The Soul in the Circuit: weaving humanity into tomorrow’s care

This extended blog is based on an opening address to the Northern Ireland Social Work and Social Care Research in Practice Conference,  given in Belfast on the 11th March

There is a moment, when you stand close to a piece of old analogue equipment, and you hear not just the operation of the device but something subtler – a faint hum, a resonance. Engineers used to say that if you listened carefully enough, you could hear the “soul in the circuit.”

Today, in a world saturated with digital systems, artificial intelligence, and learning machines, we risk believing that everything valuable must be generated by computing power or captured in data. And yet – in the quiet spaces between calculation and connection – I believe there is something profoundly human still asking to be heard.

This talk is about that something.

It is about how we care, how we age, and how we hold one another in times of vulnerability. And increasingly, how we do all of this in a world shaped by circuits, algorithms, prediction, and artificial intelligence.

I want to start our journey in a place that may seem very far from social care – the world of global retail. Some time ago, I spent a day with organisations who live at the cutting edge of prediction, personalisation, and customer behaviour, from supermarkets to global online platforms. They spoke about the evolution of digital experience: how they have moved from simply observing consumer behaviour, to predicting it.

For over a decade, retail has been obsessed with personalisation. But we are moving beyond that. We are entering the era of agentic AI – systems that act autonomously on our behalf.

In the world of online shopping, AI now: searches, compares, validates, builds baskets, completes purchases, sometimes without the human ever asking directly.

These are systems acting on our behalf, in our interests, anticipating our needs before we articulate them.

The consumer is becoming the passenger rather than the active operator.

This is not science fiction rather this is commercial reality.

As foreign as that might sound to the world of social care, the truth is this: the individuals we support are consumers in that world. Their expectations have been shaped by it. The way technology anticipates their preferences, curates their choices, tailors their experience – all of this is already forming the baseline from which they enter our care homes, our home care services, our community supports.

But here is the essential difference: in retail, anticipating preference is about convenience. In care, anticipating need is about dignity, identity, risk, autonomy, and life itself.

So, when I began reflecting on these two worlds; the frictionless, hyper‑personalised world of retail, and the intimate, relational, unpredictable world of care, I realised that the comparison is not superficial. It is revealing. Because increasingly, both environments are shaped by the same forces. AI doesn’t stay in one sector; it moves with the human person.

And that brings me to the central question: As AI moves deeper into the world of care, how do we ensure it enhances the human soul, rather than replacing or diminishing it? How do we ensure there is always soul in the circuit?

Let me take you further into what I heard that day. The leaders of these companies explained that consumers no longer want endless choice. They want meaningful relevance. Not a flood of information, but a flow of respect. Not bombardment, but anticipation. Not intrusion but understanding. And they described how their AI systems build subtle psychological profiles, micro‑signals, timing rhythms, all in service of delivering something that feels personalised, responsive, almost relational.

So retail is shifting toward anticipatory systems: AI that predicts need before need is spoken.

When I heard that, I found myself thinking about the individuals in our care homes living with dementia, or people supported in their own homes managing layers of frailty, chronic illness, trauma, or loneliness. Imagine – what could anticipatory systems contribute? Devices that learn sleep disturbance before it spirals into crisis. Sensors that understand gait patterns and predict falls. Tools that identify subtle changes in mood, speech, mobility, or appetite that even the most attentive human might miss.

In a society like Scotland, where ageing demographics and workforce pressures collide, anticipatory care is not just desirable, rather it is essential. It has the potential to reduce crises, prevent unnecessary hospitalisation, and enable people to stay rooted in their homes, their communities, and their identities for longer.

But at what point does anticipation become paternalism? At what point does support become surveillance? At what point does helpfulness become a quiet erosion of autonomy?

That tension sits right at the centre of this talk.

In retail, there is a new term: the omniconsumer.

Retail is not only evolving personalisation; it is dissolving the idea of channels altogether. You are not a user of a platform – you are the platform. Everything flows around you. You become the pivot, the context, the centre point.

In social care we are – quite frankly – nowhere near that level of integration. Instead, we ask older citizens to navigate mazes of disconnected systems, assessments, criteria, budgets, professionals, and agencies. We ask people living with dementia to retell their story every few weeks to strangers. We ask families to do detective work simply to find out what support exists. And we act surprised when those living with complexity feel lost.

Yet the possibility exists – not for a consumerised model of care, but for an ecology of support shaped around the human being, not around institutions or service silos. A model where AI becomes the connective tissue holding information together, reducing friction, amplifying the contribution of the workforce, enabling continuity, and strengthening human connection.

Retail’s omniconsumer is simply a commercial metaphor for what we in care have known for generations:

A person’s life is not a set of disconnected episodes – it is a whole, living, relational story.

And AI allows us, perhaps for the first time, to coordinate care in a way that honours that wholeness.

But with this immense capability comes risk.

For older adults – especially those living with cognitive impairment -agentic AI could begin making decisions for them rather than with them.

We could see: erosion of autonomy, opaque decision-making, surveillance without consent, systems that infantilise rather than empower and a loss of the right to “be” rather than be managed.

And perhaps the greatest risk: that overstretched services begin to rely on AI as a substitute for human presence.

This is where the soul can be lost in the circuit.

None of the positives are inevitable. It requires ethical architecture. And for me, that ethical and human rights architecture has a name: PANEL – Participation, Accountability, Non‑discrimination, Empowerment, and Legality. PANEL is not a checklist; it is a philosophy of practice. It is how we keep soul in the circuit.

Participation means the older person, the individual receiving care, must shape the technology, not simply be shaped by it. Their stories, fears, rhythms, habits, hopes –  these must be the raw material from which AI is designed. People with dementia, with learning disabilities, with mental health conditions; they know what helps, what harms, what preserves dignity. They must be co‑creators.

Accountability means there must always be a human answerable for what AI does. AI cannot become an unchallengeable oracle. Decisions must be explainable. Systems must be transparent. No person receiving care should feel powerless in the face of automated judgement.

Non‑discrimination matters deeply because AI inherits the bias of the data it is trained on. And since most datasets are drawn from younger, healthier, more digitally active adults, older people risk being mis-classified, overlooked, or misunderstood. If we do not build inclusively, AI will magnify inequality.

Empowerment is perhaps the most profound. Technology must expand a person’s independence, not diminish it. It must help someone to live the life they want, not the life a system predicts for them. It must create capability, not dependency; confidence, not compliance.

And Legality is the foundation: rights must not lag behind innovation. The frameworks that uphold privacy, consent, autonomy and protection must evolve as quickly as the systems we deploy.

These principles are the spine of ethical care in an age of AI. They are the way we keep the compass steady. They are the way we ensure dignity does not become an afterthought. They are the way we weave humanity into technology, rather than allow technology to erase humanity.

And they matter because the workforce is exhausted. We have a crisis not of compassion but of capacity. People are leaving roles they love because they cannot sustain the burden. They are drowning in documentation, in regulation, in the administrative architecture of care. We ask them to be both sherpa and shield, guide and guardian, healer and administrator.

AI enters this space not because we wish to technologise care but because we wish to preserve it. Used well, AI can remove burden, free time, streamline tasks, amplify decision‑making, and allow carers to spend their time doing the one thing no device can ever replicate — being human. Holding a hand. Listening to fear. Sitting in silence. Bearing witness to a life.

That is not automation; that is liberation.

But we must also face another truth. Loneliness is epidemic. For many older adults, companion technologies, conversational agents, memory‑prompting devices, social robots are arriving as lifelines. We should not be afraid of this. Companionship technologies can stimulate connection, reduce anxiety, support sleep, and provide reassurance in long nights. But they must never become the substitute for human contact. They must be bridges, not walls. They must lead back to community, not away from it.

