I am writing this a few hours after the end of the Global Ageing Conference which has been taking place in Glasgow over the last few days. The event was held under the auspices of Scottish Care, the National Care Forum and the Global Ageing Network. It brought together hundreds of individuals from close to 50 countries to explore issues of aged care and support, ageism, technology, sustainability and so much more. The debates and discussions were lively, and challenging.

Yesterday morning there was a particular focus on human rights and participants were privileged to hear a presentation from Dr Claudia Mahler, the United Nations Special Representative on the Enjoyment of all Human Rights by Older Persons. I was shocked to learn that the role of older person’s rights was so marginal in the world of the United Nations. I had known that age was not mentioned in the UN Declaration of Human Rights now 75 years old. I had also known that there was no distinctive Convention (as there is for disabled persons or children) to protect the rights of older people, but what I did not know was the limited extent of current day priority for older person’s rights. Indeed, Dr Mahler noted that only 0.5% of recommendations from the United Nations directly related to older people. To be frank this is both shocking and appalling given the proportion of older persons in the population of most countries across the world.

The previous day attendees were inspired by a presentation on the challenge of age and the potential of older age by the distinguished thinker and strategist, Prof Sir Geoff Mulgan. I have already referred to Geoff Mulgan’s work in this blog. In his opening remarks Geoff Mulgan spoke about the way in which the city of Glasgow had been transformed over the years since his first contact with it in the 1980s. He suggested that this was evidence of the way that change can happen but perhaps not always overnight or in the short term. In doing so he remarked on hearing the inspiring words of the trade unionist, Jimmy Reid and his speeches. Prof Mulgan’s reference made me look again at the work of Jimmy Reid, not least his famous Rector speech.

Jimmy Reid was a shop steward at the Upper Clyde Shipbuilders (UCS), and as such he opposed the proposed withdrawal of subsidies by the then Conservative government. This would have led to the closure of most of the business and the loss of 6,000 of the 8,500 employees. A work-in resulted which was an alternative to the withdrawing of labour during a strike.

Reid was elected as Rector of Glasgow University by the then student body in October 1971 and delivered a famous speech in 1972. It became an overnight success after it was published by the New York Times and is considered one of the greatest of all political speeches. Based as it was on the Marxist idea of alienation. One famous passage lamented the “scrambling for position” in modern society and stated that the “the rat race is for rats. We’re not rats. We’re human beings”.

 

Reid spoke about the way in which the working people of the yards and city ahd been alienated from the political leadership of the time; how the poor had been alienated from the exercising of their rights and that this was a denial of their humanity and equal dignity.

I hesitate to suggest that had Reid been delivering his speech today he might have used the language and framework of human rights to make broadly the same observations. But in truth I do think that there is at present an alienation of older persons from civic and popular society, not just in Scotland but elsewhere.

A survey carried out by Age Scotland and published in the last few days showed that more than two-thirds of older Scots “do not feel valued” by society, evidencing a sharp increase in the number of older people feeling that life has got worse for them. Two-thirds of people over the age of 50 said they don’t feel valued by society, up from 51% in 2021 to 66%, and more than half (56%) felt life in Scotland was getting worse for older people, up from 34% in 2021. These are depressing and alarming statistics and reflect badly on Scottish society and our political leadership.

I think there is validity in saying that older people are increasingly feeling alienated from the society and communities in which they find themselves. The prevalence of ageism and age discrimination, its societal and cultural acceptance and normalising speak to the heart of our current human rights debate.

Those who framed and shaped the original human rights legislations and frameworks emphasised the inherency of dignity as the starting point for a consideration of being human in relationship with others. But how can you feel a sense of dignity or experience worth and value if you are alienated from all that grants those sentiments and feelings to you? How can you hope to be heard and understood if you are denied voice and action? How can you make your presence felt and your needs known, if you are excluded and granted no presence?

That is why I believe that internationally the time has long since come for there to be a United Nations Convention on the Rights of Older Persons, in order for all governments and public or private bodies to be held to account for actions or inaction. That is why I believe that the time has come in Scotland for us all to support the campaign for an Older Person’s Commissioner.

‘The time for older age has come’ was the comment of one of the delegates from India who spoke this week. Alienation only ends when justice and equality regardless of age, class or circumstance sits at the heart of our being in relationship with one another.

 

Donald Macaskill

 

Next week brings the return of the parliamentary process in both Scotland and Westminster. Our MSPs will come back together after a summer of book festivals, talk shows and podcasts to govern our nation, make decisions, vote on legislation, and develop policy. September 5^th may not be the most exciting date in most of our diaries but the relevance and importance of the next few weeks and months for social care in Scotland cannot be underestimated.

We have had an intriguing summer in the world of social care in Scotland. Regular readers of this blog will have been following the failed attempts by Scottish Care and our care home and homecare provider members to influence the Scottish Government to come true on promises made. But just in case the issues have not been front and foremost in your mind here is a quick recap.

On the 18^th April in his first major address to the Scottish Parliament the First Minister Humza Yousaf indicated that it was his intention to pay frontline social care workers £12 an hour but that it could not be yet.

He said:

“We are also committed to improving social care services and to reducing delayed discharges. I know well the workforce challenges that the adult social care sector, in particular, faces. That is why I will commit to a timetable that sets out how this Government will get to £10 an hour for adult social care workers. Although we are not able to afford to do that immediately, I want to send a signal to the sector that we are absolutely serious about improving pay and terms and conditions for those who care for our most vulnerable people.” (Scottish Parliament, Official Record)

He later corrected the error to make it £12 an hour.

We then saw a period of delay, dither and disinterest. Scottish Care and others have spent the summer trying to get a timetable out of the administration. We didn’t manage it in relation to the National Care Home Contract. We didn’t manage it in relation to the failing care at home and housing support organisations. All we have been told is that civil servants and ministers are searching for the monies. That it is a lot of money to find in order to value social care staff I am in no doubt, but they seek it here, they seek it there, and no one can seem to find it anywhere.
In the meantime, the Agenda for Change settlement has started from the 1^st April which has now created a massive 19% plus gap between new care worker entrants into the NHS and those coming into third and independent sector social care. In the meantime, we have had a new settlement for dentists and additional funding for community pharmacists. In the meantime, we have had a settlement to the dispute with junior doctors. And still the care sector waits – the signal of being ‘absolutely serious about improving pay and terms and conditions for those who care for our most vulnerable people’ has grown so faint it has become invisible to see.

Can you imagine a Health Secretary or First Minister making a statement that we are going to pay junior doctors or nurses £X amount and then say but we will need to find the money first – just you hold on – and then take 19 weeks (and counting) and the promise has not been fulfilled or come to life? I think not.

