local Authorities (COSLA) about how to address its concerns.
The Scottish Government is working to implement other measures recommended by Derek Feeley’s report. These include:
work with local partners to end charging for non-residential care
developing minimum standards for terms and conditions in the social care sector, to help organisations meet fair work principles by the end of May
work to ensure there is no delay in the annual Real Living Wage uplift for Adult Social Care workers
Ms Freeman said: “The independent review of social care gives us a clear roadmap for the future of care provision in Scotland and we believe in the recommendations in this report.
“There is immediate action that can be taken now to secure improvement. I am pleased to announce a new Community Living Change Fund of £20 million to deliver a redesign of services for people with complex needs including intellectual disabilities and autism, and those who have enduring mental health problems. We will work with local partners as quickly as practicable to end all charges for non-residential care.
“The report also recognises and highlights the critical and invaluable support that the social care workforce provide to people all over Scotland. We are looking to establish a new sector-level body to ensure an effective voice for the whole of the social care workforce to enable them to respond to local conditions and address matters of importance, and support an effective collective bargaining role in the sector.
“As a priority, we will work with our stakeholders to agree a national approach to implementing the real living wage for Adult Social Care workers – for 2021 and in future years.
“We want to move from a competitive market to collaboration and ethical approaches to commissioning and procurement to help embed fair work principles and improve the consistency of services.
“The National Care Home Contract should also embed changes which drive the Fair Work Agenda and I have asked that for the first time Union representatives should be party to the discussions on this contract.
“I understand the concern expressed by COSLA on the issue of accountability. Local government is a critical partner in taking forward the radical change the Review rightly calls for and I support. We need to work together to find the best way to secure the Review’s recommendations and the spirit of its intent.
“I believe, as the report sets out, that improving adult social care gives us an important opportunity – to improve people’s lives, to build our economy, and to invest in high-quality, fair work.
“This is just beginning of a process for improvement. It is now up to us to ensure a social care system that consistently delivers high quality services across Scotland – a system that is founded in fairness, equality, and human rights, and that puts lived experience at the heart of its redesign and delivery.”
Council Leaders have already rejected the idea of a Scottish Care Service.
Speaking following the launch of the Feeley report on 11 February, Councillor Stuart Currie, COSLA’s Health and Social Care Spokesperson, said: “There was real and unanimous opposition to the recommendations on governance and accountability which would see the removal of local democratic accountability and a degree of centralisation, which Leaders rightly felt would be detrimental to the local delivery of social care and its integration with other key community services.
“They (council leaders) also felt that given the level of funding set out in the Review, Local Government would be well placed to deliver the human-rights based approach outlined at pace, whilst ensuring local democratic accountability remains front and centre of social care.”
Council leaders will consider a detailed report on the proposals and the Scottish Government’s response at the end of this month.
There is much in the Feeley Report on Adult Social Care that Local Government and Scotland’s Council Leaders have been calling for, COSLA said yesterday.
Leaders have long advocated that that the lived experience of those who rely on social care should be embedded within the system and that social care should move to a more person centred approach, recognising the value of not for profit provision, and carried out by a workforce that is valued.
However Leaders unanimously expressed ‘grave concern’ at the recommendations around the future governance and accountability arrangements contained within the Report.
Whilst they agreed with a lot of the content within the Feeley Report, Council Leaders together voiced their opposition to the recommendation which proposes the removal of local democratic accountability from Adult Social Care and the centralising of the service under a National Care Service with accountability falling to Ministers, a move that they described as being detrimental to the local delivery of social care and its integration with other key community services.
They also felt that given the level of funding set out in the Review, Local Government would be well placed to continue to deliver this vital service.
Speaking following a special meeting of Council Leaders Councillor Stuart Currie, COSLA’s Health and Social Care Spokesperson, said: “Council Leaders noted the publication of the Independent Review of Adult Social Care and endorsed many of the principles set out in the report particularly in relation to empowering people, valuing the workforce and embedding a human rights approach to social care.
“Leaders were also clear that the lived experience of those who rely on social care should be embedded within the system and that social care should move to a more person-centred approach.
“However, there was real and unanimous opposition to the recommendations on governance and accountability which would see the removal of local democratic accountability and a degree of centralisation, which Leaders rightly felt would be detrimental to the local delivery of social care and its integration with other key community services.
