Today is the International Day for the Eradication of Poverty. Since the first Day in 1992, it has become a day during which we are invited to give some thought to the grinding reality of poverty across the world. When our television screens are full of the faces of starving children in Africa or India it is probably easier for us to recognise the reality of poverty. It is probably less easy to see that reality in the lone parent struggling to make ends meet, in the child without the material possessions its peers take for granted or in the hidden life of an older neighbour too afraid to put the heating on in winter for fear of spending savings they no longer have. Poverty in our midst and in our community is often less visible and more hidden unless it is quite literally enshrined in a body sleeping rough and destitute on a doorstep. The United Nations has declared Fighting Poverty to be one of the key aims of their Millennium Development Goals. It is a recognition that poverty only grows unless direct action is taken both to address and eradicate it. The impact and effects of poverty are increasingly recognised and known not least in terms of attainment, education, life quality and importantly upon personal health. As a society we are much more in tune today than in the past with the need to address poverty especially as it impacts itself upon children and young people, recognising as we do the detrimental results this can have on the whole of their lives. One area we are less aware of or even open to discussing is the reality of poverty amongst older people. Indeed there is a growing public mantra which suggests that today’s older person has never had it so good and that those who follow will never ever enjoy the same benefits and wealth. At a factual level it is undoubtedly true that there has, especially in Scotland, been a sharp decline in what is often termed ‘pensioner poverty.’ That has to be acknowledged but the starting point of the improvement were the shockingly high levels of pensioner poverty a couple of decades ago. Acknowledging improvement also risks ignoring the reality of acute poverty, emptiness and detrimental health outcomes for a sizeable minority of older people in Scotland today. According to Scottish Government statistics:

• In 2014-17, before housing costs are accounted for, 19% of children, 16% of working age adults and 17% of pensioners in Scotland were living in relative poverty.
• After housing costs, 24% of children, 19% of working age adults and 13% of pensioners in Scotland were living in relative poverty.

By any calculation those are shameful statistics for a society as developed and relatively wealthy as ours. Behind every statistic is a story of personal pain. Thankfully there are no shortage of programmes and projects – and indeed Government focus – to address child and adult poverty and the mental health distress that results. But what is there for the 17% of older people living in relative poverty? Sadly and comparatively not as much as there needs to be or could be. Undoubtedly measures like free prescriptions, support with fuel, free bus travel and elements of free personal care have and are making a difference .. but… more could and needs to be done to address the issues of poverty, older person’s mental health distress, loneliness and isolation affecting too many older Scots. We are rightly appreciative that life expectancy has increased for both men and women. However, the length of time spent in ill health is also rising as the incidence of health problems increases with age. There is an inextricable link to living less and being unhealthy and the poverty an older person experiences. The lower a person’s social status, the more likely they are to enter older age in poor health and die younger than people from higher social classes. This is especially evident when we see the impact of the social patterning of chronic diseases such as heart disease, stroke and cancer. It is quite right that attention is given to child and adult poverty for that will significantly impact on older person health but it is dangerous – I would suggest – to ignore the factual reality of the impact of poverty upon some older Scots today and to primarily focus on poverty and older age as a future challenge. I met Joan a few months ago. She was born to a family which looked after the pounds as she put it. She was brought up with a canny Scottish appreciation of what she had and a desire never to be beholden to another. She worked hard as a secretary and saved the small amount of extra she was left with. She never married and although she had nieces and nephews they have moved away and become strangers. Joan is now in her nineties, lives in a small flat which she has rented for years, and she struggles every day. She laments the fact she can’t look after herself better, doesn’t go out as her friends have all ‘passed’ and doesn’t receive any services or support. Joan is poor but she would never ever use that word and would be affronted if she knew anyone used it to describe her. But Joan eats one small meal a day usually uncooked which in her own words gets smaller as she gets close to pension day; she massively relies on her fuel allowance but it still isn’t enough to keep the cold away in winter; she never sees anyone as she no longer can manage to go to church; she doesn’t watch television since her old set broke and she can’t remember when she last bought herself some clothes. Yet Joan proudly declares she has enough to bury herself – although no one has had the heart to say that what she has saved will never be enough. There are too many folks like Joan living as our neighbours, the quiet forgotten ones in our midst, their silence speaking to the heart of our vibrant communities. They are not included, rarely noticed, and not missed. They do not show their poverty, yet its truthfulness is as real as that we see in those more visible. Joan is poor. Her poverty is not just of material belonging but of connection, contribution and value. Today’s Day for the Eradication of Poverty should encourage us all to continue the struggle to recognise the poverty of older age, which is so easy to ignore and which all too often remains hidden. Dr Donald Macaskill CEO Scottish Care @DrDMacaskill

