Meeting of the Parliament 26 April 2017
I am pleased to speak in the debate today and to show my gratitude to the hundreds of thousands of social work staff members and unpaid carers who work tirelessly to support children and adults in need or at risk in Scotland.
Social care, which is an umbrella term for social work, personal care, protection or social support services for those who are in need or at risk—whether that arises from illness, disability, old age or poverty—has changed for the better over the past 50 years. As I am sure we will all agree today, health, dignity and control should always be at the centre of social care policy. We are moving in the right direction, despite fundamental concerns on which my colleagues and I will expand later.
Beginning with the wholesale transformation of social care for those with learning disabilities, support has shifted away from institutionalisation towards promoting independence in community-based settings. That move is still under way for mental health patients, and I welcome the progress that is being made to support people away from hospital and in truly person-centred surroundings.
The benefits of the process are unquestionable, and we hope that they will be extended even further through self-directed support, the legislation on which aims to give people control over their own support. Since the Social Care (Self-Directed Support) (Scotland) Act 2013, which came into force three years ago—obliging local authorities to offer people who are eligible for social care a range of choices over how they receive their support—people are assessed and a budget is awarded to meet their support needs. Service users have four options: to take a direct payment, which is a cash payment for them to purchase support directly; to choose a provider, but to have the council hold the budget; to have the council arrange their support in full; or a mixture of the previous three options.
As I said, the benefits of person-centred care are dramatic. I recently had the chance to speak to someone who worked for a social care provider and who was able to recite accounts that reinforced that opinion. One gentleman, who moved to supported living from hospital, would always leave his lights on—not because he was incapable of switching them off, but because, for most of his life, he had lived in hospital, where nurses switched the lights on and off for him.
In another case, a woman loathed showering, due to a hospital ritual whereby she had been forced to shower every morning straight after waking up from horrific nightmares. The freedom that her move out of hospital gave her to choose when she wanted to shower—and a more soothing ritual of coffee and a cigarette afterwards, to help her to calm down—enabled her to overcome her fear.
Both people were mental health patients who had lost all sense of independence and control during a long period of hospitalisation, and whose lives were dramatically improved when they were offered choices and dedicated, personalised support.
Despite such positive steps, there are concerns, which many members share. There are grave issues with recruitment and retention—my colleague Donald Cameron will talk about that in more detail. There are fundamental issues to do with staff numbers and working conditions. We have an ageing social care workforce and an ever-increasing workload, and we need to provide the conditions and career opportunities in the sector that will support people.