And this brings me to the heart of the matter.

The measure of success in AI in care is not efficiency. It is human connection.

If AI deepens relationship, strengthens autonomy, widens possibility, and restores dignity then it is ethical. If it replaces presence, narrows choice, or fragments relationship then it is not.

We stand at a moral threshold. Not simply a technological one. The question before us is: Who do we want to become? A society that manages ageing? Or a society that honours it? A sector that uses AI to compensate for scarcity? Or a sector that uses AI to create abundance? A world where human contact is optional? Or a world where technology frees us to be more present than ever?

The truth is simple: technology will be woven into the fabric of future care, into homes, behaviours, decisions, routines, conversations. But whether it diminishes or enhances the human experience is entirely up to us.

The soul is not in the machine.
The soul is in the intention.
The soul is in the relationship.
The soul is in the choice to design with dignity, to govern with humility, to innovate with compassion.

If we hold to PANEL, if we centre autonomy, if we prioritise presence, if we protect story, then we can weave the soul into every circuit. We can build a future defined not by what technology replaces, but by what it restores. Not by data, but by meaning. Not by scarcity, but by relationship.

And that, I believe, is our task. To ensure that as AI accelerates, humanity deepens. To ensure that as systems become more intelligent, we become more compassionate. To ensure that in every algorithm, every interface, every automated moment, the dignity of the human person remains paramount.

We have an opportunity, rare, profound, urgent, to build a future in which technology amplifies what makes us human, rather than eroding it. A future in which ageing is held with tenderness, decision‑making is honoured, vulnerability is protected, and care is celebrated as the heart of community.

Let us choose that future. Let us shape it together. Let us weave the soul into the circuit.

Thank you.

 

Holding liberty and safety in one hand: adult protection and human rights

The following is based on a talk given to the Adult Support and Protection in Supported Settings conference (ASPIRE) a couple of weeks ago.

 Every morning, somewhere in Scotland, a hand is held out.

It may be on a tenement stairwell where the paint is peeling and the light is poor. It may be at a cottage door, wind pressing against the frame. It may be across a kitchen table where the kettle has boiled twice already, because the conversation has taken longer than expected. That hand belongs to a social worker, a district nurse, a support worker, a care professional of one kind or another.

It is not a hand extended to seize control.
It is a hand offered to steady.
To accompany.
To share risk.

This is where adult protection truly lives. Not first in statute or guidance, important though these are, but in these ordinary, human moments where voice and safety pull against one another, and where the task is not to choose between them, but to hold them together.

The tension we live with

Much of our public language still frames safeguarding as a contest: autonomy on one side, protection on the other. We talk as though we must sacrifice one to secure the other. Yet anyone who has practised in adult protection knows that this framing is false.

Safety achieved at the cost of voice is not safety. It is containment.
Autonomy asserted without regard to real harm is not freedom. It is abandonment.

The real work, the hard work, takes place in the space between.

It is there, in that narrow, uncomfortable space, that practitioners reason, hesitate, listen again, and sometimes carry the weight of decisions that will never feel entirely clean. This is not technical work alone. It is moral labour, undertaken daily and often invisibly.

Scotland’s adult protection framework is, in international terms, strong. The Adult Support and Protection (Scotland) Act 2007, the Adults with Incapacity (Scotland) Act 2000, and the Mental Health (Care and Treatment) (Scotland) Act 2003 all encode a careful balance. They do not invite us to trade liberty for safety. They require us to secure safety through autonomy, participation and proportionality.

The principles are clear: benefit, least restriction, respect for wishes, supported decision‑making, review. PANEL- Participation, Accountability, Non‑discrimination, Empowerment and Legality- sits as a human rights model beneath this as a deceptively simple but profoundly demanding lens.

Yet law, on its own, does not do the work for us. It gives us scaffolding, not shelter.

Recent joint inspections of adult support and protection across Scotland have been honest about this. Multi‑agency working has improved. Commitment is evident. But variability remains, particularly in chronologies, in risk formulation, and in how consistently lived experience is captured and used to shape decisions. Where voice is poorly recorded, it is too easily overridden. Where proportionality is not clearly reasoned, restriction can quietly become routine rather than exceptional.

This is not about blaming practice. It is about recognising that rights‑based safeguarding requires constant attention. It is never finished. It must be renewed in every assessment, every case conference, every supervision conversation.

The quiet danger of urgency

One of the greatest threats to rights‑based practice is urgency.

Fear presses. Risk escalates. Time feels short. And in those moments, the temptation is to act quickly; to “do something” even if what is done narrows a life more than is truly necessary.

International human rights research repeatedly shows that when decision‑making collapses into speed alone, proportionality suffers. The most effective safeguard against unnecessary restriction is not abstract balancing, but disciplined insistence on the question: Is there a less restrictive way? Where that question is taken seriously, rights are more robustly protected and outcomes improve.

This is why proportionality is not a bureaucratic hurdle. It is an ethical brake.

To pause is not to neglect risk.
To slow down is not to be naïve.
Often, it is the most protective act available.

Beyond Scotland, the same tensions are being named with increasing clarity.

In 2024, the UN Independent Expert on the human rights of older persons, Claudia Mahler, published a major report on legal capacity and informed consent. It describes a global pattern in which consent in later life becomes procedural rather than meaningful; a nod, a signature, an acquiescence shaped by fatigue, pain or power imbalance. Capacity, too often, is assumed to be lost rather than actively supported.

The Expert’s message is disarmingly simple: presume capacity; support communication; treat consent as a process, not an event.

This resonates deeply with everyday practice. The unhurried cup of tea before the difficult conversation. The hearing aid battery replaced. The quieter room. The advocate who waits in silence until the person finds their words. These are not soft extras. They are the practical means by which autonomy is made real.

At the same time, something historic is unfolding. In April 2025, after fourteen years of evidence‑gathering and advocacy, the UN Human Rights Council established an intergovernmental working group to draft a legally binding convention on the rights of older persons. The conclusion was stark: existing international protections leave older people exposed to discrimination, abuse and the erosion of voice, particularly in health and care settings.

This is more than diplomacy. It is a signal, to governments, to inspectors, to practitioners, that age must never be treated as a proxy for incapacity, and that protection must never be used as cover for exclusion.

Even before a convention is finalised, its normative pull matters. Expectations shift. Scrutiny sharpens. What once passed unquestioned will increasingly require justification.

Most restrictions of liberty do not arrive dramatically. They arrive softly.

“She’s 89—she won’t manage.”
“He’d be safer if we just…”
“At her age, is it really worth…?”

Ageism rarely announces itself. It seeps into thresholds, hastens moves, narrows imagined futures. The UN’s work on older persons’ rights is explicit that these assumptions are not benign. They are discriminatory, and they materially increase the risk of harm rather than reduce it.

Safeguarding done badly shrinks a life.
Safeguarding done well creates the conditions in which life can still be lived.

The emotional cost of holding the balance

What is often missing from our systems is acknowledgement of the emotional labour involved in holding liberty and safety together.

To protect without overpowering.
To respect choice while living with uncertainty.
To know that whatever decision is taken, it will leave a residue.

This work demands professional courage. It asks practitioners to tolerate ambiguity, to justify restraint when necessary, and to step back when fear would rather tighten the grip. It also asks organisations and leaders to create cultures where thoughtfulness is protected, not penalised.

Holding the hand, not tightening the grip

What does this mean, practically, for adult protection?

It means treating advocacy as a default where decisions carry significant restriction, not as an optional add‑on.
It means writing chronologies that tell a causal story, not merely a timeline.
It means recording capacity as specific, supported and time‑bound, never as a fixed label.
It means making PANEL the structure of our conversations, not just our paperwork.

Above all, it means remaining present, especially when fear is loud.