Now all of this may come to fulfilment with a pronouncement ex cathedra in the Programme for Government when it appears in a few day’s time. But to be honest the damage is done. Women and men have been leaving the care sector to go elsewhere – and who can blame them – the signal of value and respect – has well and truly been lost; and there is not a hope in the proverbial we will get them back. The damage has also been done by this Government’s inaction to the morale of the frontline women and men who have bust a gut over the last few years – who go out in all weathers to care and support, who put others first and foremost rather than last and forgotten and yet 19 weeks after a promise, despite campaigns and messaging, they seem to count for nothing.

This past week as part of our friends at CCPS’s Four Steps to Fair Work campaign we saw over 400 church leaders sign a statement which amongst other things called for the immediate establishment of £12 an hour for frontline carers across all social care services, not just adult social care. This is a remarkable volume of voices committed to ensuring that social care is valued in Scottish society. In the words of the Moderator of the General Assembly, the Rt Revd Sally Foster Fulton,

“As people of faith we have a calling to honour care and service….Dignity and respect for others is at the very heart of the faith message… We have the Gospel imperative to look after each other. This includes paying the workers fairly.”

Media stories on the issue this week had a standard Scottish Government response which firstly said that carers have received increased pay in the last year – undeniably true but in a cost-of-living crisis and when everyone else is receiving a lot more than 3.8% this level of self-congratulation is offensive. The second observation from Government was that carers in Scotland are better paid than in England – come on. Again, true but a comparison with mediocrity is nothing to be proud about and to be frank is again offensive to our frontline carers.

An old Highland headmistress of my knowledge who would have been 140 years old if alive today once wrote:

“Respect as a word is easy because all you use is your mouth, but to put respect into action requires you to use your heart.”

This has been a summer of disrespect to social care frontline staff. Words and rhetoric are easy and empty; meaningful and respectful action has been as missing as a Scottish summer heatwave in these last few weeks.

So, First Minister and Health Secretary. I hope you find the money, but more than that I hope you start to really understand social care and start to respect the amazing women and men who work at the frontline, manage services, provide the resource and ideas to give Scotland its rights-based person-led social care delivery.

In keeping with our ecclesiastical theme, here is a poem about respect which has more than a ring of truth in these days for those of us in the world of social care. It is ‘The Nightingale And The Glow Worm,’ by the 18^th century English poet William Cowper.

A Nightingale, that all day long
Had cheer’d the village with his song,
Nor yet at eve his note suspended,
Nor yet when eventide was ended,
Began to feel, as well he might,
The keen demands of appetite;
When, looking eagerly around,
He spied far off, upon the ground,
A something shining in the dark,
And knew the glow-worm by his spark;
So stooping down from hawthorn top,
He thought to put him in his crop.
The worm, aware of his intent,
Harangu’d him thus, right eloquent —
Did you admire my lamp, quoth he,
As much as I your minstrelsy,
You would abhor to do me wrong,
As much as I to spoil your song;
For ’twas the self-same pow’r divine
Taught you to sing, and me to shine;
That you with music, I with light,
Might beautify and cheer the night.
The songster heard his short oration,
And, warbling out his approbation,
Releas’d him, as my story tells,
And found a supper somewhere else.

Hence jarring sectaries may learn
Their real int’rest to discern;
That brother should not war with brother,
And worry and devour each other;
But sing and shine by sweet consent,
Till life’s poor transient night is spent,
Respecting in each other’s case
The gifts of nature and of grace.

Those Christians best deserve the name
Who studiously make peace their aim;
Peace, both the duty and the prize
Of him that creeps and him that flies.

https://pickmeuppoetry.org/the-nightingale-and-the-glow-worm-by-william-cowper/

Donald Macaskill

Photo by Siim Lukka on Unsplash

I am sure I am not the only person who is fascinated by the worlds of art and design. I have always admired and appreciated the skills of individuals who are able to take their visions and mould them into visible objects and ideas, whether they be visual artist or sculptor, architect, or designer. As is evident by a groaning bookshelf I have changed my own appreciation of what I find interesting and enjoyable in the world of art and design over the years. From a fairly traditionalist stance a couple of decades ago I then discovered myself every few weeks in London for a few days and I decided to get a season ticket to the Tate galleries. Gradually over time I not only began to love the galleries in London but also the exhibitions of modern art and design which they displayed. By deliberately exposing myself to artists, sculptors, and designers who I might previously have dismissed out of hand I fostered a new appreciation and enjoyment.

When it comes to the worlds I now inhabit, those of older age and social care, design plays an exceptionally important part. There has been in Scotland over the last few years remarkable work undertaken not least by the Dementia Services Development  Centre in Stirling University (based in the Iris Murdoch Building) in increasing the awareness and appreciation of the role of design in the provision of high quality care and support for people living with dementia. Many care homes have benefitted from the lessons around layout, colour, tactile awareness, and design which have been developed over the years. There are also numerous architectural practices around the country that are really pushing the boundaries around accessible design for people who might live with disabilities and have mobility restrictions and for the ageing population as a whole. Their work needs to be celebrated and applauded and I am looking forward in a couple of weeks to hearing and seeing exemplars of innovative design at the Global Ageing conference.

This is a critical issue and is intrinsic not only to improving personal wellbeing but also to enhancing real preventative care and support. We spend around 90% of our time indoors, in buildings that are often not supporting our health and wellbeing. A place can heal and re-energise but it can also drain and empty us, and that is not just true of those buildings we describe as ‘sad.’ There is real importance in what has come to be called wellness architecture and design.

But despite the obvious sparks of innovation and real progress there are around Scotland I do bemoan the narratives around ageing which seems to act as brakes and limiters on innovative design for older life.

One such is the ever prevalent if not growing conscious and unconscious discrimination around older age. This last week I heard someone use the hackneyed meme of viewing our ageing population as a tsunami about to hit us. I heard people talk about how we can control the tide of an increasing number of older people and prevent it from overwhelming services. I heard others reflect on what we can do about the ‘problem of there being so many older people in the future.’ Everywhere you look and listen there is a suffocating negativity around older age and that infects the worlds of design as much as anywhere else. Indeed I still remember working a couple of decades ago with an architect’s practice in central London and delivering equality training when the partners proudly informed me that they were not in the least bit ageist. As I looked around the group of around 200 designers and architects sitting before me not one was over the age of 50!

Ageism in the worlds of art and design has to be challenged and addressed. There are lots of laudable efforts around age inclusivity in design, not least the Royal College of Art’s Design Age Institute (www.rca.ac.uk ) but they have to be much more appreciative of the reality that an older age population is developing some of the most radically innovative approaches to design challenges. I think of the amazingly original industrial designer Ayse Birsel who is challenging ageism by presenting real older age innovation. She recently wrote Design the Long Life You Love: A Step-by-Step Guide to Love, Purpose, Well-Being and Friendship.  For Birsel, it is critical that the design world draws on the insights of older age and she argues that longer life is a real opportunity for innovation.

