Meeting of the Parliament (Hybrid) 24 May 2022
I begin by thanking our NHS and social care workforce. Their efforts over the past two years have been beyond exemplary, and they have worked tirelessly to keep our families safe and well, and to ensure that people continue to get the care that they need in their local community.
I note the aspiration that the Government has expressed in the motion and the debate. The minister said that there is a lot to do and that
“we have a long way to go”.
Forgive me if I take a few moments to question his unfettered optimism, but it is clear that there are significant challenges and barriers to building and enhancing virtual capacity to support a sustainable future and to provide alternatives to hospital while also improving the patient experience.
The Government’s motion fails to acknowledge many of the realities that patients and health and social care workers face. I am sure that all members have heard constituents say that they are waiting too long to see their general practitioner and are not always aware of how to access alternative clinical pathways or why they are doing so. That is in stark contrast to the Government proposition today. We cannot ignore the failure to meet accident and emergency waiting times, the continued delayed discharge figures and the lack of a robust plan to recover services and support staff as we emerge from Covid-19.
The Government’s motion puts significant emphasis on alternative pathways, but evidence to the Health, Social Care and Sport Committee has shown that nowhere near enough work has been done to make people aware of those services. Evidence that was submitted by people who work in services and who support patients to access them shows that waiting times are too long and that the route is often convoluted, which puts additional pressure on general practices and accident and emergency departments.
That is not just a recent trend that can be explained away by the pandemic. One respondent to the committee’s consultation said:
“Even before the pandemic waiting times are over long and normally by the time you see anybody your condition is worse”.
General practices are at breaking point and patients are paying the price, with the pandemic having exacerbated years of decline under the Government. In a poll that was carried out last month, 86 per cent of Scotland’s GPs who responded said that they have felt anxiety, stress or depression in the past year. That is what happens when the Scottish Government does not properly fund and support our NHS. The result is that patients and the people who care for them suffer.
Those examples are not just one-offs. The recently published 2021-22 health and care experience survey has exposed plummeting satisfaction with health and care services in Scotland. The proportion of people who are satisfied with the overall care that is provided by general practices dropped by 12 percentage points in two years, with almost a third of people rating their overall care negatively. I do not believe for a second that that is a reflection of our hard-working GPs and their support and reception staff; rather, it reflects the fact that there is not enough clarity and support for people who are on alternative pathways.
When it comes to building back the foundations of the NHS stronger than before, “NHS Recovery Plan 2021-2026” has failed to deliver. Audit Scotland has highlighted that the recovery from Covid-19
“remains hindered by a lack of robust and reliable data”
across the NHS.
For all the Government’s talk of increasing the number of allied health professionals, in December 2021, there were more than 1,000 whole-time equivalent vacancies. That is simply not good enough and shows that the Government’s rhetoric does not always match reality.
Social care is in dire straits. The SNP has presided over slashing of care packages and withdrawal of respite care, and it has failed to immediately implement key recommendations of the Feeley review, including on removal of residential care charges.
The crisis in social care clearly impacts on our NHS. Delayed discharges are hitting record levels and there are unacceptable waiting times in accident and emergency departments. Despite that, the pace of change in social care has been slow and is faltering in the face of growing pressures from increasing demand and demographic changes. For months, the Royal College of Emergency Medicine has been warning that longer waits will lead to more preventable deaths; this week it repeated its calls for 1,000 new beds across the system.
In short, I say that failure to tackle social care pressures is bad for patients and bad for key services across our NHS. Our social care workforce is demoralised and understandably feels undervalued. There are significant shortages across the workforce, which is resulting in a record high number of delayed discharges that puts strain on key services across our NHS.
Unfortunately, the Government is doing little to make social care a more appealing career choice. Only six months ago, the SNP Government rejected Scottish Labour’s calls to deliver an immediate pay rise to £12 per hour; instead, it opted for a measly 48p per hour increase.
Today, Scottish Labour is calling for steps to be taken to ensure that patients who need to be seen in person can receive speedy treatment. Urgent action is needed to fix our social care system. The “wait and see” approach of the SNP Government regarding the national care service is not good enough. Non-residential care charges must be removed immediately, and the recent narrowing of eligibility for care packages must be reversed and the independent living fund reopened.
There is an urgent need not only for reform, but for tackling poverty pay in the social care sector, which has a predominantly female workforce and experiences long-standing issues of gender inequality. The Scottish Government’s proposed pay increase does not reflect the skilled nature of social care work. The growing staffing crisis that is having a direct impact on our NHS will never be addressed while people can earn more by working in a supermarket or a pub. The future of our social care sector is dependent on a strong, stable and valued workforce. That is why Scottish Labour supports the “Fight for £15” campaign to increase social care workers’ pay. We believe that they need an immediate pay rise to £12 per hour, followed by a further rise to £15 per hour.