In the end, adult protection is not about the subtraction of freedom. It is about companionship in risk. About walking with someone far enough that they remain themselves, and close enough that harm does not have the final word.

To hold liberty and safety in one hand is not easy. But it is the work.

And every morning, across Scotland, it is being done, quietly, imperfectly, thoughtfully, and with courage.

 

Donald Macaskill

 

Photo by Nathan Dumlao on Unsplash

Apricity: The warmth that breaks winter: a reflection on social care.

February is a month of thresholds. The earth is still held in winter’s grip, but the light is unmistakably returning. Days stretch by minutes, a shy lengthening, and occasionally, on those rare, crystalline afternoons like the ones we had a couple of weeks ago, the sun breaks through and offers something almost startling: a moment of warmth in the cold.

As regular readers know I’m a sucker for an unusual word, especially old ones which have fallen out of use, and I came across one such just this past week.

Apricity means the warmth of the sun in winter.

It first appeared in the 1620s, likely derived from the Latin verb apricari, meaning “to bask in the sun.” The same Latin root also gives us apricus, meaning “sunny” or “warmed by the sun.” From this root, English formed apricity; a word that flickered into use for a century or two before fading into poetic obscurity.

In essence, apricity describes a gentle, unexpected gift: the way the sun can land on your skin in the cold months and momentarily transform a harsh landscape into something quietly hopeful. It is a word that wraps meteorology in emotion, suggesting not just temperature but soothing relief, renewal, and quiet joy.

It is hard to imagine a better metaphor for the work of social care and the people who deliver it. In a season defined by scarcity, strain, and austerity; in turn a financial winter, emotional winter, political winter – at such a time as we are currently enduring – carers bring warmth that feels improbable, generous, life‑altering.

In the world of social care, apricity appears not as meteorology but as presence.

It is the warmth of the support worker who arrives with humour in their voice despite a long shift.

It is the quiet companionship offered to someone who fears the night.

It is the patience needed to listen, to really listen, when the world moves too quickly for those who can no longer keep pace.

Apricity is found in the everyday: a hand steadying someone’s steps; a cup of tea made just the way they like it; the way a carer remembers their stories, their rhythms, their personhood.

All too sadly these acts do not melt the snows of bureaucracy, nor end the frostbite of underfunding. But they are transformative in their own small, glowing way.

Social care often functions in the coldest parts of society, in places of poverty, loneliness, fragility, and grief. Yet it generates warmth that radiates outward, shaping families, communities, and the national character.

Think of the elderly woman whose world has shrunk to the dimensions of her living room. To her, the home‑care worker is not merely support: they are sunlight breaking through cloud, a reminder that life is still capable of connection.

Or consider the young woman living with complex needs whose support team empower her to take her place in the world: to go to college, nurture friendships, have ambitions. Where once she felt invisible she is now seen.

These are acts of apricity.

They are the winter sun that coaxes life into movement again.

If February’s natural world is shifting toward renewal, perhaps our social care world can do the same. The warmth carers provide is real, but they are themselves often exposed to the cold: low pay, workforce shortages, burnout, and the emotional toll of always giving, always absorbing.

To honour apricity in social care is to ensure the carers themselves are warmed.

That means valuing the emotional labour built into every interaction; it means recognising care as a skilled, relational profession; it is furthered by ensuring fair conditions that allow carers the rest and renewal their work demand, and all of this requires re‑imagining social care not as a cost but as a public, moral, and cultural asset.

Apricity is a gift, but it cannot be taken for granted. Even the winter sun needs a clear sky.

As February slips toward March, the earth prepares for its thaw. The same is needed in Scotland’s approach to social care. The last few weeks following the Scottish Budget which was signed off on Wednesday last, have been bruising and hard and full of moments of a deep lack of awareness and appreciation for the organisations and workers who make up Scotland social care sector. After years of political frostiness; debates frozen between ideologies, reforms stuck in permafrost, perhaps now is the moment to welcome a change of season.

Carers have long been the apricity in our national winter.

It is time we became theirs.

Apricity does not pretend the cold is gone.

It simply reminds us that warmth is still possible.

In the landscape of social care, that is what carers do every day. They offer small, unwavering acts of humanity that break through the bleakness and remind us that even in the hardest months, care is a form of sunlight: steady, life‑giving, and quietly revolutionary.

As February creeps to its ends, let us celebrate the apricity they bring, and work toward building a Scotland where that warmth becomes not a rare winter gift, but the climate we all live in.

Winter Light

Late‑winter light drifts across the quiet ground,

a soft glow settling where the cold once held firm,

the kind of warmth that arrives without announcement,

a reminder that the world still holds gentle surprises.

 

Shadows loosen their grip as the day unfolds,

and a pale brightness gathers in the stillness;

unhurried, steady, mindful of its own return,

a quiet promise stitched into the turning hours.

 

In this moment, there is a pulse beneath everything,

a subtle sense of belonging rising from the calm,

teaching that even in the leanest seasons,

light finds a way to begin again.

 

And as the hours stretch their fingers into evening,

a softer truth becomes visible:

even in the coldest months, renewal begins quietly,

often unnoticed, but always moving forward.

So when the first true warmth settles on your skin,

gentle as a hand placed reassuringly on a shoulder,

may it bring with it the knowledge that nothing stays frozen forever;

that in time, light returns, hearts open, and the deep work of caring

for ourselves, for one another,

is quietly renewed.

 

Donald Macaskill

Photo by elizabeth on Unsplash

When words come home: Gaelic, memory and the meaning of care

There are moments when language stops being a tool and becomes a refuge.

For me, Gaelic has always been like that. Not simply a language I inherited, but a way of being in the world, one that shaped how my family understood land, kinship, humour, grief and responsibility. It was there in the background of my childhood: half-heard phrases, songs that carried more feeling than explanation, a sense that words could hold people together even when life was hard.

In a previous blog now five years ago I spoke about how I had to be taught English to replace my mixture of twin-speak and Gaelic, of how I missed the cadences and rootedness of my original tongue, and of how my mother’s dementia was shaped by her return to the language of her childhood. I am mindful of all this in the year that the Gaelic language has received official status from the Scottish Government and two days out from the start of Seachdain na Gàidhlig (World Gaelic Week) which runs from 23rd February to the 1st March 2026. It is a Scotland wide and international celebration of Scottish Gaelic language and culture which is funded by Bòrd na Gàidhlig, with events in communities, schools, care settings, arts venues, and online. The theme for 2026 is: “Use It or Lose It / Cleachd i no caill i”

As I have grown older, that sense of language as belonging has deepened in me especially as I watched my own mother live with dementia. The sense of losing language unless it is used is also very pressing as every year without my mother’s Gaelic chats I grow further and further away.

Something remarkable happens as memory frays both with age and especially with dementia. The acquired, professional, socially expected layers of language often fall away first. What remains is older. Deeper. More elemental. For my mother, Gaelic had not disappeared in the way that names, dates or recent events sometimes did. Instead, it returned, even more dominant,  unexpectedly, tenderly, as if the mind, in its own wisdom, retreated to the place where language first felt safe.

This is not nostalgia. It is neurology, identity and care colliding.

During Seachdain na Gàidhlig, we rightly celebrate the living language, its creativity, its resilience, its future. But we also need to speak about its role at the end of life, and in the long, complex middle space of ageing, frailty and cognitive change. Because language is not just about communication. It is about recognition.

To be spoken to in your first language, especially when you are vulnerable, is to be told: you still belong here.

People living with dementia do not lose their personhood. But they do lose the scaffolding that helps them navigate a world built for speed, efficiency and cognitive performance. In those moments, language becomes more than semantics. It becomes emotional geography.

