Hansard

Today’s debate addresses a significant issue that is facing the new Scottish Government. Scotland has an ageing population. People are living longer but not necessarily more healthily, and they often have increasingly complex needs in later life. The elderly population of the 21st century is much more diverse in terms of income, mobility and health than those in previous generations, so our response needs to be more sophisticated. We must face up to the realities of a changing Scotland, and the services that we provide, whether through public, private or third sector delivery, must reflect a caring and mature society.

I will concentrate on a few issues from my personal experience and my experience as an MSP for Mid Scotland and Fife. Relatives who take on the role of caring for an older person are often lauded by politicians. It is a huge task. I know that from my family’s own experience when my grandfather moved into my parents’ home. That is the way in which we all used to look after our elderly. I was at university at the time and I was not particularly aware of, or appreciative of, the commitment that was given by my parents. It can be very hard work and it is not the answer for everyone, but if families are in a position to provide that level of care, they must be properly supported through the benefits and social care system. I am sure that we will reflect more on that area during the forthcoming carers week.

While caring for an elderly parent or spouse at home, relatives aim to make that person’s life more comfortable and familiar and to retain them in a home environment. When a family pass complete care to another provider, they look for a level of care for their loved one that meets those hopes. We know from recent shocking incidents that the system can—tragically—fail a family’s trust. Of course, many care homes have good assessments. We are right to rely on such measures as an indicator of quality but, even with them, it is often the intangible and difficult-to-measure human qualities that provide families with confidence in a care setting.

That is relevant to the care home situation in Fife and the campaign that families of care home residents there are running. Fife Council has decided to close all the local authority-run care homes and replace them with private provision. I have had meetings with care home residents’ relatives, who believe that their loved ones receive a high quality of care in local authority homes and that such care is better than that in the private sector.

Fife Council is undoubtedly making an unpopular decision—more than 70 per cent of respondents to a consultation that was held in November did not agree with it. The care commission has reported that the current buildings need improvement—en suite bathrooms are the major issue—but residents’ relatives overwhelmingly argue that such facilities are not what makes a good care home; it is the level of care and the dedication of staff that make a good care home.

Local authority care home staff feel so strongly about the decision that they are prepared to consider their terms and conditions and to change working practices to save resources. Eroding staff terms and conditions is not the best way forward in improving elderly care, but we could be looking at a staff-led, co-operative model of care that provides an alternative solution not just in Fife but across the country, where other authorities face similar challenges.

As the Scottish Government will increasingly discover, it is difficult to always make popular decisions and we should not expect decision makers to always be popular. Sometimes, they must make the case for a difficult decision and build a consensus. Of course Fife Council faces a challenge—how do we ensure that older people live in high-quality accommodation that fully meets their needs and where they are properly cared for? However, the council’s proposed solution—a wholesale move to the private sector—is increasingly being questioned.

The care home sector benefits from mixed provision. Public sector provision has considerable merits, but—realistically—we could not deliver a service without a contribution from the private sector. The private sector has good-quality care homes and some excellent care homes, although we as a Parliament are highlighting today serious concerns about what happens when the system fails, regardless of the sector. We can add to that mix the growing number of third sector or partnership-led homes. For example, Abbeyfield runs a co-operative model in Kirkcaldy, and many charities are involved in care delivery, although—as Mary Scanlon highlighted—the economics of the sector can make it difficult for them to survive. Mixed provision helps to raise standards in care homes not just for residents but for staff.

Care home staff are often undervalued and underpaid. We should aim to raise the value of care staff, whether those they look after are young or old. Access to training and skills supports a more motivated and professional workforce and, overall, the public sector has a better record on that than the private sector does.

Southern Cross’s current financial difficulties should cause a rethink of Fife Council’s decision. Unison suggests that other major companies also face financial problems. The difference between the home care fees that local authorities pay the private sector and those that they pay the public sector has long been a social care financing issue that has been raised with MSPs, but it is dwarfed by the problem that we face of large social care companies that are run for shareholders’ profits and now face financial collapse. Many are concerned that this is the tip of the iceberg.

Last week, the First Minister said:

“Given the difficulties that arise when a private company is on the brink of administration and given the position in which that leaves vulnerable people in social care or the health service, the current situation should be a cautionary note for those who seem to think that private intervention is a solution in the health service or in the social care service.”—[Official Report, 2 June 2011; c 299.]

We are all concerned about the future security of healthcare. The cabinet secretary must continue dialogue with Southern Cross and be alert to concerns about other companies.

In the current environment, Fife Council should hear that cautionary note and reconsider its decision. There are alternatives—Abbeyfield in Kirkcaldy should be proof of that—and the council should commit to exploring them. The Scottish Government could take a lead in exploring and promoting alternative models to maintain mixed provision if local authorities step away from direct delivery. It should not take crises—whether financial or in social care delivery—to force an examination of the sector, but we must all be confident that the care models that operate in Scotland can meet our future needs and reflect our society’s values.

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