At the heart of the social care sector in Scotland there is a systemic discrimination that is often not named or called out for what it is – it is a discrimination based on sex or gender. Over a year ago in its exploration of the Gender Pay Gap, the Economy and Fair Work Committee of the Scottish Parliament in its important report ‘No Small Change’  identified that gender segregation was a real phenomenon within the care sector in Scotland. Indeed, the evidence submission from Scottish Care to that Inquiry argued that gender discrimination was at the root of a great deal of the issues facing the sector. Yet more than a year later has anything changed? – absolutely nothing other than a wider dialogue and acceptance of the challenges of gender discrimination in care and all that entails. Indeed part of this wider valuing of social care has seen the same Parliamentary Committee’s acceptance of the important economic contribution of social care to the overall economy of Scotland. (See Scotland’s Economic Performance) So at the risk of simplification what do I mean by discrimination and why is it an issue? Put simply discrimination is when you treat one group or sector in society in a manner which is less favourable than the way you would treat another person or group. We can easily recognise the racism which considers one group as being less than another because of their county of origin or the colour of their skin. We have become increasingly aware and critical of the way someone who might define their sexual orientation as lesbian, gay, or bisexual might be the victim of homophobia and hate crime. But I would contend that we have become almost blase, dismissive or immune to gender and sex discrimination? Maybe we shouldn’t be surprised. The great strides of the feminist movement in the 1960s have passed into history. There are increasingly very few folks around who remember the fact that a woman employed by a public authority when she returned to work having had a child was often demoted had she been in a management post. Such occurrences seem the stuff of history text books and yet they were happening less than 50 years ago. We have come a long way in some areas and yet in others we have stood still or even gone into reverse. One such area is the way as a society we think about care as a personal responsibility and care as a professional role. We still think of care as primarily a female activity, almost as if the male of the species has not been endowed with the biological attributes to care for someone other than their own self; as if the skills of empathy, compassion and affectiveness were solely female genetic constructs. I would suggest in the face of this that we need to develop a response to this sex and gender discrimination – a response fit for the new age we find ourselves in. Such a response, I would contend, has numerous strands to it but at least must include the following: • A re-designed early years and child support system that enables real participation of all in the workplace. There has long been widespread recognition that a critical enabler of female and male participation in the workplace is a coherent, high quality and affordable child care and early years system that gives parents confidence to go out into the workplace. Despite improvements we are some distance from achieving this in Scotland. Childcare is still ridiculously expensive and for many the thought of working in the care sector when they have young children is simply unaffordable. Our Government could significantly incentivise investment in social care by giving special credit status to enable care workers to benefit from reduced or even free child care. • An increased emphasis in challenging stereotype and gender segregation in primary and secondary education. We know that many children have consolidated their sense of occupational identity and thus role segregation by mid way through primary school. We must give children opportunities to understand that care is without gender and is both a responsibility of and opportunity for all. The increased emphasis on inter-generational working and shared facilities is serving to put a spotlight on what can be achieved in changing attitudes to older age and frailty. Significant investment from central Government and making this a key cultural and economic priority would consolidate these early foundations. • A real focus on workforce in social care – and that is a whole system and a root and branch reformation of practice. On the one hand there is a growing recognition that social care is an enabler of economic performance and community wellbeing but on the other the way we reward and remunerate those who care suggests a low societal esteem and community value. Undoubtedly the Scottish Living Wage sought to be a step-change but it’s patchy implementation has brought even greater fragility to the care sector. Pay on its own won’t address the challenges of fair work though failing to adequately resource a decent wage will remain damaging of future development. But more needs to be done. This includes addressing the reality that in the medium to short term most of our workforce will be older. As a result we need to address one of the major barriers presented by those who return to or enter the care sector later in life. That is, alongside low rates of pay, the costs of retraining and qualifications. The work of Scottish Care in its recent report ‘The Experience of the Experienced’ has helped to focus upon the unique and distinctive contribution of the mature workforce. It has also highlighted that we need to re-frame and re-design our current learning and qualification frameworks to enable greater appreciation of prior-learning and skills than that which currently occurs. But re-framing conditions has to also be inclusive of the principles of fair work. Is it fair that in social care we effectively electronically tag our frontline workforce? Can we expect fairness in work practice when the way we commission care fosters a lack of trust, embeds low value in the worker and creates employment practices which are less than they could be? • We need a re-gendering of the whole care sector. The inescapable reality of our history is that because the care of our most vulnerable has been seen as women’s work then we have accepted it as a task constituting low skill and worthy of lower financial remuneration. We have not done the same for equivalent male dominated areas of work at a similar skill level. There should be an immense shame in the fact that despite nearly 50 years of equal pay legislation we still have women paid less than men for equivalent jobs. Indeed why is it that men undertaking manual jobs are paid so much more? – well the answer is probably pretty obvious – the financial and political decision making not least in both local and national government have been for long dominated by men. We need a dramatic challenge to the gendering of the role and task of care – better paid workers with fairer conditions employed by providers who operate under realistic and properly resourced contracts. We need a re-conception of care which is evident across the whole of society from children’s books to the latest soap opera. This has to be broader than social care commentators. It entails a cultural and societal multi-media strategy. The American Pulitzer Prize winning journalist Susan Faludi famously wrote in 1991 a book called ‘Backlash: The Undeclared War Against American Women.’ In it she argued that the 1980s saw a backlash against feminism, especially due to the spread of negative stereotypes against career-minded women. Her work has become a classic text of gender and sociology and warns women of every generation that the gains of feminism should not be taken for granted but that re-defining and valuing contribution is a continual challenge. With some glorious exceptions, such as the #metoo social movement, I suspect she has been largely prescient. The care sector in Scotland has huge potential to contribute yet more to the Scottish economy, to re-frame our communities as places that welcome older age and frailty, that recognise care is the responsibility of all regardless of gender. We have the potential of creating a dynamic, valued and skilled social care workforce. But it will involve a dramatic shift in cultural thinking and current social norms – re-defining care so that it becomes gender inclusive means that that task becomes all our concern and not just a woman’s work. Donald Macaskill @DrDMacaskill   The Scottish Care workshop ‘Kaleidoscope of Care’ on Friday 28th September explores many of the themes covered in this blog.