A familiar phrase can calm distress where medication cannot. A song can unlock connection when logic fails. A word spoken with the right rhythm and accent can say you are known in a way no care plan ever could.

This is as true for Gaelic speakers as it is for people whose first language is Urdu, Polish, Cantonese, BSL, Scots, or any other language carried into later life. Scotland is not monolingual in its ageing. Our care systems often behave as if it is.

Cianalas

There is a Gaelic word I keep circling back to as I get older: cianalas.
It is usually translated as homesickness, but the word is larger than that. Cianalas is the ache for what shaped you, the place, the people, the sounds, the blàs (the flavour, the accent) of speech that tells you you belong. It is a longing that is not simply for a geography, but for a known way of being.

In the gentle erosion that dementia brings, I have watched how cianalas moves from the edges of a life to its centre. My mother’s English, the language that carried so many of her adult years slipped away like a tide. But Gaelic did not go far. It returned in the mornings, in the intimacies of care, in the quiet between questions. A phrase. A hymn. The cadence of a blessing half‑remembered. And when a carer answers in kind, even with a few words, even with an approximation of the blàs, recognition sparks. The room settles. The person is seen.

This is not romanticism. It is what so many of us know from lived experience and professional practice: first languages often endure somewhere in the layered self, and when we meet someone in that language, we meet them in a place of safety and identity.

But what happens to language when the system and structures of social care become so pressured and stressed that just as in this past week we read of yet another Health and Care Partnership warning that care will potentially have to be reduced just to those with critical need?

For years, we have spoken about person‑centred care as a moral and professional baseline. But the reality across social care today is stark. Underfunding, workforce shortages and crisis commissioning have narrowed care down to task completion and risk management.

When the system is forced to focus only on what is “critical”, everything relational is framed as optional. A focus on language becomes a “nice to have”. Culture becomes an “extra”. Time becomes the enemy.

And yet, for someone living with dementia, language is not an extra. It is care.

A care plan that captures first language, familiar songs, place‑names; a team who learn basic greetings; signage and small rituals that carry the beul‑aithris (oral tradition) into daily life – these simple acts lowers anxiety, restores dignity, and anchors the self.

I have seen a single line of a psalm do more to soothe than any sedative; a remembered place‑name (An t‑Eilean, An Gleann) restore orientation more quickly than any timetable. These are not luxuries. They are expressions of dignity. But they are precisely the things most at risk when care is reduced to survival mode.

Gaelic carries concepts that modern care policy struggles to articulate. Ideas of belonging, mutual responsibility, and continuity between generations. Words that assume relationship rather than transaction. Care as something done with, not to.

When older people lose access to their language, they are not just losing words. They are losing a moral universe that once made sense of the world.

In a country that is ageing, diverse, and increasingly unequal, this should trouble us deeply.

If we allow the social care crisis to hollow out language, culture and relationship; if we accept a system that only meets “high‑level needs” while neglecting the human ones then we will end up with services that keep people alive but fail to help them live.

Seachdain na Gàidhlig reminds us that languages survive not because they are protected in law, but because they are used in daily life especially in moments of vulnerability.

I leave you with a poem:

Speak to me
not only so I understand,
but so I am recognised.

When my words come slowly,
meet me there.
When they come from another time,
do not correct them,
walk with them.

Care is not the task you finish,
but the person you remain with
when the task is done.

If we forget this,
we will build places
where bodies are kept safe
and selves are quietly lost.

Listen.
The language is still here.
It is asking
to be answered.

 

Donald Macaskill

At the rim of the world: Love in the world of care.

Love is not a word you will find in most policy documents. It does not feature in strategic frameworks, regulatory standards, or workforce planning spreadsheets. It is too soft, too subjective, too human. It resists the tidy categorisation of outcomes or indicators.

Yet, walk into any care home, supported living service, or the home of someone receiving daily support, and you will find love everywhere. Not the commercialised romance that dominates 14th February each year, but the quieter, sturdier forms of love: presence, patience, kindness, fidelity, and regard. These are not sentimental extras. They are the hidden architecture on which good care depends.

We speak of care as if it were primarily a task, something to be delivered, commissioned, or purchased. We live in a time when so much of care is framed through metrics: minutes allocated, tasks completed, regulations checked. These things matter because they provide structure and accountability, but they do not reveal the soul of care. They cannot. Because the soul of care is relational. It lives in the space between people. It is the meeting of one human being with another at a point of need or vulnerability. And it is love, in its broadest and most elemental sense, that makes this meeting transformative rather than transactional.

To name love explicitly in this context is not sentimental. It is honest. It is professional. It is human.

Love appears in the way a carer notices the slight change in a resident’s breathing. In the way a support worker sits quietly with someone in the distressing confusion of dementia. In the way a team keeps vigil at the bedside of a person approaching the end of their life. In the way families entrust their mother, father, partner or child to the hands of strangers who, over time, become companions.

None of these fits easily on a procurement form.

In recent years, we have become braver in acknowledging that the emotional labour of social care is real labour; skilled, demanding, draining, and profoundly important. But we still hesitate to name love as part of that skill set. Perhaps we fear sentimentality. Perhaps we worry that invoking love will weaken the professional boundaries we have so carefully crafted. Or perhaps we are uneasy with the idea that a system so chronically underfunded depends on something as immeasurable as the human heart.

But naming love does not diminish professionalism; it deepens it. It reminds us that care is not simply a service but part of the moral fabric of society. Love is what roots dignity. It is what honours the personhood of individuals who may have lost speech, memory, mobility, or independence. Love refuses to reduce people to tasks, conditions, or risks. It insists that each person is deserving of attention, respect, and warmth.

I have long believed that the crisis in social care is not only a funding crisis, workforce crisis, or demographic crisis. It is also a crisis of imagination. We have forgotten that systems exist to serve human beings, and not the other way around. If love were recognised as a central component of care, we might design our structures differently. We might prioritise time over throughput. We might value continuity of relationship rather than the cheapest unit cost. We might reward the emotional intelligence required to soothe, reassure, and accompany.

Love, after all, is not free. It requires time, training, support, reflection, and fair pay. It requires leaders who understand the emotional ecosystems of their services. It requires political leaders courageous enough to speak not only of budgets and efficiencies, but of the ethical duty we owe one another.

Love is costly. It demands presence, patience, resilience, and vulnerability. It asks carers to carry the stories of others as gently as their own. It asks families to trust strangers who will become companions. It asks society to honour those at the margins, not with pity, but with regard.

And perhaps, if we are truly bold, it requires us to rethink what we consider to be success. A life well supported may not be measured in metrics, but in moments of connection: the smile that returns after days of silence; the shared memory that breaks through the fog of dementia; the comfort of being held, known, and not abandoned.

And when love is absent? We see loneliness deepen. We see distress unaddressed. We see people reduced to tasks and time slots. We see a system that may function on paper but fails in humanity.

This Valentine’s Day, while the world trades roses and declarations, it is worth pausing to honour the quieter forms of love that shape the everyday practice of care across Scotland. The love that is expressed in touch, tone, patience, and presence. The love that sustains people at their most fragile. The love that is given freely, but not without cost. The love that sustains social care in Scotland through long nights, under immense pressure, in moments of grief and in moments of joy.

Love may never appear in the formal architecture of our social care system. But without it, nothing holds. Love is not the soft centre of care. It is the structure. Love is the architecture.

As I reflect on the central argument of this piece; that love is the hidden architecture of care, I’m drawn again to the clarity of our poets. Naomi Mitchison, was a woman of fierce humanity and political tenderness, and in her work, she names love as a kind of ballast: a weight that keeps the world from spinning apart. Her steady, grounded lines feel perfectly at home in the landscape of care.

She understood that love and belonging are often expressed not in grand gestures, but in the small acts that hold people in relationship with one another. Her voice reminds us that care is built from these daily, patient continuities.

