Hansard

How we care for the old, the vulnerable and the young is considered to demonstrate the essential character of a society, its values and its beliefs. The provision of social care is an essential service to our older people, those with learning disabilities, physical disabilities and mental health problems. At its best, it is about providing care and support to help people to live independent lives. It plays a key role in sustaining people in their own homes, in their own communities, without the need for more formal care.

Social care is provided by local authorities, the voluntary sector and the private sector. We all know about the pressures facing local government, with an average 5.5 per cent real-terms reduction in its budget this year. Nowhere is that financial pressure more evident than in the social care budget.

Local authorities are facing real challenges, such as increased demand set against a backdrop of tightening budgets. We need to be creative about how we do things and how we deliver good outcomes for people and design services to meet their needs and aspirations. There are some positive examples of that, yet they are few and far between.

What appears to be happening across local authorities is a race to the bottom in the procurement of social care, driven solely by cost, and the inevitable sacrifice of quality. Let me be clear: that is not just happening this year; it has been going on for some time. We need only consider what is happening with employment conditions among voluntary sector care providers to see the truth of that. For the past three years, 79 per cent of staff have had no cost of living increase equivalent to local authority rises; 57 per cent of them have had pay freezes. Sixty per cent of voluntary sector care providers have made cuts to their training budgets. Only 15 per cent have any link to public sector pension arrangements.

If members need any more convincing, they should consider what is happening at Quarriers today. Ninety-day redundancy notices have been issued to all staff, front-line staff have been asked to take a 23 per cent pay cut and changes have been made to terms and conditions. Quarriers is not alone: that is happening across the social care sector. I welcome the Unison members from Quarriers who are in the public gallery today and remind members that those front-line staff are being asked to take a 23 per cent pay cut, which, on a modest salary, is staggering. Although I do not want to comment on industrial relations at Quarriers, it is clear to me that the problem that is being experienced there lies with the procurement system.

Local authorities are questioning the hourly rates of care employees of other organisations—interfering, in effect, in the internal pay arrangements of provider organisations. Surely, we should seek to commission services on the basis of the outcomes that are delivered and on quality, rather than on the volume of service that is delivered boiled down to an hourly rate. What does the kind of cut that is being experienced at Quarriers do to staff morale? We would all do well to pause and think. We all agree that the quality of care is of primary importance and that that quality is delivered by people: by families, by friends and by social care staff. In my experience, the people who work in social care are well motivated and care passionately about how they do the job and the people whom they work with, who are often the most vulnerable in our society. We all value what they do—we have said so many times in this chamber. They are at the very heart of ensuring the quality of care that we all care about so much; yet, we choose to reward them by cutting their terms and conditions and slashing their pay.

There is one central truth in all this: we cannot get good-quality care on the cheap. In the past few years, local authorities have increased their charges for services to make up the shortfall in social care budgets. I have some sympathy with the principle that, when people have sufficient resources, they should be asked to make a contribution. However, the approach across Scotland is piecemeal. We have a postcode lottery of care, with different eligibility criteria, different costs and 32 different ways of doing things, which creates an inherent lack of fairness in the provision of social care.

Let us consider the illustration that was provided to members by the Learning Disability Alliance Scotland for further evidence of that. The criteria for charging vary widely. Argyll and Bute Council considers 100 per cent of somebody’s income; across the water in Inverclyde, only 25 per cent of income is considered. How about the hourly rates for home care, which is just one social care service? A picture is painted of wildly different costs in that, too. In West Lothian, home care is £7.76 an hour, but in Angus it is £22 an hour—three times the amount. How is that fair? The guidance on the procurement process has been revised, but the opportunity to do it differently was missed. There are risks in our approach: the unforeseen costs, the disruption to service continuity and the real anxiety for the people who are being supported, their families and their carers. Even leaving those things to one side, it is increasingly clear that the guidance is being ignored in practice and that there is a need for stronger enforcement mechanisms.

The Scottish Government and the Convention of Scottish Local Authorities have published guidance on eligibility for social care. However, frankly, that is being used in local authorities as a rationing system to deny people with needs access to social care, as only the most critically ill and those with the highest needs are getting services. Where is the focus on prevention now? I know that the Scottish Government and COSLA intend to review care charging, but members will forgive me for being slightly impatient. I have been raising the matter for almost three years and voluntary organisations have been doing so for a lot longer—we are nothing if not persistent. It is becoming boring, but every time that we raise the issue, we are told that COSLA and the Scottish Government are going to sit down and review care charging. If they were on performance-related pay, they would take a salary cut for that kind of approach.

Let me resist the temptation to apportion blame, because doing so would not serve us well. I acknowledge that local authorities are struggling to do the best that they can with increasingly limited resources. I want to look ahead. We must urgently ensure that our social care provision is the best that it can be, and I believe that that ambition is shared across the chamber. It is therefore not good enough for the Scottish National Party to sit to one side and say that responsibility lies with the 32 local authorities. The Scottish Government must provide a lead; it must provide a coherent framework that brings together all the different strands of social care—setting minimum expectations across the country, but at the same time stimulating innovation at local level.

The framework could include how to promote choice and independence, and I commend the Government for introducing a bill on self-directed support. The Government knows that it will enjoy the support of members on this side of the chamber for that bill. The framework could also ensure consistent criteria and fairness in the determining of care provision and charging. The framework could focus on prevention and early intervention, not just on crisis, and it could set out a new form of commissioning based on outcomes and quality, not on volume and unit price.

Scotland is not such a vast country that we should experience such wide variation and injustice in the provision of social care. Whether a person lives in Dumbarton or Dunbar, in Dingwall or Dumfries, they deserve a care system that supports them to live as independently as possible and which offers access to the best-quality care possible. The basis of the system, and how much people pay for it, must be fair.

Today’s debate is about people, standards and quality of care. I am therefore disappointed that the cabinet secretary is unable to be here with us, given her personal commitment to the issue. I am astonished that the planning minister is leading in this debate for the Government, and I hope that the Government is not sending a signal that it is more interested in producer interests than in vulnerable people receiving a service.

This task is not for local authorities alone. This is a task for the Scottish Government, and it needs to get on with it. There is no room for complacency. We will contribute; we will feed in ideas; and we will push the Government to do more, as it would expect us to. Above all, this chamber must ensure that our system of social care is overhauled so that it is fair and available to the most vulnerable in our society.

I move,

That the Parliament notes the 5% real-terms cut to the local authority settlement by the Scottish Government; further notes the demographic and financial challenges facing local government in the delivery of social care; recognises that these financial pressures have resulted in substantial reductions in service, with some care providers proposing changes to staff terms and conditions and pay cuts of up to 23%, leading to unprecedented industrial action; further notes the increasing postcode lottery of care, with differing criteria for eligibility and charges across Scotland; believes that the procurement of social care is characterised by short-term decisions based on reducing the cost of existing services rather than having a focus on the improvement, development and redesign of services to provide long-term value for money; further believes that quality and continuity of care is of primary importance and cannot be achieved on the cheap, and calls on the Scottish Government to bring forward a framework for social care to ensure consistency and raise standards for the benefit of some of the most vulnerable people in society.