Hansard

First, I thank the dedicated and hard-working staff who work in social care. I am incredibly grateful for the work that they do.

My statement will focus on the far-reaching impacts of recent decisions by the UK Labour Government. However, before that, I would like to take a moment to reflect on how far we have come. Under this Scottish National Party Government, we have introduced free personal nursing care for every person over the age of 65; we are making strides towards effective sectoral bargaining with our trade union partners; and, rather than kicking the can down the road on social care reform, as we have seen from successive UK Governments, we are implementing changes through our Care Reform (Scotland) Bill, which will improve the life of every person who is in receipt of care. We have also continued to invest in social care, having increased spending on adult social care by 69 per cent between 2011 and 2024.

However, that progress is under threat from the decisions of a UK Government that is intent on delivering blow after blow to social care. The latest of those falls from the devastating and needless proposal to end new visas for those working in social care. For workers, for the many vital social care services and for the people in receipt of care, there is no other way to describe that than as catastrophic.

Scottish Care has said that the policy

“would not only be irresponsible, but it would also be reckless. It would put lives, services, and whole communities at risk.”

Providers in the independent and third sectors, who are grappling with the last round of visa changes, have now had the rug pulled from under them. A number of providers are reliant on international workers to fill critical vacancies. Already, Home Office statistics show that, since March 2024, when the callous and cruel ban on visas for dependants of care workers was brought in, there have been 81 per cent fewer applicants for health and care visas. Now, shockingly, Labour wants to reduce the number even further.

We are clear that migration is vital for supporting sustainable communities, our economy and public services in Scotland. Scotland needs talented and committed people from across the world to work here without excessive barriers.

I echo the views of the Coalition of Care and Support Providers in Scotland and reject the notion that social care staff are “lower skilled workers”. They are staff who provide critical and complex care to the most vulnerable people in our country, and for them to be labelled “lower skilled” is demeaning and disrespectful.

The immigration white paper represented a clear opportunity to redress the imbalances in the current system, and, through meaningful engagement, create a system that is flexible, forward thinking and well placed to promote economic growth across the UK.

We have consistently made the case for tailored migration routes within a single UK immigration system, and in March, we provided a set of policy proposals to the Home Office to feed into the white paper’s development. Shamefully, to date there has been no substantive engagement from the Home Office on any of the policy proposals that we contributed. The UK Government’s complete failure to engage with the Scottish Government underlines, once again, that Scotland is barely an afterthought for Labour. Now, more than ever, it is clear that Scotland needs full powers over immigration in order to properly support our public services.

However, we know that this is not the only challenge facing the sector. Over recent years, the social care sector has been hit by a whole host of issues: Brexit, Covid, increasing demand, the cost of living crisis and workforce challenges. Those have increased the risk to the continuity and quality of care and support for people across all communities in Scotland.

Despite that, in its autumn statement, the UK Labour Government took the decision to increase employer national insurance contributions and lower the threshold at which employers start to pay them. That reckless decision has placed a heavy and entirely avoidable financial pressure on our social care sector. My officials have estimated that Labour’s decision will cost adult social care alone more than £84 million. When you factor in the costs for directly employed, contracted and commissioned services across health and social care, the figure increases to over £300 million.

At every opportunity, the Scottish Government has vehemently opposed that disastrous decision. We have made our view very clear to the UK Government and called for additional support to fund those costs. That, sadly, has fallen on deaf ears.

In an extremely difficult financial environment, the Scottish Government has responded as best it can by increasing investment into both health and social care. This year’s budget sees a record £21.7 billion going into health and social care, which exceeds front-line Barnett consequentials. The investment will deliver reform and improvement across our services, driving efficiency and delivering the quality and access to services that people have a right to expect.

We have provided almost £2.2 billion for social care and integration, which is almost £350 million more than was set out in our previous commitment to increase social care funding by 25 per cent over the parliamentary session. We are uplifting pay to a minimum of £12.60 per hour for adult social care workers, reflecting the real living wage. We are providing an additional £125 million in order to make that happen, and we have invested an extra £5.9 million in the Care Inspectorate and an extra £13.4 million in our independent living fund. I am also pleased that the partners that are involved in the national care home contract were able to reach an agreement that delivers an additional 5.8 per cent for nursing care and 6.8 per cent for residential care, incorporating some of the increase in employer national insurance contributions, pay rises and inflation.

However, despite substantial funding increases, we know that the national insurance increase remains a significant concern for the sector. While we will continue to demand that the UK Government changes course on national insurance, it is becoming more and more apparent that Labour is perfectly content to balance the books on the backs of the most vulnerable. That is why we have wasted no time in working with local government and the sector to understand the impact of these changes, and explore what might be possible to help address the pressures.

We have provided targeted support through our collaborative response and assurance group, and the cabinet secretary has hosted monthly round-table sessions with the Convention of Scottish Local Authorities, provider representatives and local leaders. We have established a joint financial viability response group with COSLA to engage with key partners. The group has been meeting weekly since February and working at pace to identify the proactive steps that can be taken to mitigate the impact of increasing financial pressures, to protect services and to support people who are in receipt of care. That work is on-going, but we remain committed to exploring options and solutions in a collaborative way.

The new national care service advisory board will also work openly and collaboratively with integration joint boards, local authorities, health boards and organisations across community health, social work and social care in Scotland. It will have a vital role in strengthening transparency around spend and considering how effective spending on integrated health and social care has been.

Once again, I urge the UK Government to rethink, to fully fund the cost of the national insurance changes to social care and to work with us to deliver an immigration system that works for Scotland. To quote Scottish Care again:

“It’s like the UK government decided to make social care provision as hard as possible. National insurance is a nightmare, immigration changes are awful, disability changes will increase demand.”

These decisions cannot wait. In just the past month, we have been notified of five adult social care services that are closing, where the increases in national insurance were a major contributing factor. Those closures alone will result in the loss of more than 80 care home beds. Quite simply, we cannot stand by and allow the social care sector to be sacrificed. We will always work collaboratively, constructively and proactively to support the social care sector in the face of substantial risk. There is only so much that we can do. Without swift action from the UK Government, I fully anticipate that more care services will close and that there will be areas of Scotland that do not have access to social care. That might mean that some have difficulty in securing a care home placement or individuals being cared for many miles from their friends, family and community. That is not a future that I want to see, and that is why I find it heartbreaking that the UK Labour Government is prepared to accept that.