Discrimination and lack of appreciation of the contribution and capacity of older age has to be addressed in part by ensuring the voice of older age influences design but also by addressing the stereotypes of age which many folk, however well intentioned, may still possess.

For instance, if architecture is a manifestation of the most public form of art, then we dare not restrict it to designing environments which are simply more accessible for people as they age. Ageing is not solely about decline and deterioration; it is not just about making sure environments are accessible (though that is critical), there has also to be space for the ideas and inspiration of older designers and artists to contribute to the creation of a new built environment.

Further if product design is to capture the imagination and energy of the person who uses the finished article regardless of their age it must be more than simply usable and functional. So much of what passes as age sensitive design in relation to products is certainly great in its accessibility, its appreciation of visual and aural changes and restrictions, and awareness of the divergences of colour as people age. But in truth so much of it is boring and dull and lacking in any life and vitality. Ageing may restrict visual capacity, but it does not result in the removal of joie de vivre, a loss of the imaginative spirit or simply enjoyment in life.

Designing for an ageing population should not be simply about thinking about the worlds of care and support, about limitation and accessibility, about decline and diminishment. It should be about a continual pushing of the boundaries of spirit to ensure that older age is celebrated. The fact that most of us do not slip off our mortal coil in our fifties as our predecessors did is something to celebrate not to sit and mourn over in dour distress.

Design at its best removes the word old from the vocabulary of the creative. It is truly intergenerational in its appreciation that what works for one age should speak to another. We need inclusive intergenerational design.  And at its heart all design that I have enjoyed over the years sought to go beyond functionalist benefit to demonstrate the value of enjoyment and even adoration.

There is something about the impatience of older age which demands not to be caged and restricted even by accessible and well-intentioned design in this poem by Maya Angelou,

On Aging

When you see me sitting quietly,

Like a sack left on the shelf,

Don’t think I need your chattering.

I’m listening to myself.

Hold! Stop! Don’t pity me!

Hold! Stop your sympathy!

Understanding if you got it,

Otherwise I’ll do without it!

When my bones are stiff and aching,

And my feet won’t climb the stair,

I will only ask one favor:

Don’t bring me no rocking chair.

When you see me walking, stumbling,

Don’t study and get it wrong.

‘Cause tired don’t mean lazy

And every goodbye ain’t gone.

I’m the same person I was back then,

A little less hair, a little less chin,

A lot less lungs and much less wind.

But ain’t I lucky I can still breathe in.

On Aging by Maya Angelou – Famous poems, famous poets. – All Poetry

Donald Macaskill

photo by Med Badr Chemmaoui on Unsplash

My late mother used to say that the seasons changed when the schools went back. With the passage of time, I have come to realise the truthfulness of such observation rather than to dismiss it as I once did as the fruit of Highland pessimism. As Scotland’s schools have returned or are just about to, the seasons do indeed seem to be changing. The days are getting shorter, the summer bedding plants are dying back, and there is a slowing of nature as it begins to get ready and prepared for colder times.

It is therefore maybe not surprising that next week along with colleagues from across health and social care I will be attending a workshop session to explore winter preparedness. Last year was a very challenging time for many who worked in, delivered and importantly those who used social care and health services. So, it is very necessary for planning and preparation to take place early in our autumn. But just how ready are we for the weeks and months that lie ahead? I want to reflect in this blog, briefly, on where we are at in the world of social care in Scotland as we start to move towards the winter.

Covid 19.

To all intents and purposes, for the vast majority of the public in Scotland Covid has disappeared from both thought and consciousness over the last few months. Its fear and hold have been burnt back by the summer sun. Indeed, at the end of the month the current practices around testing of health and social care staff will stop altogether unless someone is being discharged from a hospital into a care home. Though there is a rider that testing will happen for individuals if there is a clinical need.

But of course, for those of us working in social care Covid has never disappeared. It is still here and the casual dismissal of its impact by some ill serves those for whom its impact remains significant. There are countless thousands of Scots who are immune suppressed and who are struggling to lead ‘new normal’ lives because of their fear of catching a potentially damaging virus if they interact with a society where protections and mitigations are minimal. Indeed, for those individuals the very dismissal and denigration of their desire to protect themselves has made themselves even more fearful of social exchange.

In addition, there are tens of thousands of our fellow citizens for whom Covid has had a lasting potentially life-long impact because they are living with the consequences of Long Covid. I cannot imagine there is anyone out there who does not know someone living with Long Covid. And for those who simply and dismissively say catching Covid is just like getting the flu (though when did getting the flu become such a casual happenstance) then I would ask when did you hear of tens of thousands with ‘Long Flu’ or permanent damage from the flu affecting thousands? Indeed, the negative impacts of frequent infections of Covid are increasingly being researched with not a little scientific and clinical concern in some early studies. Covid is not ‘just’ the flu by any stretch of any imagination.

As we move into autumn this last week there has been a much increased media coverage about whether or not there has been a growth in Covid cases over the last period and whether this is something we should be concerned about. In truth this is hard to determine when there is no real community surveillance, but we do know that the World Health Organisation continues to identify new variants. One such is EG5 or Eris and even more recently BA2.86 which was identified first in Israel just last week and is already causing some anxiety as to its rapidity of spread. Not surprisingly new variants will keep coming. What is important is whether they will escape the vaccine and community protection which the majority have at the moment. The BBC related the levels of Covid in a good piece this past week  in Should we be worried about Covid this winter? – BBC News  .

But anecdotally I am coming across many more friends, family and colleagues who have Covid or have recently had it. (If only we had decent community tracking!). The data we do have is mixed but does seem to show an upward trend which is a concern given that this is early August. Data reported on the 17^th August on the Public Health Scotland database indicated that there were 183 people admitted to hospital described as acute Covid admissions. This was up from 139 the week before. This meant that there were 219 people in hospital with Covid19 on the 13th of August compared to 166 the week before. According to data from National Records of Scotland reported on 17^th August there were 17 deaths involving COVID-19 in the preceding week (to the 13^th). This is an increase on previous weeks. The Care Inspectorate reported that in terms of the number of Covid outbreaks in the week to the 15^th August there were 39 care homes which was 17 more than the previous week and is 4% of all homes reporting. This is a 3% increase in a fortnight, and I hope is not a developing trend but anecdotally one is hearing of more staff off ill with Covid which is also reflected in their data stating that for the care homes which reported to the week ending the 15^th August with Covid here were 108 staff absent which is 0.3% of the workforce from those 60% of homes which reported. A fortnight before this was 47 staff – so a doubling in absence rates.

