Chamber
Meeting of the Parliament 09 June 2011
09 Jun 2011 · S4 · Meeting of the Parliament
Item of business
Caring for Scotland’s Older People
Care of our older people has always been a priority, and older people were the major beneficiaries of the achievements of the previous Government, which delivered the lowest-ever waiting times, a fall in hospital infections and more nurses than ever.
Of course, there are aspects of caring for Scotland’s older people over which, in the meantime, we have no control. The full implications of the United Kingdom coalition's benefits changes may not yet be clear, but our older folk will not escape the attack on the vulnerable, and they will not, of course, be spared the fuel poverty that continues to blight communities in our energy-rich nation while the energy companies make obscene profits. Scottish Power’s 19 per cent price rise is a case in point.
I am proud to represent the Highlands and Islands and am very aware of the challenges that its geography poses for the delivery of public services, not least health and social care services. The First Minister’s assurance of continuity of care for Southern Cross residents has been welcomed in the Highlands, where the company has four homes and the local authority is a key customer. Last year, one of Southern Cross’s Highland homes was completely destroyed by fire—thankfully, the 59 residents were unharmed. That home is not to be rebuilt, which perhaps reflects the flawed business model. It was, of course, Highland Council that arranged continuity of care for the residents after the fire.
It has been said many times in the debate—and I have no doubt that it will be said again—that a society is judged by how it treats its older people. I welcome the increased scrutiny that is being placed on those who provide care, not least the unannounced inspections of care homes and the valuable unofficial monitoring role that is undertaken by the various friends-of groups and, in my area, the excellent Highland Senior Citizens Network.
Scotland has an ageing population, and we have a statutory requirement and, more important, a moral obligation to provide high-quality, publicly funded health and social care for them. There is no doubt that that will prove challenging in the face of unprecedented cuts from London. The largest portion of the NHS’s £3 billion-plus spend on older people is on emergency admissions, which no one wants. That compares with 7 per cent of the older people’s budget that is directed to care at home, which everyone wants.
Care at home and care homes are part of our so-called mixed economy, but I am uncomfortable about profit being associated with care and would welcome greater public sector provision in both areas. I hope that local authorities’ risk registers recognise that, unlike the reassuring words of our First Minister, the market gives no guarantee of continuity of care for residents whom authorities place in private care homes.
That mixed care economy works only where there is volume, of course. There was no shortage of bidders for Highland’s care at home contract for the 20-minute home visits in the towns and villages around the Moray Firth, but it is, of course, the council that continues to deal with the person with complex needs who lives miles up a glen that is accessed by a single-track road. Any public sector comparator for future work looks ridiculously expensive when compared with the apparently efficient private sector folk. I regret that care of our older folk is dealt with like grass-cutting or information technology contracts. Let no one be in any doubt that those companies’ primary statutory obligation is to maximise profit for their shareholders.
The statutory obligation in relation to care rests with the local authority. Although those who become dissatisfied with the level of profit—invariably, they are the same folk who seek light-touch regulation—might come and go, the public sector must and will be there to care. In some of our remote communities, there are examples of not-for-profit models of community care working and delivering the quality care at home that reduces emergency admissions. If somebody has to be taken into hospital, any discharge is accelerated by virtue of the additional support at home.
Welcome, too, are the telehealth advances, which respect people’s privacy and reduce the need for human interventions. However, although the technology has its place, social contact is vital for our older people. Lunch clubs and social groups, which are often run by volunteers, must continue to enjoy public funding. Their benefits are significant and their closure is devastating to users and to their friends and families. The social mobility that concessionary travel has given our older folk is another positive example of support.
There is no disputing that we must work to move moneys from dealing with unnecessary emergency admissions to providing quality care at home, in houses that are suitable for our older people. There are good examples of that across the Highlands and Islands where, thanks to funding from the previous Government, the first council houses in a generation have been built, with more to follow. I commend the work that Highland Council and NHS Highland have done on the lead commissioning model and the support that the Government has given that project. However, it is vital that any such major change enjoys the support of staff and their unions. It is fair to report that there might be some way to go with that yet.
Reassurance is key to caring. The Government cares dearly about the NHS. If the public sector focuses on agreed outcomes, any perceived barriers to integrating social care and healthcare will be avoided. I believe that the results that we should focus on will not be found in the share listing of those who are engaged in profiting from care; instead, they will be found in ensuring that person-centred, safe and efficient care is delivered to our older people, regardless of their location.
