Meeting of the Parliament (Hybrid)16 February 2021
It gives me great pleasure to rise for the Liberal Democrats. I welcome the publication of the report of the independent review of adult social care, which examines the future delivery of care for older people and disabled people in Scotland. The review’s recommendations focus, rightly, on a better service for care users and fairer pay and conditions for care workers, all of whom we have come to rely on so much—that is, we have come to understand how much we rely on them—in the course of the pandemic.
The review also sought to address disabled people’s concerns that previous pieces of legislation, such as the Carers (Scotland) Act 2016, the Public Bodies (Joint Working) (Scotland) Act 2014 and the Social Care (Self-directed Support) (Scotland) Act 2013, have not worked sufficiently well or lived up to the aspirations that were set for them. They have not created a system that is based on human rights, which would allow each individual to achieve their goals.
The review’s aims are laudable, and the Liberal Democrats will always support efforts to stretch ever higher in the quality of support that we offer. We support moves such as the establishment of national entitlements and paying our workforce so as to make social care a profession of choice and recognise the tremendous contribution that those workers make to the fabric of our society.
We have tried and failed to reform social care through policy before, so this root-and-branch review is both timely and necessary. However, the suggested move to a national governance structure causes us significant concern. To our minds, the delivery of health and social care is not suited to central control. That is why we—rightly—have 14 territorial health boards, and even more integration joint boards. Subsidiarity must apply here, because Scotland is too diverse for a one-size-fits-all approach to the delivery of care that is governed from the centre. We need only look at the problems that came with the amalgamation of Scotland’s regional police forces to form Police Scotland to see the difficulties that can arise from a central-belt-knows-best approach.
As Liberals, we believe that there should be a step change in social care so that it is provided on a human rights basis and is built around the individual and the realities of their geography. Care should be considered a normal part of human life that merits investment in order to allow people to achieve their goals and secure their own wellbeing. As with all aspects of intervention in health and social care, we should embrace prevention first and foremost to offset the need for that care. Where care is needed, as it will be more often than not, people should have the security of nationally prescribed entitlements and the expectation of a gold standard of provision. We need a step change in how we do that, and that change will be key to improving quality of life for social care users. Implementation should begin now, through existing systems, and should not be delayed by the need to create a cumbersome, overarching organisation to deliver it.
Above all, those in the social care workforce should be respected for the work that they do. As a result of the pandemic, they have finally received—perhaps for the first time—some of the recognition that they deserve. They should be afforded a nationally agreed and mandatory fair work package that will make social care a profession of choice and allow us to retain those vital high-quality individuals in the profession.
The answer in social care is never centralisation. Centralisation has not delivered the benefits that were promised for other public services, and the loss of local democratic accountability is a risk, not a benefit, to care users and staff. As Liberal Democrats, we will work with other parties in the chamber, and with the architects of the report, to reform social care in our communities, embracing much of what those communities ask of us.
We need changes in the experience of care users and care workers, as described by the independent review, built around a new national consensus that social care should be provided on the basis of human rights first and foremost. We need the setting of national care service standards and entitlements, with the funding put in place to meet those standards. Effective complaint resolution procedures for those for whom services do not come up to scratch should be at the heart of the system. We need local commissioning to involve disabled people and other care users in service design, and to be informed by local experience of unmet needs, as highlighted by the independent review.
Changes to value the social care workforce better should include a requirement that any care service, whether it is delivered by public, private or charitable providers, must comply with fair work requirements that are set nationally, and all staff should have nationally agreed pay, terms of employment and career progression.