As someone who looks at this data on a weekly basis there is clearly an impact from new variants and what appears increased transmission. It makes the roll out of the winter vaccination programme all the more critical for all who are eligible. What I think is a concern is the potential impact of a bad flu season on top of Covid19. Last winter we avoided a bad flu impact in part because of a more effective vaccine.

So even if we are able to step up our Covid and respiratory response there is likely to be a continued pressure on a health system which is already under strain and on a social care system and workforce which is in a worrying state.

Workforce

The health and morale of our workforce is a key issue for winter preparedness. Obviously, absence due to Covid is a matter of concern for any person working in social care. But we are already in a situation where the workforce in social care is, I would contend, at its lowest ebb. I will not rehearse again the immense disappointment felt by frontline workers and organisations around the failure of the current Scottish Government to come good on their promise to pay frontline staff £12 an hour. We still do not have an indication of a timeframe for this despite the promise being made in the spring. What has happened since is what we all knew would happen and that is a haemorrhaging of frontline care staff from independent and third sector organisations into both better paid public organisations and the NHS, and even more worryingly out of the health and care sectors in entirety. Like many I was pleased with the news of a few days ago that our junior doctors had settled their dispute, but even this news makes frontline social care staff feel yet another kick in the teeth. What must happen for the promise of increased remuneration to become more than a political soundbite and instead to be a promise fulfilled?

Last year was very challenging for the organisations I know whether care homes or homecare providers, regardless of them being charitable or private. It was very hard to hold onto staff and even harder to recruit in such a high employment and competitive environment. With the fact that NHS colleagues are now getting paid so much more than social care it will be harder still. The gaps were plugged at huge cost last winter using agency staff, but even agencies are struggling to recruit.

But more than the issue of pay is the issue of regard and value. I have lost count of the demoralising conversations I have held over the summer with frontline care staff who simply do not feel valued. We are a lifetime away from claps on a Covid Thursday night.

Sustainable services

Alongside a demoralised workforce social care provision in Scotland has never faced the extent of financial instability it is now enduring. Given that in Scotland so much provision is delivered by smaller organisations this has left them susceptible to very real risks not least because of the ongoing cost of living crisis and the lack of external and public investment in care and support. I have a very real concern that to keep their heads above the water and because of a lack of frontline staff that social care providers, whether care homes or homecare organisations, if called upon to increase capacity and response in the weeks and months to come, have done previously.

We are already witnessing a level of care home closure and a reduction in bed availability the like of which no one I talk to can remember. More and more care homes, if they can, are making the decision not to admit residents funded by the National Care Home Contract because it is simply not sustainable. In terms of homecare more and more hours are being handed back because they organisations cannot afford to deliver them at what they are being paid. More recently the level of late payments and cash-flow issues are having a profound impact on small homecare organisations. Social care is a sector whose fiscal fragility should send alarm bells ringing.

Whole system thinking.

What matters most to people at any time of the year not just winter is that they remain at the centre of all our planning and preparedness in the weeks ahead. The challenge of these days is not about numbers and statistics, but about what the experience of every individual is. I have written many times in this blog that getting through a winter (or any season) is not ‘just’ about delayed discharge, or making sure that the acute sector hospital flow is operating well, or even discharging people to be supported in their own home through models like hospital at home. It is all that, of course, but it is also critically about preventative care and support; intervention upstream that delays decline and enables people to remain independent for as long as possible. Too much of our focus (both in terms of media and politics) is on one part of the health and social care system at the cost of the whole. Investment in social care and homecare in particular would massively re-right that imbalance.

In general terms then I am very concerned about the capacity of an already stretched system in health and social care to respond to whatever the winter brings us. If we use the obsessive media metric of delayed discharge our numbers are very high for the time of year. According to the latest published data at June 2023 census, 1,738 people were delayed. The high point of November 2022 was 1,977 people delayed. Our hospitals are working at levels which after such a long period of maximum occupancy are exhaustive.

The risks of the following season are clear from rising Covid and other respiratory conditions, a tired, exhausted and devalued social care workforce, a failure to invest in the social care system as a whole, and in my viewpoint a myopic focus on one part of the system rather than the whole. This is all made worse by the stripping of funding and support from many communities and third sector organisations which has left our neighbourhoods ill prepared to support their citizens. Added to this the immense pressure placed upon the army of unpaid and family carers over the last few years has led many to the brink of being unable to continue and this is not helped by the voids and gaps in respite day support and opportunities.

There is, however, no shortage of talented committed individuals across the whole of Scotland willing to make the difference, working hard to get things right. There are plenty of innovative ideas which are being put into practice and implemented across the country to make sure that the experience of citizens is as positive as it can be and literally that lives are saved and enhanced. We all know planning is critical but planning only works with honest appraisal of the environment around you and if the adequate tools and resources are made available in order to get the job done. Planning only works if the analysis (which most agree on) and the solutions and interventions (around which there is much agreement) are enacted upon. I hope by working together rather than in siloes we will not only get through these coming weeks but thrive but all of that doesn’t just depend on collaboration, critical through it is to have everyone pulling in the one direction, it also depends on political and societal leadership and making hard fiscal decisions which for me means starting to prioritise social care. If we get social care right this autumn we will all get through the winter.

Donald Macaskill

 

Photo by Aaron Burden on Unsplash

I was chatting to my 9-year-old daughter the other day about the Global Ageing conference and events which are coming to Glasgow in a few weeks. She turned to me and asked, ‘Are there going to be young people and children there?’ I replied that there were sessions on inter-generational work but I wasn’t sure if there would be children. Her retort was ‘Ageing is for everyone not just old people. Children are ageing.’ Out of the mouths of babes ….

Because of course, she is right. The way we age is for all generations and years. And yet I am made to reflect on the extent to which both in policy and practice we are not always inclusive of the perspectives of the young when we consider ageing. Have we made ageing just the preserve of the middle and older generations? If the saying that youthfulnes is too important to leave it to the young is true, is it also true that older age is too important to be left to those who might think of themselves as old?

I continue to be shocked by what I see and read on social media about attitudes to older age in particular. Even this past week when responding to the news that there were increases in the rate of Covid19 in some parts of the UK one person on ‘Twitter’ or is it X, stated quite openly that it was positive as it would remove more old people and thus reduce the pressure on the NHS!

We have a long way to go before we create a society where all ages matter and are valued and treated with dignity and respect. Our humanity and our lives should not have a use by date stamped on it dependent upon another’s perceived sense of value.

