Hansard

I am wondering whether I have been in the same chamber as the cabinet secretary for the past couple of hours. She came to the conclusion that we should have substance over rhetoric with no sense of irony whatsoever. My word, the cabinet secretary needs to reflect on that.

It was a pleasure to listen to Dr Simpson’s commentary today; he has a complete grasp of the issues. I forgive him for calling me Dr Findlay earlier. I know that he is stepping down at the election, and the Scottish Parliament will be poorer for the fact that he will not be here to comment on such vital matters as the integration of health and social care. We will not write his political obituary quite yet, but his contribution today was very powerful.

I will come to the challenges in the health and social care system, which Jackie Baillie set out, in a minute, but I must start by saying that high-quality social care for our elderly and vulnerable citizens is one of the most important and pressing issues affecting our society.

Jenny Marra, Nanette Milne and the cabinet secretary all mentioned the Audit Scotland report. Of course, reports can be, and are, spun by politicians in many ways. We can all do that, and we can all talk about structures and management issues. However, the reality is that, as a society, we are failing to provide decent care for our older and most vulnerable people, and the Government is failing to deal with a crisis that is going on here and now.

Last year, the Scottish Government claimed in its discredited white paper on independence, “Scotland’s Future: Your Guide to an Independent Scotland”, that it would

“continue to provide ... world-leading ... social care”.

I ask the cabinet secretary to reflect on that statement, because that is not the lived reality for so many people and their families; for social care staff who are trying valiantly to do the work that they love; or for councils that are bled dry of funds with yet more pressures heaped on them.

Today, more than 61,000 people receive more than 700,000 hours of part-time care a week, which equates to an average of 11.5 hours per person. On top of that, there are others in long-term residential care. There are 141,000 care workers who provide that care. Care is a big employer, and the sector is only going to grow and grow.

Those numbers prove what we already know: that social care is an area that impacts on all of us. We all know or are related to someone who is either receiving care or who works in the sector. Indeed, many of us will depend on the care sector to look after and care for us at some point in the future—for some of us possibly sooner than for others, but I will not go into that too much. We have a growing elderly population, and many people are living longer with multiple conditions. That is all happening at a time of social care integration, running alongside huge cuts to public services—a perfect storm indeed. All the time, our hospitals are backed up with people who could and should be looked after at home in familiar surroundings.

As budgets have been cut, care has been privatised and standards have fallen. Care visits of 15 minutes, which were originally designed as a management tool, have become the default allocation of care time. Contracting has driven down costs to the extent that the sector is now typified by low pay, job insecurity and poor conditions. Many staff who love their job and go well beyond the call of duty to provide care are at breaking point or have left the sector altogether. They feel undervalued, and they have little job security. They do not get paid for travel, some do not get paid for their uniform and some have to pay for their own mobile phone calls. That is the type of system that we have created. Time and time again, we hear of care staff leaving to work in supermarkets or shops, or in other types of employment—anywhere else, because they cannot live and bring up their families under such conditions.

Mark McDonald said that he wanted care staff to speak out positively about their jobs, and Richard Lyle said that care workers were “heroes”. Let us listen to what some of those heroes are saying. This information comes from a staff survey by Unison 18 months ago, and the situation will have got worse since that survey was published. The survey reported that the majority of workers believed that the service that they provided was not sufficient to meet the needs of the people whom they cared for, in relation to both the time that they can spend with clients and the quality of care that they can provide, with 44 per cent saying that they had very limited time for doing their work so there was a limit to how much time they could spend with their clients. One carer said:

“I have to just rush from one house to the next. It’s very, very stressful. I have told my manager but nothing is done.”

Another said:

“We are not able to deliver the care we are trained to do and want to give/should be delivering to our service users.”

Another said:

“Rush rush rush, I think they forget we are dealing with human beings, old ones at that.”

Another said:

“I’ve been a carer for 16 and a half years ... I am old school, I spend time with my clients, and therefore if I am over my time”—

so be it. The carer continued:

“These are people who rely on you”,

so the carer cannot just go “in and out” and has to have

“a couple of minutes for a wee chat”

because

“it makes their day”,

and they do not want

“rushed about in the morning or evening.”

If we speak to care staff, we find that such stories are repeated time and again.

We know that 39,000 care workers out of the 141,000 working in Scotland receive less than the living wage. That is no way to treat staff in this vital sector. All of that impacts on the care provided.

We hear all the time about people not knowing which carer or how many carers they will see in a week, or even sometimes in a day. They do not know whether the carer who starts one week will be there the next week. That is not good for the continuity or the quality of the care provided. How can we build relationships between the carer and the client in such circumstances? It simply cannot be done. One carer recently told me:

“Staff are not receiving the training they need to carry out their roles, we only get low cost basic training.”

I appeal to everyone to agree that that situation cannot go on. We cannot treat social care staff as if they were second-class or third-class citizens and then be surprised when the service that they provide is substandard, but that is what we are doing to our elderly and vulnerable friends and neighbours.

That is why we published today the report of our commission for the provision of quality care in Scotland, which was an independent commission chaired by David Kelly, the former director of West Lothian community health and care partnership. I thank Mr Kelly and the commissioners who sat on the commission and produced such a good report. The report is a challenge to us all. I am happy to provide any member with a copy of it.

In the report, the commission identifies the need to set out a new social contract of rights and responsibilities that are understood by our citizens; the need for greater devolution of budgets to local teams to develop local solutions with GPs, care staff, social workers and allied health professionals working together; and the need to elevate the status of social care to make it a valued career that people want to go into and remain in—rather than one that they want to get out of—with training and a proper structure. The commission sees the workforce as central to the future of the sector.

Of course, the biggest issue is cash. Some of this is as simple as money. We must put more cash into the care system, and Scottish Labour is committed to doing that. We recognise the vitally important work that carers do, so today we commit to a national care workers guarantee. Under that guarantee, we will ensure that 39,000 care workers gain from a living wage for all care staff, that all staff are paid for their travel, that zero-hours contracts are ended for care staff, and that the staff are well trained to do their job. All of that will improve morale and productivity; most important, it will improve the care that our mums and dads, neighbours and grandparents deserve. We need a service that is fit to address the problems and issues of the 2030s and 40s, not the 1930s and 40s. We commit today to provide extra money to the health and social care sector.