So it feels right to close with Mitchison’s poem,  a reminder that love does the quiet work of holding things together, in poetry as in care.

“Love Poem”

Naomi Mitchison

Love, like a stone at the rim of the world,
Holds the edge of things together;
It is the weight that keeps the sky from falling,
The stillness that steadies the weather.

Not loud, not sudden, not possessed,
But patient as the turning sea;
Love is the thing we build with daily,
And the thing that builds us, quietly.

Donald Macaskill.

Photo by Mayur Gala on Unsplash

A sense of betrayal: social care and the SNP Government.

There are moments in public life when the gap between rhetoric and reality becomes so wide that it can no longer be bridged by warm words, sympathetic tones, or polished political narratives. The Scottish Government’s 2026–27 Budget is one such moment. It speaks the language of dignity, rights and fairness, yet delivers a settlement that undermines all three. For those who work in social care, and even more critically, those who depend upon it, this Budget is not simply inadequate. It is to put it frankly, a betrayal.

The tenth anniversary of me doing this job as the CEO of Scottish Care comes on the 1st April. I remember it well because on the 1st April 2016 the ground-breaking and at the time dramatically innovative commitment of the then Scottish Government to pay all care workers the Real Living Wage (or as we used to call it the Scottish Living Wage) came into force. Indeed one of my first tasks as CEO, was a radio interview to laud the game-changing nature of this action. But even then, although it valued workers, we all recognised it was a first step on a journey towards the proper reward and renumeration our critical frontline care workforce deserved. Along with many others I had been involved for months in the planning for the day and in ensuring there was sufficient funds in place. We didn’t get it completely right, and there remains huge issues f equity not least at local government level, but it was a great first step. Roll on ten years and we have a very different set of behaviours at play in the current Scottish Government.

The Real Living Wage: a promise broken

The Real Living Wage was meant to be a baseline of decency, a statement that Scotland values the people who provide intimate, skilled and emotionally demanding care. It has been a continual commitment of successive administrations. Yet the latest Budget fails to fund this commitment. COSLA described the Budget a failure “to fully fund… the Real Living Wage to workers in Adult Social Care”, leaving local authorities to absorb the difference.

The consequences are profound.

Social care organisations, particularly independent, charitable and small providers, cannot magic up unfunded wages. They operate on ultra‑thin margins, with fee rates set by local authorities. When government increases wage expectations without increasing funding, providers must either cut services, reduce hours, freeze recruitment, or hand back contracts. This is not hypothetical. It is already happening.

And all this means that staff who are continually told they are valued, are denied the means to live. Frontline workers hear ministers praise them as heroes while watching other sectors achieve pay rises. Without funded differentials, experienced workers earn the same as new entrants. Without stable contracts and predictable hours, workers juggle shifts to pay the rent. Without respect reflected in pay, they leave.

Every unfunded wage rise becomes a cut in disguise: shorter visits, inconsistent staff, unmet need, closed services, exhausted families. The Budget may never state it in writing, but this is how human rights erode, not by decision, but by neglect. And the human rights of those who use social care in Scotland have been run into the ground.

Government cannot meaningfully claim commitment to social care while shifting the financial goalposts year after year.

This is not partnership. It is the slow extraction of responsibility from government onto providers, workers and unpaid carers, cloaked in the language of “efficiency” and “local flexibility”.

The result is that councils will be forced to raise council tax; services are being trimmed to statutory minimum; community supports are being hollowed out and the most vulnerable and valuable of our citizens are being left with fewer options and longer waits.

Scottish Care’s verdict is unambiguous: “This Budget fails the people who rely on social care support – and those who deliver it.”

This failure is not abstract; it is personal. It touches so many lives.

It means older people waiting months for assessments and years for packages of care and support. When providers cannot recruit because pay is uncompetitive, packages do not start. People deteriorate. Families burn out. Hospitals fill.

It means people with disabilities whose independence depends on stable care relationships have their very autonomy undermined because of inconsistent staffing, driven by poor wages and high turnover, all of which puts their lives at risk.

It means unpaid carers are continually being stretched past breaking point. Shared Care Scotland and the National Carer Organisations highlight the absence of clear investment in short breaks, respite and local support organisations. These omissions are not oversights; they are choices.

It means that workers cannot afford to stay and cannot afford to leave. They hold lives in their hands daily, supporting complex care, offering emotional labour, and carrying profound responsibility and yet they are told, through this Budget, that their worth is negotiable.

Now I know that a Government Minister or spokesperson will give the oft quoted statement about ‘record’ investment. Indeed, ministers have presented the Budget as delivering a “record” £22.5 billion for health and social care and a “record settlement” for local government. But this narrative dissolves when placed beside the truth which is no full funding for the Real Living Wage policy for adult social care, children’s social care, or early learning and childcare.

These headline figures create the illusion of investment while disguising the truth: frontline social care does not feel “record” anything. It feels cut, stretched and disregarded.

If the Government truly believed in social care, the Budget would have:

  • Fully funded the Real Living Wage, including progression and differentials.
  • Provided ring‑fenced, multi‑year social care funding aligned to evidence‑based cost‑of‑care models.
  • Invested in ethical digital transformation rather than delaying core infrastructure until 2029.
  • Protected and expanded community‑based supports that keep people well.

These actions would stabilise the system, honour the workforce, and safeguard human rights.

The 2026–27 Budget represents a deliberate political choice: to underfund social care while claiming otherwise. It asks the workforce to bear the burden of government decisions. It asks families to fill the gaps left by inadequate planning. It asks providers to deliver more with less until they collapse. It makes clear that this Government no longer funds the Real Living Wage for frontline carers.

But most of all, it asks the people who need support to wait. To cope. To endure.

That is not dignity. It is not fairness. It is not Scotland at its best.

It is a betrayal—and it must not stand.

Donald Macaskill

Photo by Sarah Agnew on Unsplash

Loneliness: Scotland’s quiet Public Health crisis

 

Walk any Scottish street and you will find, behind the closed doors and neat hedges, someone who feels profoundly alone. Age Scotland’s 2025 report puts it starkly: almost half of over‑50s in Scotland experience loneliness at least some of the time, and around one in ten older people live with chronic loneliness: “the equivalent of one on every street.” This is not a fringe concern or a soft social issue; it is a public health emergency that damages bodies, minds, communities, and the sustainability of our care system.

In this long read, I’ll set out why loneliness among older people in Scotland must be treated as an urgent health and social care priority, where the evidence points, and what practical, proven actions we can take, locally, nationally, and personally.

What the evidence tells us

Loneliness harms health. Robust meta‑analyses show that social isolation and loneliness are associated with a significant increase in all‑cause mortality; one 2023 synthesis across 90 cohorts (involving more than 2 million adults) found a 32% higher mortality risk for social isolation and 14% higher for loneliness. Earlier work demonstrated increased risks comparable in magnitude to other well‑established risk factors and highlighted pathways to cardiovascular disease, cognitive decline, and depression.

Internationally, the US Surgeon General has framed loneliness as an epidemic linked to cardiovascular disease, dementia, stroke, anxiety, and premature death, calling for system‑wide action to rebuild social connection. While headlines often compare chronic loneliness to “smoking 15 cigarettes a day,” experts caution that the analogy whilst useful for awareness, can oversimplify the science; the underlying message remains: loneliness carries serious health risk.

In Scotland, the scale is stark. As noted above Age Scotland’s On Every Street documents that “almost half” of over‑50s feel lonely at least some of the time. Scottish media coverage and charity analysis underline the lived reality, namely older people describing silence, bereavement, caring, poor health, and the cost‑of‑living crisis as drivers.