Today is the United Nation’s International Youth Day. This is an annual event to celebrate younger age and is not unlike the similar event to recognise the value and contribution of older age held on the 1^st October each year. This year’s theme is

Green Skills for Youth: Towards a Sustainable World. It is a recognition of our global transition towards an environmentally sustainable and climate-friendly world. As it states ‘a successful transition towards a greener world will depend on the development of green skills in the population. Green skills are “knowledge, abilities, values and attitudes needed to live in, develop and support a sustainable and resource-efficient society”.

All ages can, I suspect agree and applaud such a statement.  I hope that International Youth Day will as always enhance its message. But whether it is this year’s theme or any other it is not a campaign or destination that will succeed or be reached by the young alone, any more than any campaign of an older age group or day can be successful without the voice, presence, and contribution of the young. So why do we consistently act as if we are all on different journeys?

We have come a long way from a situation where it was believed that engaging with young people in the aged care sector was about the quarterly visit of primary school children into a care home to entertain and perform (though there is nothing wrong with that!). The work of organisations like ‘Generations Working Together’ has shown us that real inter- or multi- generational work is not to consolidate the cultural stereotypes of age but to challenge them. The young child visiting a care home has so much story and vision to share and the older resident has so much creativity and innovation to commence in the dialogue between the ages. One is not passive and the other active. There must be a mutuality of understanding that each generation, each person has as much to learn and share, to receive and give as the next.

Organisations like GWT have a vision, which in their case is ‘to live in a Scotland where different generations are more connected, and everyone has the opportunity to build relationships that help to create a fairer society.’

This is about moving and breaking down the barriers of ignorance and stereotype, priority and policy which can present blocks and stop the generations from working together.

So, whilst it is always going to be important that we challenge discrimination where one group is treated more or less favourably than other – and that still exists in our society in relationship to age as the older you are the more likely to be the victim of discrimination you become – we need to expend as much priority and resource upon  inter-generational working.

Ageing belongs to everyone – it is not just the preserve or focus of one demographic group. What do the young say about what it means to age? What does ageing mean to the youth of today? Well that is inevitably a very individual question but one thing we know is that there is a library full of research papers and reports that show that people who view the ageing process in a positive manner and as something to enable them to achieve their potential and dreams tend to enjoy much better health into their later years than people who think about ageing as decline and deterioration, frailty and loss of independence. A positive attitude around ageing benefits us both physiologically and emotionally. If we think positively about growing old, then we live longer – it is as simple as that!

In the face of such overwhelmingly clear research around being positive about ageing, it would also have to be admitted that the cultural stereotypes about older age still dominate and perhaps have become even more consolidated.

Ageing really is for everyone – it is the business of our whole society not just to challenge negative attitudes and behaviours (which remains critical) but to start to celebrate, value, appreciate and herald older age and ageing. My nine-year-old is absolutely right and I hope by the time she reaches ninety she will belong to a community and a nation where all generations celebrate together as well as on their own days for youth and older age.

I agree with the positivity of the Argyll based poet Rebecca Pine:

Old Age

I have, I think, most organs that
I started with. Some shaped by time
foreshortened, elongated, dulled.
I keep at bay time’s passage with the thought
this must I do, this might I do, this ought.
Thus never having nothing on my slate
I draw a little, dance a little, write;
and sometimes in the middle of the night
think splendid thoughts which trickle down
to verse. While opera and music still delight;
there’s history and nature to explore
and conversation with the worldly wise,
I’m washed by tides like pebbles on the shore.

Old age! Old age?
I’m sorry sir, I fail to recognise
the title on the page.

Old Age by Rebecca Pine – Scottish Poetry Library

Photo by Paolo Bendandi on Unsplash

Donald Macaskill

I read recently that both because of the cost-of-living crisis but significantly because of the severe environmental changes which we have witnessed across Europe this year that the way in which people spend their holidays is likely to change. The argument stated was that it is likely that fewer people will chose to go abroad and spend time outside their own country. This has long been an issue for citizens of the United States where only 37% of people hold a passport and an even smaller proportion of that have left their country but it is not something we have witnessed in Scotland or in the UK as a whole. The journalist who was reporting these factors questioned whether or not the lack of people going abroad from Britain would result in a change of attitude and behaviour towards other countries. He opined about whether or not people would become more insular and perhaps dismissive of the perspectives, views, and attitudes of others. Is there a risk we will lose an internationalist perspective?

Internationalism is at the heart of the Scottish character. It is that conviction that we become better, we mature and grow as individuals and as a nation, when we look beyond the horizons of our own knowledge, experience and world to explore elsewhere, include all and to learn from others. It has been a characteristic of Scottish identity from the earliest of times and has enriched our nation and communities.

As many of you will be aware my own organisation Scottish Care together with the National Care Forum will be hosting the Global Ageing Conference to be held in Glasgow from 6-8 September. A lot of work has gone into creating an event which will bring some amazing international voices to Scotland to reflect, share and inspire on issues relating to the care and support of older adults in the years to come. You can find details and sign-up opportunities on the website at Global Ageing Conference 2023 (globalageing2023.com).

As one of those involved in the planning and delivery of an international event, I have been spending some time reflecting on the nature of internationalism not just in general but for the world of social care in specific and I want briefly in this week’s blog to reflect on a few issues and themes that have arisen about working internationally and the diverse perspectives that come to bear when being involved in such an experience.

I have already stated above that in wider society in the United Kingdom there seems to be a growing trend in part because of circumstance but also because of changing attitude away from internationalism and international approaches. Some of the comments I hear in relation to social care go along similar lines. I have heard the statement that ‘everyone is different, so I am not sure that the perspectives of others in other countries have much to teach me and the way I work or deliver support and care.’ Undeniably it is true that every community and society works and acts differently, equally true it is one of the principles of social care that we should always have at the centre of all our work and relationships the peculiar and particular needs of the individual (person-centerdness) but it is I think naivety in the extreme to suppose or imagine that circumstances both in terms of an individual person or a community are so unique and distinctive that there are not lessons to be learnt, perspectives garnered and insights to be explored from contexts and communities very different from our own. Indeed, the last couple of years has taught me personally that in Scotland we have an astonishing amount to learn about a whole host of areas from perspectives and communities very different from our own, whether it be insights on community engagement and person-led approaches to care from Singapore, innovative approaches to dementia from India, or the empowering and skilling of the care workforce in Africa. The loss of a sense of internationalism whether in social care or society in general is a real risk because it impoverishes and risks the development in its place of narrow parochialism and negative nationalism.

