Hansard

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."