To be fair Scottish Government recognises the issue. Scotland was among the first countries to publish a national strategy on social isolation and loneliness, A Connected Scotland (2018) and  then in 2023 it released the Recovering our Connections delivery plan for 2023–2026, which frames loneliness explicitly as a public health issue and commits to community‑led action. Funding has followed through the Social Isolation and Loneliness Fund (2023–2026) to support local groups and third‑sector partners to reduce harm and widen connection.

Public health voices are growing louder. The Scottish Forum on Isolation and Loneliness, bringing together over 120 organisations, has called for loneliness to be formally declared a public health crisis in Scotland and for a long‑term framework to cut chronic loneliness by half in the next decade, echoing WHO’s designation of loneliness as a priority public health problem. It is high time that was the case.

Why older people are especially at risk

Loneliness can affect anyone, but older people face cumulative risks: bereavement; ill‑health and disability; retirement; reduced income; shrinking social networks; transport barriers; and digital exclusion. Scotland’s own research (HAGIS) and policy framing recognise these risk profiles and the need for targeted interventions.

Rural Scotland adds another layer: evidence reviews  including the excellent work of Impact, highlight higher prevalence and distinctive barriers for older people in rural areas, distance, transport, fewer services, and link loneliness with increased anxiety, depression, stroke, diminished immunity, and higher health costs.

Loneliness is not only painful; it is also expensive. Analyses cited by Scottish charities and public health advocates estimate that people who report being “often lonely” cost the NHS ~£900 extra per person annually, and that the excess costs for health and long‑term care can reach £11,725 per person over 15 years. Public Health Scotland’s presentations to the national forum summarise the biological, behavioural, and social pathways; stress, poor sleep, lower activity, worse diet, poorer treatment adherence all of which means that loneliness worsens health.

So faced with all this reality what helps to address these profound issues?

The Scottish Government’s delivery plan commits to empowering communities and creating opportunities to connect; the SIAL Fund operationalises this, but the third sector has continually warned of fragile volunteer bases and short‑term funding. Sustained investment and clear, national measures for reducing chronic loneliness are essential.
Link Workers in primary care can connect older people to befriending, walking groups, arts, men’s sheds, and local clubs. Evidence from the Campaign to End Loneliness points to improvements in sociability, confidence, and reduced loneliness, although long‑term outcome measurement still needs strengthening;

Transport, libraries, community halls, warm spaces, and digital support all reduce isolation even if they are not “loneliness services” on the label; Scotland’s strategy explicitly recognises the need to bolster the places and systems where connection happens.

But the current delivery plan runs to 2026. That’s both a deadline and an opportunity.

I think our experience in delivering social care to increasingly isolated individuals and communities leads me to strongly believe that we need to declare loneliness a public health crisis and set a national target to halve chronic loneliness in 10 years, aligned with WHO’s framing and as argued by Chest Heart and Stroke Scotland’s recent Forum manifesto. Alongside this we need political leadership to protect what we have, invest in Link Workers, and identify additional resource for third and community sector efforts. If not things will only get worse.

If we are serious about preventative care, we must design connection into health and social care pathways. Scotland already has the scaffolding: a national strategy, a delivery plan, targeted funds, and a skilled third sector. What’s needed now is stability, scale, and standards and the political courage to name loneliness as the public health crisis it is.

Older people do not ask for much. They want to be seen, heard, and included. The remedy to loneliness is not complicated, but it is collective: it lives in the volunteer who keeps turning up, the link worker who walks with someone to their first club, the bus that still runs after dark, the hall that stays open through winter.

It is also in the critical role that social care plays but that is not going to continue as we strip out real care and support and put in place more and more  Elastoplast services, not least the obscenity of 15 minute visits which provide neither connection or care. on the door.

On every street in Scotland there is a person waiting for the knock on the door.  In this election year let’s make 2026 the year we decide, together, to knock.

I end with a poem.

“The Last Neighbour”

He sits by the window
counting the gulls
as if they were old friends
returning by instinct alone.

The kettle clicks off,
a small applause
for another morning managed.
He pours one cup.
Only one now.

Outside, the street keeps its hurry,
but his days move like tidewater,
slow, deliberate,
reshaping the sand of routine
into something that still holds him.

He says he’s “fine,”
in the way men of his age do;
a word worn thin
from carrying too much weight.

Sometimes the phone rings
from someone paid to ask,
sometimes from someone who cares.
He hears the difference.

And in the long quiet
between dusk and the ten‑o’clock news,
he lights the lamp in the hallway,
a small act of defiance
against the gathering dark.

If you pass his house tonight,
you’ll see that low, steady glow.
It is not a signal of distress
but a soft and stubborn truth:
no life should drift alone.
No neighbour should fade unheard.

Donald Macaskill

Photo by Sasha Freemind on Unsplash

Planting what outlives us: on legacy and ageing.

There is a moment, often somewhere in our 50s or 60s when the future shifts its angle. The horizon draws closer, the noise recedes, and a quieter question makes itself heard: What do I want to leave behind?

Not the inventory of possessions, but the pattern of our presence. The imprint of our care. The courage of our convictions. The habits of kindness that might keep on happening after we are gone.

This blog is an invitation to linger with that idea of legacy: how the desire to leave something of worth shapes our older age; what the psychology says; and how we can attend to it in ourselves, in our families, and in the craft of social care.

I find myself in this space because this past week I’ve been reflecting on my own late twin brother who died 8 years ago last week. Too soon and too young, with so many left empty by his absence. As is so often the case in someone who knows that they are going to die, we did not spend the time that we could have in reflecting or speaking about what life had been like. We spent the time we had left together in laughter and remembrance, in anecdote and fondness, keeping the uncomfortable away and the fear largely unmentioned.

But this past week both because of his own early death and because of so many others who I know, and the far too frequent conversations I have, I have spent time reflecting on legacy and purpose.

It is perhaps a truism to say that there are days when life’s timetable is torn up. A diagnosis, a sudden decline, and the horizon that once stretched decades ahead now feels alarmingly near.

Psychologists have long observed that, in mid-to-late life, that many of us turn outward with a concern for the generations to follow. My old psychologist inspiration Erik H. Erikson called this generativity, the developmental pivot from “What did I achieve?” to “Whom and what did I grow?” The fruits are not just external. It is the impulse to nurture what will outlast us.

Generativity predicts better well‑being and even stronger cognition in later life, whereas its shadow which is described as stagnation can shrink our world to self-preoccupation, which is often the accusation of those in older age.

What is undeniable is that numerous sources of research show that people who engage in legacy-building, through storytelling, mentoring, or creating tangible gifts, report lower anxiety, greater sense of purpose, and improved emotional well-being, even in palliative contexts.

Legacy work is not about grandeur. It is about continuity: ensuring that something of our values, our love, our wisdom remains in the world when we cannot and perhaps especially in the lives of those whom we have loved and who mean so much to us.

Another favourite, Dan McAdams’ psychological research adds texture to the work of Erikson on legacy, arguing as he does that highly generative people tend to tell redemptive life stories, transforming setbacks into service, threading meaning through adversity; such narrative style correlates with psychological adaptation and prosocial engagement. Legacy is not only what we do; it is how we narrate what we’ve done, which is in and of itself critical because that story mobilises us to keep giving. It is the words we chose to tell the tale of our being in life.

As we grow older and age we also reorganise our motivations. Laura Carstensen’s work on Socioemotional Selectivity Theory shows that as time horizons feel shorter, we prioritise emotionally meaningful goals and relationships. Legacy work naturally fits this shift: we invest in fewer, deeper ties and do things whose meaning can be felt now and remembered later.

We can see this in clinical and care contexts as well. Life review work which was first described by Robert Butler in the 1960s, offers structured reflection that helps older adults integrate memory, resolve regrets, and move towards integrity. It’s a cornerstone in later‑life and palliative practice, and when facilitated well and sensitively, it can reduce distress and enhance a sense of coherence: a psychological soil in which legacy grows.