A second point I sometimes hear is that when there are times of very real challenge then one should concentrate and focus on the issues to hand and not invest in either the future or in exploring new approaches, ideas, and models wherever they may come from. The risk of such a perspective is once again that a community or a person becomes insular, narrows the vision of the possible to that which is known, and creates a future solely from inside their own mind or experience. It shrinks the world to their own backyard. It means that we are not open to be inspired by others, prepared to accept that what or the way we do things might not be the best or end point, and that there could well be insights and imaginations from elsewhere that could literally change our world. Of course, there are very real challenges in investing resource into exploring new approaches and possibilities, but it strikes me that to draw the horizon of the future so close to your own experience, risks a very limited perception of what is possible in our living.

One last observation I have about what I fear is a loss of internationalism is that faced with so many challenges that as organisations, communities, and individuals we need to expend our energies on those challenges alone and not to seek to take on new work or activity. Concentrate on the now and leave the bigger issues or threats to others. Personally I consider that such a turning your back on the questions and answers of another is very risky. It is a perspective that believes it is possible to confront global or shared threats alone. The very opposite is the case. Whether it is the challenge of environmental and climate threat, the shared challenge of safety and defence, or in my world the shared challenges of how do your recruit and retain a workforce in social care; what approaches and models of care and support will people want in their older age in 10, 15, 20 years’ time; how do we meet the threats to our society brought about by dementia, delirium or any other condition – then all of these yes could be challenged and addressed on their own, within Scotland – or far better they can and should be addressed by a shared international collectivism.

There is, I believe, an importance if not an imperative in being challenged and unsettled out of our own situation and context by people who do things differently, whose insights are not ours and whose discoveries may not be those of our priority. There is a strength to be gained by the solidarity which comes from an internationalist perspective, an energy created by the inspiration and imaginations of others, and an adventure to be discovered when we move beyond the horizons of our own knowledge.

In a few weeks’ time I hope (and know) when the Global Ageing conference and its week of events comes to a close I will as will all those who have taken part, have been inspired, moved, enriched and challenged by the people I will have met (from at this stage 40 countries around the globe), and the conversations I will hold, and the experience of realising that my world and perspectives are not the only ones when we face global issues and shared concerns.

Any international event changes you for the best and I really hope that as a society in Scotland, never mind the world of social care, that we will not go down the path of withdrawing from others in the belief we can be or are best alone. One of the very earliest poems I heard and explored as a child at school is printed below. It is one whose insights I keep learning. I will be renewing my passport when it comes time to do so next year!

‘No Man is an Island’

No man is an island entire of itself; every man

is a piece of the continent, a part of the main;

if a clod be washed away by the sea, Europe

is the less, as well as if a promontory were, as

well as any manner of thy friends or of thine

own were; any man’s death diminishes me,

because I am involved in mankind.

And therefore never send to know for whom

the bell tolls; it tolls for thee.

 

MEDITATION XVII, Devotions upon Emergent Occasions by John Donne

Photo by Anthony Cantin on Unsplash

Donald Macaskill

Tomorrow is International Day of Friendship which was created over a decade ago by the United Nations to underline the critical importance of friendship to human well-being and to society.

As the UN stated when the day was established our world is a complicated place, but it is a place where friendship is probably more important than ever. The idea of having a day to celebrate friends originated from Hallmark (the card folks) in 1919 and was intended to be a day for people to celebrate their friendship by sending each other cards. But by 1940 it died out completely.

It wasn’t until 2011, that the United Nations officially recognised 30th July as International Friendship Day, even though many countries celebrate on the first Sunday of August.

According to the International Friendship Day declaration, people are invited to “observe this day in an appropriate manner, in accordance with the culture and other appropriate circumstances or customs of their local, national and regional communities, including through education and public awareness-raising activities.”

Friendship makes a real difference to people. The United Nations underlines that amongst other things that friendship enhances emotional resilience helping people through good and bad times. Research has shown that even spending just 10 minutes with friends can boost your ability to solve problems and your brainpower. And it helps you sleep and makes you healthier.

Regardless of all the research most of us know that having a network of friends brings real benefit to us. I sometimes wonder with all our focus on social media whether our virtual networks evidence the same depth of friendship that our physical ones do. That said I know that during Covid technology rescued, fostered, and encouraged friendships.

As you age and grow older it can become harder to maintain friendships. This can be the case for lots of reasons, whether due to moving to s new location at key stages of older age and losing networks you had built up or not being able to be as involved in the community and socialising less frequently perhaps because of ill health or even affordability.

Friendship has to be worked at and I remember speaking to residents in a care home some years ago who had become low in mood because though their families visited they had over time lost touch with friends in the community who after some time had stopped visiting. The home manager took it upon herself to undertake a ‘friend’s audit’ during which she discovered who people were describing as ‘missing friends’ and she had colleagues purposefully and over time re-created connections and the benefit to individuals was visible to see. They always had an open door to the community but now the community was much better at supporting those who had chosen the care home to be their place of residence.

I’ve written before about the impact of loneliness in our communities and even in your own home people can over time become isolated through loss of contact with friends. Good social care used to be as much about enabling friends to be in touch, connecting people in ‘social ways’ than just personal care needs. Friendship and its maintenance has tremendous preventative health benefits if only we resourced and prioritised it adequately.

The poet Jackie Kay wrote these words about friendship over a decade ago.

“The Scottish poetry Library asked me to pick a favourite Burns poem and write my own version. A tall order! A big ask. I decided to go for a short poem. I love John Anderson my Jo-in two perfect wee stanzas it tells the story of a lifetime’s marriage and even imagines a kind of togetherness in death…

But I wanted to write a poem that celebrated friendship; so many poems celebrate romantic relationships. So I took the idea of a friendship over the course of a lifetime, imagining that we’d been friends as girls, Ali and I, and that we still will be friends as old women. I couldn’t quite manage the two short stanzas, so I went for three instead! I pronounced fiere -feeree, not fear; the latter is the correct pronunciation but I liked the ee ending since it afforded me more rhymes, and also sounds more like friend to me, dearie fiere. But I was also thinking about what makes us who we are, and that if it weren’t for the friends that we meet along the road, the chance, happy meetings and the ones that feel fated, we would all be very different. Friends shape and carve your life, opening doors, alerting you to possibilities, giving you sustenance and belief. Not just a shoulder to cry on, a rock to fly off. You choose your friends. The gift of a deep friendship goes to the very heart of who you yourself are. It’s hard to imagine how you would get through any challenge, separation, bereavement, disappointment, embarrassment, without your fine fieres.’

I do hope people will give some time to think of those they have lost touch with and to try to reconnect on this International Day of Friendship. I also hope that groups and individuals in our wider community consider those in our midst who are in need of being reconnected of indeed in need of befriending.

I’d encourage you to read Jackie Kay’s poem but my own favourite friend poem is one that equally captures the truth that true friendship just creates a space that allows you to be. It’s written by the poet, physician and scientist Norman Kreitman who died in 2012.

