Hansard

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