Then at the end of life, Dignity Therapy takes this further: a brief, guided process that invites people to record what they most want remembered. Research trials report heightened dignity, meaning, and perceived benefit for families with the legacy document becoming a tangible bridge between the living and the soon‑to‑be‑bereaved.

If we want to leave something of worth, psychology suggests two reciprocal movements: doing (generative acts) and meaning-making (stories that redeem and bind).

This past week I have been reflecting on the extent to which in residential care and in homecare in all our palliative care and support of residents and citizens whether we have properly maximised the potential of legacy work. Because even accepting all the understandable constraints of time, resource and capacity I am not sure we have. And at the same time I am equally convinced just how important for the grieving and bereavement of those we leave behind; how critical it is that we do much better at this work which is to aid the art of dying and the gifting of legacy.

For those of us whose work it is to care and support folks at the end of their lives, I think we need to get better at embedding life review and legacy work in assessments and care planning (especially in hospice, care homes, and community nursing). We need to train staff in dignity‑conserving practices; create quiet rituals for recording and returning a person’s words to their family. We need to measure outcomes beyond symptom control: track family perceptions of meaning, appreciation, and connectedness post‑bereavement.

All that might just start by asking the ‘why’ questions, however provisional they may be. An encouragement to try to write a brief “legacy sentence”: “I want the people and places I love to be more X because I was here.”  It might move on to a guided life review where time is set aside – together or alone – to walk your story: chapters, turning points, the regrets that still disquiet, the gifts you’ve given and received.

And of course, all of this means tackling head on all the barriers that silence people. Those who have spent a life convincing themselves that they have nothing to leave. This is poverty of imagination, not of worth. Those who say, “Talking about death feels morbid.” Completely understandable on the one hand but at the same time we know that shared meaning and esteem buffer anxiety. In community, we can approach finitude not with fear but with craft: rituals, conversation, song. And there is so much more practitioners of endings in care home and community can do.

Legacy is not the marble we carve; it is the meal we keep setting. It is the apprentice we welcome into the workshop; the young carer we notice and support; the foreign‑born neighbour we draw into our circle until this land is also theirs.

Our social care, when at its best, is legacy in motion: the daily transfer of attention from one generation to the next. It is where the values we say we hold are stress‑tested against reality. If we make our services places where people can remember, make meaning, and give one last time, then we will have honoured the dignity of ageing and have given space and place to a legacy that never ends.

Bequeathal

Leave not the stone with your name,
leave the path you wore through the field,
the one that knows your footfall and invites another’s tread.

Leave not the chair at the table,
leave the habit of an extra place,
the cup that finds the hand that trembles.

Leave not the answer, clean and sure,
leave the question, kindly asked,
that opens like a gate and lets the younger through.

Leave not the purse alone,
leave the skill of open hands,
and the craft of making enough into plenty.

Leave not the speech fine‑phrased,
leave the story told in kitchens,
where steam writes blessings on the window glass.

Leave not a claim on land,
leave belonging to a people,
soil in the marrow, duty turned to joy.

And when the light goes thin,
and names begin to loosen from their faces,
let what you have planted be your speaking:
the neighbourly knock; the steady chair;
the path; the cup; the open gate.

 

My late twin had two loves in his life – his family and his roses – after he had died, I took cuttings of some of the roses and to my great surprise managed to get them to grow in my own garden in another country from their original soil. Even after transplanting they lived on – a memory, a legacy of his creativity and so much more. Planting what outlives us in hope and love, dignity and desire, is the work we should all seek to undertake, every day.

If legacy is love with a timetable, then ageing is not the end of that work; it is the season when love gets organised. May we be found busy planting what will outlive us and may Scotland’s people and places be the richer for it.

Donald Macaskill

Photo by Amarbayasgalan Gelegjargal on Unsplash

Care Creates: A Call to Action and a Vision for Scotland’s Future

The third Saturday of January 2026 arrives not with celebration, but with a heavy sense of reckoning. The Scottish Government’s newly announced Budget, for all its rhetoric of renewal, has once again relegated social care to the margins. For those of us who live and breathe social care, this is not just a policy disappointment rather it is a profound moral failing. The question before us is urgent and inescapable: What kind of Scotland do we want to create together, and why does our Government not share that vision?

Every day, in every corner of Scotland, social care is the quiet infrastructure that holds our communities together. It is not a discretionary spend, nor a luxury to be afforded only in times of plenty. It is the scaffolding that allows individuals to thrive, families to stay together, and communities to flourish. Yet once again, this Budget treats care as an afterthought: “a budget that talks about dignity but does not fund it”.

In the wake of this Budget, each of the six pillars which comprise the vision within  the Scottish Care 2026 Election manifesto Care Creates feel more like a distant aspiration than a policy reality. Rights‑based budgeting and ethical commissioning remain words on paper, not principles in practice. The workforce; already stretched to breaking, faces another year of undervaluation and uncertainty. Promises of integration and innovation ring hollow without the resources to make them real. And now, Scottish Care’s own analysis makes the picture starker: the budget “falls dramatically short of what is required to protect essential care and support services, the workforce that delivers them, and… the individuals, families and communities who rely on them.”

We cannot ignore the consequences of this chronic underfunding. Workforce shortages deepen, finances grow ever more fragile, and the scars of austerity persist. Increasingly we are relying on people to pay more and more for their own care and support whilst the Government pays less and less. Increasingly this current Government is creating a two tier social care system in Scotland whether by default or deliberate design. The Government has failed to meet COSLA’s call for an additional £750 million in core funding to stabilise and grow social care support. Instead, providers are left “delivering more with less,” absorbing unsustainable costs and shielding people from the fallout of an under‑resourced system.

“Care Creates” is not just a campaign tagline; it is a summons to action and a framework for transformation. The Scottish Care Manifesto for 2026 sets out a bold, necessary vision: six pillars that, if embraced, could reshape our nation.

  1. Rights at the heart of Social Care

Human rights are non‑negotiable. Embedding rights‑based budgeting and ethical commissioning ensures decisions reflect the voices of those who rely on support. Yet, as the Budget analysis makes clear, this Government has again offered “no ring‑fenced protection for social care support, no alignment to the true cost of care”. Human rights cannot flourish in the vacuum left by insufficient investment.

  1. Fair Pay, Fair Work, Fair Care

A thriving social care system demands a valued workforce. Fair remuneration, career progression and parity with NHS roles are essential. But “warm words will not pay the bills”. The Real Living Wage uplift, while welcome, remains inadequate without funded differentials or career pathways. With thousands of vacancies, we cannot afford to lose more skilled professionals to sectors offering better pay and lower responsibility.

  1. Integration across systems

Care cannot exist in silos. We know that integrated care teams reduce admissions and transform outcomes. But without resources, integration is rhetoric. Today we face “crisis conditions” where unmanaged pressures threaten to further reduce care packages and increase unmet need across health and social care. We are faced with the sad daily reality that people are dying whilst waiting for their care but because they are unseen by everyone except their families, they are the hidden victims of a broken system.

  1. Future‑Ready Care

Our sector has proven its capacity for innovation, from digital tools to climate‑conscious planning. Ethical AI and adaptive models offer huge potential- but only if investment matches ambition. Instead, Scotland remains “a decade behind before we even begin,” with key digital infrastructure not expected to be social‑care‑ready until 2029 – an “unacceptable delay” that entrenches inefficiency and stalls innovation.

  1. Investing like it matters

Funding care is not charity: it is a strategic, national economic investment. Every pound invested in social care returns more than double in socio‑economic value, strengthening local economies and enabling people to live well in their communities. Yet this Budget once again chooses not to unlock those benefits for Scotland.