Fishing With Norman MacCaig

Each time I called for him he was perfectly ready,
equipment checked and in smooth order,
pared to essentials. And I, cluttered with gadgets,
would clatter behind as he led the way downstairs.

In the boat, as befits a sedulous angler,
he was taciturn, though between essential words
he would give that courteous, gentle smile
that was his signature, before his gaze returned

to the contemplation of the water. And when
in his own good time he hooked a trout
he’d eye it dispassionately, as one whose life was spent
retrieving silver from all the elements of Scotland.

Fishing With Norman MacCaig by Norman Kreitman – Scottish Poetry Library

Donald Macaskill

Photo by Ricardas Brogys on Unsplash

In two days’ time on the 24 July, it is Samaritans Awareness Day. The very nature and heart of the Samaritans is the fact that they are there to listen to people when they need to talk to someone. They do so 24/7.

Finding someone to listen to your pain and hurt, to give space to have your questions and concerns, your anxieties and fears heard can be really hard.

Listening is not easy. We spend so much of our time communicating but I often reflect upon how little of that time is spent in real and attentive listening to another. In an increasingly hectic and busy world so many of us spend time surrounded by sound and noise, we hear voices and listen to conversations, but I wonder if we give ourselves the time and space to develop in ourselves the skills of deep and attentive listening.

It is a truism that we communicate in many different ways. Academic researchers have stated that in any communication what we hear is actually the smallest part of what someone is trying to ‘say’ to us. It is argued by Meharabian and others that maybe as much as 90% of what we communicate is ‘non-verbal’ I mean by that we do not only ‘talk’ with our mouths and voices but in so many other ways. Our bodies talk to others. The way we lean forward or away from another; our use of wider posture and gesture; the use of our eyes, as to whether we give direct contact or not; the mannerisms we may have; all parts of us communicate and talk. Whilst airport bookshops are full of theories about how we communicate and much of it are the  theories of the unobserved, it is nevertheless true that when we communicate with those we know well we learn to read the signs of how they are saying what they are saying as much as the ‘what’.

Just as our fingerprints are unique to us, I believe every human individual communicates in a unique and distinctive way. Of course, there are consistent similarities, but the art of true communication is to learn what is my own individual language.

Phoebe Caldwell, whose work and career in speech and language therapy and whose development of intensive interaction especially for people with autism has been so seminal, once said to me that communication is like a bridge. There is a hubris and arrogance that assumes that someone can only communicate if they use my language, my way of using body, and sound and word and silence. Real communication is like a bridge. It is as we meet each other in the middle of that bridge that we learn to understand what another wants to say to us and is saying to us, and vice-versa they learn what matters to us. This is the heart of all good relationships.

But when it comes to listening in my experience it is also often the case that what is left unsaid is often what someone comes to talk to you about. We have to give space for people to share what it is that they want to share and talk to us about. Picture a classic visit to the doctor or to someone you have to speak to about an important or urgent matter. I have learned that many folks hide their hurt and issues in the small talk of generalities. It is that small talk that allows them to gain and build the confidence to share what really troubles or concerns them. But it is often shared at the end, in the moment when their hands are on the door-knob of the exit, at a point when they feel as if they can flee and escape from the encounter that is before them. So it is that we all in our own way have to give people the space to share and talk about what is troubling and bothering them. The art of true listening is not always the sounds we hear but recognise what is being said in the silence between the words, the feelings, and emotions someone wants to share but can only do so through the look of an eye, the gesture of a hand, or the shrug of a shoulder.

I would love it if every child at school spent some time learning about how we can truly and attentively listen to others. How we can learn to not interrupt a speaker because we presume to know what it is they are already going to say; how we can give space for people to go deep into what they want to share; how we can recognise the way in which someone uniquely expresses themselves; how to use open and not closed dialogue; how to be comfortable with a silence just long enough for it to be filed not by our voice but by our listening. I suspect if attentive listening were to be part of our school curriculum of learning then our experience of living in community would be so much richer.

Today there will be many people in our acquaintance who will want to talk, who have found the courage to start to reach out and talk, we can and should encourage them to talk to those who are adept at listening like the Samaritans. But I also hope we can use these days as an opportunity for all of us to start to learn how to listen better. I know personally it is a journey of improvement on which I have a long distance to travel – but it is always better to listen, because it is then we truly begin to hear another.

That well known philosopher the Liverpool football manager Jurgen Klopp once said: “If you want to be a leader you have to be a good listener because if you are a good listener, you might just find out what people want.”

And deep listening really does make a difference as the American poet and therapist John Fox puts it:

When Someone Deeply Listens To You

When someone deeply listens to you
it is like holding out a dented cup
you’ve had since childhood
and watching it fill up with
cold, fresh water.
When it balances on top of the brim,
you are understood.
When it overflows and touches your skin,
you are loved.

When someone deeply listens to you
the room where you stay
starts a new life
and the place where you wrote
your first poem
begins to glow in your mind’s eye.
It is as if gold has been discovered!

When someone deeply listens to you
your bare feet are on the earth
and a beloved land that seemed distant
is now at home within you.

When Someone Deeply Listens To You, by John Fox (awakin.org)

 

Donald Macaskill

 

In one of those calendar quirks today the 15^th July happens to be St Swithin’s Day and also the first Saturday of the Glasgow Fair. St Swithin’s Day as many of you might remember from the rhymes of childhood is a day when according to tradition, whatever the weather is like on St Swithin’s Day – whether rainy or sunny – it will continue for the next 40 days and 40 nights.

‘St Swithin’s Day, if it does rain

Full forty days, it will remain

St Swithin’s Day, if it be fair

For forty days, twill rain no more.’

Now I am no meteorologist, but I doubt the late St Swithin, the Bishop of Winchester in the 800s, has much influence over the weather. But it would not at all surprise me that on this first day of the Fair that the rain is pouring somewhere in the west.

As a child growing up the Glasgow Fair was very important. It was the time of year when my family made our annual pilgrimage to Skye to visit grandparents, and to allow my father to turn the day job into a fortnight of shearing sheep, picking potatoes and having more than the occasional dram to catch up with friends and relatives. It was also a time when it was either sweltering heat or continual rain – so good old St Swithin might have known a thing or two.

The story of the Fair is an interesting one. Historically it’s the oldest ‘Fair’ of its type and dates back to the 12^th century and indeed up until the late 19^th century markets and fairs were always held around the fields and green spaces around Glasgow Cathedral.

Before the 1960s it was commonplace for most businesses, factories and the shipyards to close on ‘Fair Friday’ to allow workers and their families to attend, and for folks to take their holidays by going “doon the watter” to the Ayrshire coast. Today whilst the name lives on people in the city take their holidays at many and diverse times to fit into a very changed pattern of work and leisure. You are likely to see many more Glaswegians in the streets of Palma and Albufeira than in Ardrossan and Troon.

