Meeting of the Parliament (Hybrid)16 February 2021
I will begin by setting out where we find common ground on this subject. In his foreword to the review’s report, Derek Feeley said:
“If we want a different set of results, we need a different system.”
I agree with him. Our system should be built on the values of human rights, equity and equality. We need to have co-production by service users in the design and delivery of social care. We must demand, at last, a decisive shift in public policy, and a shift of public spending towards prevention, which was recommended a decade ago by Campbell Christie. Instead of that, over the past 10 years we have witnessed cuts of up to 20 per cent to social care services in Scotland, as the SNP central Government has decimated local government budgets year after year.
As the report says, public spending on social care represents
“an investment in the Scottish economy”
and the principle of
“social care free at the point of need”
should be adopted right across Scotland. In addition, the long-standing—and outstanding—question of the undervaluation of the sector’s predominantly female workforce must be addressed with renewed urgency and unwavering ambition.
But let me turn to the report’s main conclusion, which is that we need to create a national care service. I agree. The Government’s motion speaks of establishing
“a National Care Service in law, on an equal footing with NHS Scotland”.
I agree with that, too. However, that is not what the review recommends. In fact, it goes out of its way on that point by devoting a whole section to an attack on the case for public ownership. It points to the example of Home Farm care home on Skye. However, that care home does not make the case for continued private ownership of social care; it makes the case against it.
We know—because it is in the report—that 84 per cent of the current annual funding of social care in Scotland comes directly from the public purse, through the public sector. However, instead of recommending the creation of a national care service that is publicly funded, and so publicly owned—which would place it on an equal footing with the NHS—the Feeley review recommends that local councils, and the tens of thousands of social care workers whom they employ, be reduced to competing as just another provider in a procurement exercise run by unelected integration joint boards. I ask the cabinet secretary to reflect on whether that is an equal footing.
I accept that the review calls for a “new deal” with private providers. However, its silence is deafening on the ethics of the biggest providers of residential care in Scotland being run by private companies whose ultimate ownership is in offshore tax havens. It is also silent on how public ownership keeps all funding in the local economy and all money reinvested in the care service and its workforce.
If the Parliament is serious—as I believe it must be—about establishing a national care service with the same values as our national health service, and on an equal footing with it, it must be based on public service, not private markets, collaborative or otherwise; human dignity, not corporate profit; and public interest, not the money interest. The means by which it is delivered should be local, it must be democratically accountable and it must be owned and run publicly and not privately.
That matters because, as the cabinet secretary knows, it is about the kind of society that we want to live in, and the relationships of power within it. She must also know that now is the time for boldness, courage and conviction, and that the change that we need to make is not simply for this generation but for future generations. It demands vision from the Government and resolve from the Parliament; above all else, it demands the active consent of the people. That is what we need if we are to create a national care service that is truly worthy of the name.
17:10