Chamber
Plenary, 15 May 2008
15 May 2008 · S3 · Plenary
Item of business
Free Personal Care
We welcome this debate on free personal and nursing care, which is often referred to as the flagship policy of the Scottish Parliament's first session. In moving the Conservative amendment, I confirm that it has nothing to do with blame but everything to do with fairness. We seek the support of MSPs across the chamber to ensure that there is no postcode lottery in relation to funding or payments in different local authorities in Scotland. It is neither fair nor equitable for elderly people to pay for assistance with food preparation in eight council areas while the service is free in the remaining council areas. My colleague David McLetchie will speak in more detail on that issue.
I pay tribute to the Presiding Officer—I wanted the opportunity to use the word "you", but Alex Fergusson is not in the chair—for the sterling work that he has done in supporting his constituents in successfully challenging Dumfries and Galloway Council to overturn its policy of charging for food preparation.
The £40 million to address the funding shortfall that Stewart Sutherland identified is welcome. However, I ask the cabinet secretary to ensure that the monitoring of the new single outcome agreements ensures that that money is allocated to the care of the elderly.
Another issue that I want to raise is the higher funding that is provided to people in council-run homes in comparison with the funding that is provided to those in homes in the independent and voluntary sector. I note the report's reference to the positive work that is being done by the Government and COSLA. I hope that the end result of that is that all elderly people who are eligible for free personal care are treated fairly and equitably. It cannot be right that councils pay a higher amount to residents in council-run homes than they pay to those in homes in the independent and voluntary sectors, given that all care homes are expected to achieve the same Scottish Commission for the Regulation of Care quality standards.
On the issue of direct payments, still not enough elderly people or their carers are aware of the scheme. Direct payments offer people freedom and choice of care package as well as the independence to ensure that care is given in accordance with the assessment, rather than the monopoly of council-only care provision. For many people throughout Scotland, the care provided by councils is first class—the time promised is the time given—but in many instances that is simply not the case. We seek more choice.
I make no apologies for repeating my next point on integrated care homes. When the Community Care and Health (Scotland) Bill passed through its various parliamentary stages, we were given to understand that every care home would have nursing input. That might mean a nurse on duty 24/7 or a visit by a district nurse as and when required. When a frail elderly person's condition deteriorated, a move to a nursing home was not to be necessary for the person to receive the appropriate end-of-life care. However, somewhere between the bill's parliamentary stages, the care commission, guidance and the bill's implementation, we ended up with not one type of care home but three: residential care homes, nursing homes and integrated care homes. Only in integrated care homes will elderly people receive care that ranges from that found in residential care homes to that found in nursing homes. As a result, elderly people are now being kept in residential care homes when they need nursing care. Before the expansion in the number of care homes, frail elderly people were treated in NHS hospitals for their end-of-life care, with the appropriate medical and nursing input. What we have now is a lesser service, with less nursing and medical input in end-of-life care.
The selling of the family home to pay for care also needs to be examined. I had a recent case—two or three years ago—in which a 50-year-old woman who had lived with her mother all her life and cared for her at home was faced with having to sell her home or take out a mortgage to buy out her mother's share in order to pay for care. I trust that that issue will be examined along with the other financial points that Lord Sutherland raised.
Jackson Carlaw will discuss future needs in relation to demographic policy, which is an absolutely crucial issue that Margaret Curran spoke about well. I found the figures in Lord Sutherland's report quite shocking. Over the past five years, from 2002 to 2007, the average increase in the number of publicly funded older people receiving care at home was 51 per cent. The increases ranged from 0.1 per cent in Dumfries and Galloway to 212 per cent in Perth and Kinross.
I never miss an opportunity to talk about podiatry. Elderly people would undoubtedly be more mobile and less likely to need care in the early stages if they had greater access to chiropody, which is now called podiatry. I am not talking about getting someone to cut toenails; I am talking about ensuring access to a qualified podiatrist, where appropriate, who would provide high-quality foot care advice and ensure that people had greater mobility.
We will support the Government in its pursuit of fair and equitable care for the elderly and in addressing the issues raised in the Sutherland report. However, we will not support the Scottish National Party motion, mainly because it contains the phrase "pursue vigorously", which, in nationalist speak, tends to mean having a big rammy or a big constitutional wrangle with Westminster.
We will support the considered Labour amendment, not only because of the content but because of the tone. The amendment calls on the Scottish Government "to enter into discussions" with Westminster. We would always prefer that the issue of the care of the elderly was examined in a mature and dignified manner and that elderly people were put first and foremost, rather than being used as pawns in a constitutional wrangle.