“They also felt that given the level of funding set out in the Review, Local Government would be well placed to deliver the human-rights based approach outlined at pace, whilst ensuring local democratic accountability remains front and centre of social care.”
A further detailed report on the proposals will be considered by Council Leaders at the end of February.
Coalition of Care and Support Providers welcome Independent Review of Adult Social Care in Scotland
CCPS(Coalition of Care and Support Providers) has welcomed the publication of the Independent Review of Adult Social Care in Scotland and its call for a renewed purpose for social care with human rights at its heart.
CCPS are delighted by the commitment to a new narrative which replaces crisis with prevention and wellbeing, burden with investment, competition with collaboration and variation with fairness and equity.
We strongly endorse the call to put people front and centre of social care delivery – people who are supported by social care, their families and carers, and people who work in social care services.
We agree that Scotland already has strong foundations on which to build a National Care Service. We want to work with the Scottish Government, national and local stakeholders – including those who support people and people who are supported – to redesign the system to make the ambitions set out in the Review happen.
We wholeheartedly back the Review’s assertion of a duty to co-produce a new system with people who it is designed to support.
Over the coming weeks we will be working closely with our members to explore the Review’s recommendations in detail. As the membership body for third sector providers, we are especially interested in participating in the conversation about the Review’s recommendations on commissioning and procurement.
In 2020, we published our own contribution to that conversation, a series of Big Ideas about changing the way social care is planned, purchased, and paid for. We are grateful to the Review team for citing those ideas. In particular, we thank them for including as one of their recommendations, our suggestion to press pause on all current procurement in the context of a National Care Service, with a view to rapid, carefully planned implementation.
We agree with the Review team that implementation is the most significant challenge. Now is the moment for whole system change, hand in hand with the implementation of The Promise and the recommendations of the Social Renewal Advisory Board.
We would echo the Review Team’s own words – ‘If not now, when? If not this way, how? And if not us – who?’
Annie Gunner Logan, Chief Executive of CCPS said:“CCPS congratulates Derek Feeley and the Review team on completing a mammoth task in record time and their willingness to listen to many voices including those of providers and the people we support.
“Reform of social care in Scotland is long overdue. The COVID-19 pandemic has exposed fault lines which require radical overhaul and long-term change. It has also revealed what can be achieved when obstacles are removed in a crisis.
“We are heartened by the direction of travel set out in the Review. The challenge now must be to turn aspiration into implementation. Change is needed urgently but how it is achieved matters too.
“The debate about a National Care Service must not become a bunfight at the expense of those who provide social care and the people they support.
“The upcoming election period provides an opportunity to discuss the Review’s recommendations openly and widely. But when the votes have been counted, and Scotland gets down to the series business of design and implementation, their voices must be in every room, every step of the way.”
Responding to the publication of the Independent Review of Adult Social Care in Scotland Report yesterday, GMB Scotland’s Women’s Campaign Unit Organiser Rhea Wolfson said:“Scotland has a once in a generation opportunity to transform social care, if the recommendations of this report are underpinned by proper value for the workers who will deliver it.
“We are pleased the report acknowledges our campaign for a £15 an hour minimum wage in social care and we would stress to the government and the industry this is very achievable with collaboration and political will.
“The report is clear that if government and the industry invest properly in the sector and its people, the economic multiplier effects of social care spending could have transformative effects not just for workers’ pay and the quality of care, but for the equalities agenda and the wider economy.
“The COVID-19 pandemic ruthlessly exposed the long-standing crises in social care which everyone well understood, and for a workforce of mainly low-paid and often exploited women this has meant a chronic struggle for proper value and respect.
“After the crises and tragedy of the last eleven months, and with tough times still ahead of us, there is hope in these recommendations.
“If we are serious about what we really value as a society, then we have a chance to finally get the social care agenda right.”
The Scottish Pensioners’ Forum, the campaigning organisation for older people in Scotland, have today released a report calling for the creation of a National Care Service in light of the tragic number of deaths related to Covid-19 within care home settings.
The report is supported by the STUC.
Rose Jackson, SPF Chair, argued: “Covid-19 has had a disproportionate impact on the most vulnerable members of our society with many older people losing their lives prematurely due to the inadequate measures in place within residential care settings – things must change as a matter of urgency to ensure that more older people don’t lose their lives unnecessarily as a consequence of this.”
