Meeting of the Parliament 14 November 2018
We suggest that another way of doing that would be to look at the Scottish Government directly funding the IJBs. However, another main point in our motion is that there needs to be discussion between the key partners around a financial model that will provide long-term stability for both health and social care in Scotland. The cabinet secretary makes that point herself when she says that they are blaming each other. Why not direct the funding from the Scottish Government directly into the IJBs so that we have transparency?
Moving resources from health to social care is proving to be challenging and progress is not fast enough. Realistically, shifting the balance of care will require investment in social care services if real improvements are to be made. The Scottish Council for Voluntary Organisations raised an important issue around the commissioning of social care services and pointed out that sustainability issues are coming to the fore as the result of factors such as low hourly rates and lack of resources. We must realise that driving down the cost of social care is, in the main, achieved by driving down the pay and conditions of care workers.
My personal experience of home care was when my dad was ill before he died. He had a full care package of four visits per day and, as we spoke to the carers, we discovered that two of those visits were from carers employed by the council and two were from carers employed by an agency. All the carers were brilliant and we could never repay the amazing care and support that they provided to my dad. At the end of the day, therefore, the only difference between those carers was that some were paid a lot less than others, had poorer terms and conditions than others and did not have the same job security as others. Surely, that cannot be right. Surely, we should be promoting a more sustainable model of care that gets the maximum social value from public funds.
That should include more in-house provision so that public funding of care is not used to drive the profits of large-scale commercial providers. Where contracting currently remains necessary, more effort should be made to break up contracts into smaller units, which gives locally based providers a meaningful chance to bid for that work, rather than it going to large commercial chains that are increasingly financially unstable.