10:07
Of course, there are aspects of caring for Scotland’s older people over which, in the meantime, we have no control. The full implications of the United Kingdom coalition's benefits changes may not yet be clear, but our older folk will not escape the attack on the vulnerable, and they will not, of course, be spared the fuel poverty that continues to blight communities in our energy-rich nation while the energy companies make obscene profits. Scottish Power’s 19 per cent price rise is a case in point.
I am proud to represent the Highlands and Islands and am very aware of the challenges that its geography poses for the delivery of public services, not least health and social care services. The First Minister’s assurance of continuity of care for Southern Cross residents has been welcomed in the Highlands, where the company has four homes and the local authority is a key customer. Last year, one of Southern Cross’s Highland homes was completely destroyed by fire—thankfully, the 59 residents were unharmed. That home is not to be rebuilt, which perhaps reflects the flawed business model. It was, of course, Highland Council that arranged continuity of care for the residents after the fire.
It has been said many times in the debate—and I have no doubt that it will be said again—that a society is judged by how it treats its older people. I welcome the increased scrutiny that is being placed on those who provide care, not least the unannounced inspections of care homes and the valuable unofficial monitoring role that is undertaken by the various friends-of groups and, in my area, the excellent Highland Senior Citizens Network.
Scotland has an ageing population, and we have a statutory requirement and, more important, a moral obligation to provide high-quality, publicly funded health and social care for them. There is no doubt that that will prove challenging in the face of unprecedented cuts from London. The largest portion of the NHS’s £3 billion-plus spend on older people is on emergency admissions, which no one wants. That compares with 7 per cent of the older people’s budget that is directed to care at home, which everyone wants.
Care at home and care homes are part of our so-called mixed economy, but I am uncomfortable about profit being associated with care and would welcome greater public sector provision in both areas. I hope that local authorities’ risk registers recognise that, unlike the reassuring words of our First Minister, the market gives no guarantee of continuity of care for residents whom authorities place in private care homes.
That mixed care economy works only where there is volume, of course. There was no shortage of bidders for Highland’s care at home contract for the 20-minute home visits in the towns and villages around the Moray Firth, but it is, of course, the council that continues to deal with the person with complex needs who lives miles up a glen that is accessed by a single-track road. Any public sector comparator for future work looks ridiculously expensive when compared with the apparently efficient private sector folk. I regret that care of our older folk is dealt with like grass-cutting or information technology contracts. Let no one be in any doubt that those companies’ primary statutory obligation is to maximise profit for their shareholders.
The statutory obligation in relation to care rests with the local authority. Although those who become dissatisfied with the level of profit—invariably, they are the same folk who seek light-touch regulation—might come and go, the public sector must and will be there to care. In some of our remote communities, there are examples of not-for-profit models of community care working and delivering the quality care at home that reduces emergency admissions. If somebody has to be taken into hospital, any discharge is accelerated by virtue of the additional support at home.
Welcome, too, are the telehealth advances, which respect people’s privacy and reduce the need for human interventions. However, although the technology has its place, social contact is vital for our older people. Lunch clubs and social groups, which are often run by volunteers, must continue to enjoy public funding. Their benefits are significant and their closure is devastating to users and to their friends and families. The social mobility that concessionary travel has given our older folk is another positive example of support.
There is no disputing that we must work to move moneys from dealing with unnecessary emergency admissions to providing quality care at home, in houses that are suitable for our older people. There are good examples of that across the Highlands and Islands where, thanks to funding from the previous Government, the first council houses in a generation have been built, with more to follow. I commend the work that Highland Council and NHS Highland have done on the lead commissioning model and the support that the Government has given that project. However, it is vital that any such major change enjoys the support of staff and their unions. It is fair to report that there might be some way to go with that yet.
Reassurance is key to caring. The Government cares dearly about the NHS. If the public sector focuses on agreed outcomes, any perceived barriers to integrating social care and healthcare will be avoided. I believe that the results that we should focus on will not be found in the share listing of those who are engaged in profiting from care; instead, they will be found in ensuring that person-centred, safe and efficient care is delivered to our older people, regardless of their location.
10:07
In the same item of business
The Presiding Officer (Tricia Marwick)
NPA
Good morning. The first item of business is a debate on motion S4M-00234, in the name of Jackie Baillie, on caring for Scotland’s older people.09:15
Jackie Baillie (Dumbarton) (Lab)
Lab
I welcome the opportunity to open this debate on caring for Scotland’s older people. I can think of nothing more important that deserves the Parliament’s urg...