  1. Care for people and planet

Ethical commissioning, sustainability and community wellbeing must shape every decision. But the absence of robust investment renders environmental and community ambition fragile. As Scottish Care notes, “This Budget does not meet the moment”: a moment demanding bold choices, not incrementalism.

The “Care Creates” campaign exists to shift public and political understanding: social care is not a cost to be contained, but an essential investment in Scotland’s future. It underpins health, drives economic participation, sustains communities and supports family life. Yet at a time when “providers are closing” and “workforce shortages are at crisis levels”, Scotland’s Budget has offered neither boldness nor stability.

It has chosen caution where courage was required.

It has chosen system preservation over human flourishing.

It has chosen short‑termism over Scotland’s long‑term wellbeing.

Disappointment must not become despair. Realistic positivity means acknowledging the constraints while refusing to surrender hope. It means saying: Yes, the road is hard, but it is not impassable. It means recognising that although Government has not led, we will.

As Scottish Care affirms:
“Investing in social care support is not a cost, it is a national dividend. Care creates stability. Care creates opportunity. Care creates Scotland’s future.”

Even as we face disappointment, we are never alone. Together we can influence change, support those who suffer, and celebrate the compassion, expertise and community that define our sector. With courage, creativity and solidarity, we can build the Scotland we know is possible; one where social care is not an afterthought, but the beating heart of national life.

Care creates Scotland’s future.
If our Government will not lead, then we must.

Donald Macaskill

Photo by Nick Fewings on Unsplash

 

Bereavement and belonging: a call for constructive compassion.

The turning of the year always invites reflection and an opportunity to consider both personal and societal priorities and ambitions. It offers us an opportunity to reflect not only on what lies ahead but on what binds us together as a community and for me the ties that bind us are often seen best and most clearly at times of loss and grief. Bereavement is not a private shadow; it is a communal experience that shapes the health and wellbeing of our society. As we step into January, I am thoughtful of the extent to which as a society and as communities in Scotland we do or do not support every single person who is living with loss and experiencing grief in our midst at this time.

Bereavement is not merely a health service concern; it is a public health issue. Research shows that unresolved grief increases risks of mental illness, physical health decline, and economic strain through lost productivity and higher healthcare costs. I became very well aware of this whilst serving as a Commissioner on the UK Bereavement Commission and listening to the stories of hundreds of individuals whose lives were so damaged by grief. Poor bereavement support both costs lives and cripples our economic wellbeing. A very convincing article in The Lancet some eighteen months ago reminds us that failure to integrate bereavement care into public health systems leaves families vulnerable to illness and isolation, exacerbating the societal toll of loss. It forcefully argues what I believe personally to be truthful and that is that investing in bereavement care and support is a public health priority.

This past week those individuals and organisations involved in Scotland’s National Charter on Bereavement for Adults and Children, which was launched in 2020, published their Manifesto for the upcoming Scottish Parliamentary elections.

The manifesto calls for:

  • A National Bereavement Lead within government to coordinate policy and ensure bereavement does not fall between departmental cracks.
  • Investment in Bereavement Charter Marks for workplaces, schools, and other locations such as prisons and ordinary businesses thus creating cultures of compassion where grief is acknowledged and supported.
  • Community Partnerships that embed bereavement support in local networks, from hospices to voluntary groups.

The Manifesto uses a number of case scenarios to show the sort of success that has been achieved to date, all of which evidence compassion in practice and the positive impact that good bereavement support can bring to communities as well as individuals.

It tells the story of ten Scottish schools who have embraced the Bereavement Charter Mark, integrating grief literacy into education and partnering with local hospices. Teachers report that this work “takes a village” building resilience and empathy among pupils and staff alike. The Manifesto shows how employers adopting bereavement-friendly policies have seen improved staff wellbeing and retention. As one case study notes, “a single act of kindness kept me afloat”—a reminder that organisational culture can transform grief into belonging.

Strong bereavement support is not charity; it is social infrastructure. A 2023 study by Marie Curie and Warwick University found that equitable access to bereavement care reduces health inequalities and fosters community cohesion, particularly for marginalised groups. When grief is met with understanding, people return to work sooner, families avoid crisis, and communities grow stronger.

The Charter Group is making simple asks of our new parliamentarians and whoever it is that will form the next Scottish Government. These practical steps are to:

  1. Fund the Vision: Allocate resources for Bereavement Charter initiatives – especially by resourcing the process with £250K over three years which is a modest investment for systemic change.
  2. Appoint a National Bereavement Lead: The next Government needs to create a dedicated role within Scottish Government to coordinate bereavement policy and practice across departments.
  3. Develop a National Bereavement Strategy: The lack of a national strategy is a real gap in Scottish public policy. We need to co-produce a national strategy for bereavement support, building on the Charter and addressing gaps in the current palliative care strategy
  4. Embed Bereavement in Public Health strategies: We need to integrate grief support into mental health and wellbeing plans, ensuring timely, culturally competent care. This can be achieved by more groups adopting the Charter Mark, but that work needs to be resourced.
  5. Mobilise Communities: We need to encourage local employers, schools, and voluntary groups to adopt Charter principles and collaborate with bereavement organisations, and lastly
  6. Prioritise Succession Rights in the Housing Bill: We need to implement actions to protect the housing rights of terminally ill people and bereaved families.

As someone who has walked alongside countless individuals and families in the aftermath of loss, I know that bereavement is not an event rather it is a landscape. It shapes how we live, work, and belong. Policy matters because it signals what we value as a society. When we invest in bereavement support, we invest in humanity. When we consider bereavement support as a matter of societal and economic priority then we shape our communities into places where all are welcome, where none are excluded even in the rawness of grief and the pain of absence. Bereavement support opens the door to belonging.

Belonging is not a feeling we manufacture; it is a practice we share. It looks like a school that teaches grief literacy and a workplace that keeps the door open when someone returns. It looks like a local café that knows how to hold a silence, and a parish that lights a candle with a name. It looks like government appointing a Bereavement Lead and resourcing Charter Marks so compassion becomes ordinary and everywhere. It looks like the neighbour who brings bread, the nurse who calls back, the friend who sits and says nothing at all. If we want a Scotland where everyone has a place, then we must keep making places where grief is met, supported, and held. When we invest in bereavement support, we invest in community. When we stand with the grieving, we stand with ourselves.

The UK Commission on Bereavement captured this truth with clarity:

“Bereavement is everyone’s business. It is not a niche concern but a universal experience that demands a collective response.”

Starting the year with compassion means making this more than a slogan. It means embedding bereavement care and support into the architecture of our communities and the heart of our governance. As we’ve set out in the Charter and its Manifesto, these are simple, fundable acts that make compassion part of the everyday. Let us make 2026 the year we turn manifesto into movement.

I am mindful of one of my favourite poems from a favourite poet, Jackie Kay, who offers us a tender, communal vision of how those who have died  “are still here holding our hands,”

Darling

You might forget the exact sound of her voice
or how her face looked when sleeping.
You might forget the sound of her quiet weeping
curled into the shape of a half moon,

when smaller than her self, she seemed already to be leaving
before she left, when the blossom was on the trees
and the sun was out, and all seemed good in the world.
I held her hand and sang a song from when I was a girl –

Heel y’ho boys, let her go boys –
and when I stopped singing she had slipped away,
already a slip of a girl again, skipping off,
her heart light, her face almost smiling.

And what I didn’t know or couldn’t say then
was that she hadn’t really gone.
The dead don’t go till you do, loved ones.
The dead are still here holding our hands.

Darling by Jackie Kay – Scottish Poetry Library

 

Donald Macaskill

Photo by Priscilla Du Preez 🇨🇦 on Unsplash.