I move amendment S3M-1902.1, to insert at end:
"and calls on the eight Scottish councils which continue to charge for assisting with food preparation to cease to do so forthwith and all councils which have levied such charges to refund everyone who has been wrongly charged for this service."
I pay tribute to the Presiding Officer—I wanted the opportunity to use the word "you", but Alex Fergusson is not in the chair—for the sterling work that he has done in supporting his constituents in successfully challenging Dumfries and Galloway Council to overturn its policy of charging for food preparation.
The £40 million to address the funding shortfall that Stewart Sutherland identified is welcome. However, I ask the cabinet secretary to ensure that the monitoring of the new single outcome agreements ensures that that money is allocated to the care of the elderly.
Another issue that I want to raise is the higher funding that is provided to people in council-run homes in comparison with the funding that is provided to those in homes in the independent and voluntary sector. I note the report's reference to the positive work that is being done by the Government and COSLA. I hope that the end result of that is that all elderly people who are eligible for free personal care are treated fairly and equitably. It cannot be right that councils pay a higher amount to residents in council-run homes than they pay to those in homes in the independent and voluntary sectors, given that all care homes are expected to achieve the same Scottish Commission for the Regulation of Care quality standards.
On the issue of direct payments, still not enough elderly people or their carers are aware of the scheme. Direct payments offer people freedom and choice of care package as well as the independence to ensure that care is given in accordance with the assessment, rather than the monopoly of council-only care provision. For many people throughout Scotland, the care provided by councils is first class—the time promised is the time given—but in many instances that is simply not the case. We seek more choice.
I make no apologies for repeating my next point on integrated care homes. When the Community Care and Health (Scotland) Bill passed through its various parliamentary stages, we were given to understand that every care home would have nursing input. That might mean a nurse on duty 24/7 or a visit by a district nurse as and when required. When a frail elderly person's condition deteriorated, a move to a nursing home was not to be necessary for the person to receive the appropriate end-of-life care. However, somewhere between the bill's parliamentary stages, the care commission, guidance and the bill's implementation, we ended up with not one type of care home but three: residential care homes, nursing homes and integrated care homes. Only in integrated care homes will elderly people receive care that ranges from that found in residential care homes to that found in nursing homes. As a result, elderly people are now being kept in residential care homes when they need nursing care. Before the expansion in the number of care homes, frail elderly people were treated in NHS hospitals for their end-of-life care, with the appropriate medical and nursing input. What we have now is a lesser service, with less nursing and medical input in end-of-life care.
The selling of the family home to pay for care also needs to be examined. I had a recent case—two or three years ago—in which a 50-year-old woman who had lived with her mother all her life and cared for her at home was faced with having to sell her home or take out a mortgage to buy out her mother's share in order to pay for care. I trust that that issue will be examined along with the other financial points that Lord Sutherland raised.
Jackson Carlaw will discuss future needs in relation to demographic policy, which is an absolutely crucial issue that Margaret Curran spoke about well. I found the figures in Lord Sutherland's report quite shocking. Over the past five years, from 2002 to 2007, the average increase in the number of publicly funded older people receiving care at home was 51 per cent. The increases ranged from 0.1 per cent in Dumfries and Galloway to 212 per cent in Perth and Kinross.
I never miss an opportunity to talk about podiatry. Elderly people would undoubtedly be more mobile and less likely to need care in the early stages if they had greater access to chiropody, which is now called podiatry. I am not talking about getting someone to cut toenails; I am talking about ensuring access to a qualified podiatrist, where appropriate, who would provide high-quality foot care advice and ensure that people had greater mobility.
We will support the Government in its pursuit of fair and equitable care for the elderly and in addressing the issues raised in the Sutherland report. However, we will not support the Scottish National Party motion, mainly because it contains the phrase "pursue vigorously", which, in nationalist speak, tends to mean having a big rammy or a big constitutional wrangle with Westminster.
We will support the considered Labour amendment, not only because of the content but because of the tone. The amendment calls on the Scottish Government "to enter into discussions" with Westminster. We would always prefer that the issue of the care of the elderly was examined in a mature and dignified manner and that elderly people were put first and foremost, rather than being used as pawns in a constitutional wrangle.
I move amendment S3M-1902.1, to insert at end:
"and calls on the eight Scottish councils which continue to charge for assisting with food preparation to cease to do so forthwith and all councils which have levied such charges to refund everyone who has been wrongly charged for this service."