The Deputy First Minister and Cabinet Secretary for Health, Wellbeing and Cities Strategy (Nicola Sturgeon)
SNP
I begin by doing what I failed to do yesterday when I spoke, which was to welcome Michael Matheson to his new role and to say how much I am looking forward t...
Murdo Fraser (Mid Scotland and Fife) (Con)
Con
I am very grateful to Nicola Sturgeon for giving way. One of the major concerns for residents is the future of the homes. Has the cabinet secretary had any d...
Nicola Sturgeon
SNP
A variety of discussions of that nature are taking place, as the member would expect. I am sure that landlords of the homes will be having discussions with a...
Michael McMahon (Uddingston and Bellshill) (Lab)
Lab
I welcome the fact that the cabinet secretary has spoken directly to COSLA and that discussions are continuing. Have the cabinet secretary’s officials been t...
Nicola Sturgeon
SNP
The Government has a direct interest not only in ensuring that plans are in place overall but in ensuring that arrangements are in place authority by authori...
Neil Findlay (Lothian) (Lab)
Lab
Will the cabinet secretary take an intervention?
Nicola Sturgeon
SNP
I will take one more intervention on Southern Cross, but I have to make progress.
Neil Findlay
Lab
Thank you. West Lothian Council advises me that its contingency plans include seeking placements for residents with other local authorities, suspending respi...
Nicola Sturgeon
SNP
I have already said, in response to an earlier intervention, that the presumption that underpins our contingency arrangements is that older people will not b...
Jackie Baillie
Lab
Will the cabinet secretary take an intervention?
Nicola Sturgeon
SNP
I have a lot of material to get through, but if the Presiding Officer will bear with me, I will take an intervention.
Jackie Baillie
Lab
It is really just to correct what the cabinet secretary said. For the record, I have received no such e-mail.
Nicola Sturgeon
SNP
I have a copy of it here, so I am sure that Jackie Baillie will take it up with the leader of West Lothian Council. I am holding a copy of an e-mail to Ms Ba...
Mary Scanlon (Highlands and Islands) (Con)
Con
I thank the Labour Party for using its time to debate this topic and I commend Jackie Baillie for her well-considered and measured speech.An estimated £4.5 b...
The Presiding Officer
NPA
We move to the open debate. I remind members that they have six minutes in which to speak. We have a wee bit of time in hand, so if you take interventions we...
Claire Baker (Mid Scotland and Fife) (Lab)
Lab
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 ...
Fiona McLeod (Strathkelvin and Bearsden) (SNP)
SNP
As a returning MSP, I have to say that it is a great privilege to make my first speech in what, to me, is a new Parliament. It is also an honour and a respon...
Neil Findlay
Lab
Perhaps the people in Strathkelvin and Bearsden buy food for their older people in M and S, but where I come from many certainly do not.
Fiona McLeod
SNP
I apologise—I was probably being a bit flippant. All I was trying to say was that older people in such situations tend to eat something in a plastic microwav...
The Deputy Presiding Officer (Elaine Smith)
Lab
I call John Finnie, to be followed by Alex Johnstone. John Finnie is making his first speech in the chamber.10:01
John Finnie (Highlands and Islands) (SNP)
SNP
Care of our older people has always been a priority, and older people were the major beneficiaries of the achievements of the previous Government, which deli...
Alex Johnstone (North East Scotland) (Con)
Con
I congratulate John Finnie on his maiden speech and I welcome the fact that he raised a number of constructive issues that we will need to deal with in the d...
Jackie Baillie
Lab
Does the member acknowledge that the overall spending on social care, particularly for older people, runs to billions of pounds and that free personal care i...
Alex Johnstone
Con
Indeed, but I believe that it is indicative of the problem that our commitment to such things will always be more expensive than we hoped it would be.I want ...
Mark McDonald (North East Scotland) (SNP)
SNP
Does the member accept the point that the private sector is good in some areas but there are other areas in which profit-driven motivation is neither require...
Alex Johnstone
Con
I do not believe that there is any evidence to support the idea that the public sector is somehow intrinsically better than the private sector, and I do not ...
The Deputy Presiding Officer
Lab
I call Bill Walker, who is making his first speech.10:13
Bill Walker (Dunfermline) (SNP)
SNP
Thank you, Presiding Officer. I am proud to be the first Scottish National Party MSP for the Dunfermline constituency, which comprises both the city of Dunfe...