The report also highlights the profits being made by private companies and overseas investment in the care home sector and calls for an urgent review of this practice.
“We must replace a profit based system with something more akin to the NHS to avoid tax payers providing grossly inflated profits to shell companies and overseas speculators.”
The SPF, who have strong links with the STUC and its affiliates, have also set out a plan for a care service which would be beneficial for care home residents whilst also protecting the rights and welfare of employees in the care sector.
Roz Foyer, STUC General Secretary, welcomed the report stating: “Older people in Scotland have suffered greatly during this pandemic. Reports that half of all Covid deaths in Scotland have been from people living in care homes is a disgrace that should shame Governments and employers.
“The STUC has repeatedly called for a National Care Service, and while the Scottish Government have promised to review it, we must continue to push for a fully nationalised service that puts service users and care workers before profit and greed. That is why we continue to demand that the voice of care users and the voice of workers is directly represented on the Adult Social Care Inquiry.
“It is the least we, as a society, can do for our older population and for future generations to come.”
An independent review is to consider the idea of a national care service.
The review, a Programme for Government commitment, will aim to ensure Scotland provides consistently excellent support for people who use these services, as well as their carers and their families.
It will be chaired by Derek Feeley, former director general of Health and Social Care in the Scottish Government, and will report by January 2021.
Adult social care comprises a wide array of services and non-clinical support in a range of settings, involving care homes, care at home, day services, and community support for people with a range of needs.
Social care supports more than 200,000 people across Scotland – those with disabilities, older people, people with mental health problems and those with drug and alcohol problems.
The review will take into account the experiences of those supported by, and who work, in social care, as well as looking at funding, governance, administration and delivery.
The review will consider the needs, rights and preferences of people who use services, their families, and their carers.
Health Secretary Jeane Freeman said: “This will be a wide ranging review of all aspects of a service which supports and involves so many people across Scotland. I am looking forward to recommendations that help ensure high standards of service and support into the future.
“This independent review will examine how adult social care can be most effectively reformed to deliver a national approach to care and support services – and this will include consideration of a national care service.
“It will also build upon our existing commitments to improving provision – long standing issues in adult social care have been thrown into sharp relief during the pandemic, and they demand our attention.
“We owe it to those who use and work in adult social care services to acknowledge these challenges, to learn from them, and to consider carefully how we can most effective plan for the future.”
The chair of the review Derek Feeley, a former director general of Health and Social Care in the Scottish Government, is also a former Chief Executive of NHS Scotland and former Chief Executive and President of the Institute for Healthcare Improvement.
Derek Feeley said: “I am grateful to the Health Secretary for the invitation to chair this independent review and to the advisory panel for agreeing to bring their considerable expertise to our work to recommend improvements to adult social care in Scotland.
“I look forward to views of everyone involved in our social care system and, in particular, to hearing from service users about what it will take for us to better meet their needs, rights and preferences.
“We have a broad remit that touches on every part of the social care landscape; from the experience of those using and working in the system to how it should be funded and regulated. We will look at every option and opportunity to bring about the improvements that I know everyone working in the system aspires to achieve.”
The panel of experts for the review includes: Malcolm Chisholm, former Scottish Minister for Health and Community Care, Anna Dixon, chief executive of the Centre for Better Ageing, Caroline Gardner, Auditor General 2012-2020, Councillor Stuart Currie, Ian Welsh, chief executive of the Health and Social Care Alliance and Göran Henriks, Chief Executive of Learning and Innovation in Jönköping, Sweden.
The possible remit and structure of a potential national care service has not yet been set out. It could cover a range of organisational, funding and delivery options, which will be for the independent review to consider.
The review will also consider previous and ongoing work, including:
the programme for social care reform currently being taken forward by the Scottish Government and COSLA
progress with integration of health and social care in Scotland, including the outcomes of the recent review undertaken by the Scottish Government and COSLA
work undertaken by the Care Inspectorate to consider opportunities for improving adult social care provision
work undertaken by wider partners including the third sector to understand people’s experience of care and support improvement
scrutiny by Audit Scotland of social care and progress with integrating health and social care
scrutiny by the Health and Sport Committee of the Scottish Parliament of reform of social care to date and progress with integrating health and social care