In the same item of business
The Deputy Presiding Officer (Trish Godman):
Lab
The next item of business is a debate on motion S3M-1902, in the name of Nicola Sturgeon, on free personal care.
The Deputy First Minister and Cabinet Secretary for Health and Wellbeing (Nicola Sturgeon):
SNP
I welcome this opportunity for members to consider and explore more fully our response to the independent funding review of free personal and nursing care. T...
George Foulkes (Lothians) (Lab):
Lab
Will the member give way?
Nicola Sturgeon:
SNP
No. If Lord Foulkes cares to listen to me for now, I will take an intervention later.When Labour said two weeks ago that it accepted all Lord Sutherland's re...
George Foulkes:
Lab
Will the member give way?
Nicola Sturgeon:
SNP
I would be happy to hear Lord Foulkes's explanation of the U-turn.
George Foulkes:
Lab
First, I want to offer a little piece of advice. So far, the cabinet secretary is not being very clever in trying to convince us to accept anything that she ...
The Deputy Presiding Officer:
Lab
I have not discussed the Barnett formula.Mr Foulkes, this is an intervention.
Nicola Sturgeon:
SNP
I say to Lord George Foulkes that whatever else the Barnett formula may or may not be intended to do, it is not intended to penalise and punish this Parliame...
George Foulkes:
Lab
Will the cabinet secretary take an intervention?
Nicola Sturgeon:
SNP
Lord George Foulkes has had sufficient time to intervene already.The second reason to pursue the issue relates to the point made last week by Ross Finnie. Th...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
I will of course explain the substance behind our amendment in my speech. Does the cabinet secretary acknowledge that, in his report, Lord Sutherland recogni...
Nicola Sturgeon:
SNP
I hope that the later explanation of Labour's U-turn is better than that pathetic effort from Margaret Curran.The third reason to pursue the issue involves t...
Duncan McNeil (Greenock and Inverclyde) (Lab):
Lab
Will the cabinet secretary take an intervention?
Nicola Sturgeon:
SNP
I am in my last minute.I agree whole-heartedly with Labour's former First Minister Henry McLeish that the issue should not be a matter of petty rivalries. It...
Margaret Curran (Glasgow Baillieston) (Lab):
Lab
I reiterate what the cabinet secretary said: this debate is indeed important and welcome. I also reiterate what was said last week. We thank Lord Sutherland ...
Nicola Sturgeon:
SNP
I accept the points that Margaret Curran makes. She is absolutely right and has correctly quoted Lord Sutherland. However, he also said that before we review...
Margaret Curran:
Lab
I was just about to address the issue of attendance allowance directly. To some extent, Nicola Sturgeon has made my case for me. In her fairly lengthy speech...
Christine Grahame (South of Scotland) (SNP) rose—
SNP
Margaret Curran:
Lab
I ask Christine Grahame to let me make a point that I need to make.We accept and have argued consistently that the resources should come to Scotland, but I w...
Mary Scanlon (Highlands and Islands) (Con):
Con
We welcome this debate on free personal and nursing care, which is often referred to as the flagship policy of the Scottish Parliament's first session. In mo...
Ross Finnie (West of Scotland) (LD):
LD
The position of the Liberal Democrats remains that one of the hallmarks of a civilised society is how it looks after its elderly. In common with many, we hav...
George Foulkes:
Lab
Will the member give way on that point?
Ross Finnie:
LD
I hope that this intervention will be considerably briefer than the member's earlier intervention. However, I am graciously pleased to allow him to intervene.
George Foulkes:
Lab
Ross Finnie will remember that the UK Government, of which I was a member at the time, made it absolutely clear that it could not make a specific grant to th...
Ross Finnie:
LD
I do not mind entirely accurate recollections but, with all due respect, that intervention was not entirely accurate. I do not think that the then Scottish E...
Dr Richard Simpson (Mid Scotland and Fife) (Lab):
Lab
That is a gross misinterpretation of the Wanless report, the point of which is the need for a broad and strategic review of the policy. Indeed, that is why t...
Ross Finnie:
LD
Ross Finnie might not have got it correct, but he knows that after setting out three possible models, including free personal care for the elderly and a part...
Christine Grahame (South of Scotland) (SNP):
SNP
I congratulate Ross Finnie on his thorough and logical analysis of the issue and support the Liberal Democrat amendment. As those who recall my question to t...
Margaret Curran:
Lab
Christine Grahame must appreciate the argument that I am making today. I am not saying that the attendance allowance issue should not be addressed. My issue ...