The way we holiday may have changed but for many people taking a couple of weeks off in the summer has become almost a ritual. This year I have heard of families who despite the pressure of money and the cost-of-living crisis trying their best to give especially their children some time away even if it is just another part of Scotland.  I have also been having quite a few social media chats and DMs around the issue of holidays at this time of year from staff who work in social care struggling to make ends meet to older people who struggle with holidays per se both on the grounds of finance and also in the sense that their normal contacts and routines are so changed that it often leads them to feel so much more alone and lonely during the summer months.

Holidays are very often hard times for people for so many reasons. The loss of routine can be hard for all ages. The constant being together with people who you may not always get on with in new environments can be stressful. The process of travelling, staying in a new place, feeling you need to keep children entertained and amused – a lot of family holidays whilst fun can be the complete opposite. And in soaring temperatures tempers can become frayed and strained. Dealing with heat and humidity can be very hard for many people.

Like many of you I am well acquainted with SAD (seasonal affected disorder) and having worked in Orkney for a while was very aware of the impact the short days and long winter nights could have on the mental health and wellbeing of people. What I have been less well aware of is the impact of summer and of summer holidays on folks.

I recently came across a fascinating article by Michelle Pugle which explore the issue of Summertime SAD. It states that summer affected disorder whilst less common is just as serious. It argues that we all of us, not least those who support others, need to become much more aware of the impacts of summer and the holiday season on the health and wellbeing of people, not least as the impacts of global warming and climate change are worsening as the years go by.

“It’s important to remember that everyone is different, and while most seasonal episodes of depression occur in the winter, up to 30 percent of people [with seasonal depression] will experience summer depression…

People with summer-pattern seasonal affective disorder (SAD) — aka “reverse SAD” — typically experience common symptoms of depression for about four to five months each year when the weather is warmer.”

It goes on to detail the effects of such depression, such as feeling sad or low most days, having lower energy levels, losing interest in activities and relationships, insomnia, loss of appetite, agitation and restlessness.

The article also suggests some coping mechanisms which those who care for and support others might find useful including, identifying summertime triggers ( maybe the heat and humidity, loss of role, changes in family, issues of body image); make sleep a priority ( find out what helps you sleep in the hot nights and accentuate your sleep but do not try and sleep outwith normal patterns) ; develop a routine for the time and keep to it ( it can help you feel more motivated and put-together); attend and make space for your emotions; avoid the traps which can often make you depressed such as eating when you’re bored, but not hungry; playing video games or being on your phone for hours; drinking excessive amounts of alcohol); and build self-care into your routine.

Holiday time and summer-time are undeniable escapes for many but they bring burden and challenge to some and those who work in and receive social care and support are no exception.

So on St Swithin’s Day and during the Glasgow (or any other holiday) Fair let us look after ourselves and others.

Donald Macaskill

Photo by Deep Trivedi on Unsplash

The past few days has been full of events, from the 75^th anniversary of the start of the NHS, to the celebrations around the King receiving the Honours of Scotland, to the first 100 days of our new First Minister. A very busy week indeed. Sadly though the 5^th July was also the 75^th anniversary of modern social care in the UK I seemed to have missed any national celebration. But therein lies the lot of social care!

Closer to home the care home members of Scottish Care have been conducting a vote on whether or not they should accept the COSLA offer of 6% to increase the National Care Home Contract rate. You may have seen from the media statement on the Scottish Care website this morning that the decision was reluctantly made to accept the 6% though in so doing many considered that they were merely delaying their inevitable closure. What the statement also made clear is that Scottish Care, both its staff and members, frontline managers and carers will continue to campaign for a just and equitable pay settlement for the women and men who work in social care across Scotland, whether in someone’s own home or in a care home and for urgent sustainable funding.

At a personal and professional level, I have always been a seeker of compromise and consensus, believing that bringing people with you, working through the hard problems and issues of the moment, is more important than grandstanding or being constantly oppositional. Indeed, even during the largest crisis which social care delivery and people using care and support services in Scotland have faced in a lifetime, during the pandemic, personally and professionally I have sought to find common ground even in those moments of sharp disagreement. So it is that Scottish Care has entered constructively into engagement and negotiation over what is an urgent and national social care crisis.

Coming to a settlement over social care funding has always been a challenge and this year I think we all knew that with such large increases in the cost of living, in energy and food prices together with a critical shortage of nursing and care staff, that it was going to be especially hard. Care providers, whether they are small charities, private family run businesses or employee owned, are continually faced with a reality which is that workers can earn so much more outside the sector with so much less demand. The astonishing human value and affirmation that you get from working in social care has to be set against a personal financial reality that means you have to pay the bills!

It was always going to be the case that because of these pressures where local government simply did not have the monies that the whole process would need to turn to Scottish Government. Why? Because ultimately it is the central government of the day that has legal and moral responsibility for ensuring that there is enough money made available to pay social care staff and organisations who deliver care and support in its name.

To begin with we were optimistic about these discussions with the Government. After all they had recently negotiated a hugely positive Agenda for Change settlement for our nurses and other NHS staff. Indeed, social care providers recognised that this settlement effectively meant that NHS colleagues doing the same job were now getting paid nearly 20% more than their social care colleagues. And after all the Scottish Government has consistently said that social care is important, valuable, and even critical for the delivery of health and care.

Right across the social care sector the asks have been simple. Reward our amazing frontline staff with a pay settlement that treats them with dignity, respect, and professionalism. What was on the table – and now has for the moment had to be accepted – was an offer of 3.8%. All the very real benefits which the Scottish Government had achieved by introducing the Scottish Living Wage and by even going beyond it, have now effectively been lost.

But still those of us talking to Ministers and the Cabinet Secretary were optimistic. After all – surely, they would see the need for equity? Surely, they would recognise the risk that more and more staff would leave social care and thus risk the very foundations of a sector upon which the NHS and so much of Scottish society is so dependent? Surely, they would recognise the trauma for folks at the later stages in life of having their care home close because the provider could no longer pay the bills. Surely, they would want to work with us to end the blight of 15-minute homecare visit and so much more? Surely, they recognised the lack of funding at local level which would mean local authorities were not free to respond in any flexible way to the crisis on their doorsteps?

Well, we continued to have hope – after all the junior doctors were yesterday offered 12.4%; and earlier this last week we heard that NHS Scotland senior medical and dental staff and general medical practitioners will receive a 6% pay increase for this year, backdated to 1 April 2023. Constructive offers and deals and a valuing of people for the work they do. So surely the social care staff who literally gave everything during Covid and beyond – as politicians have stated – would receive equal treatment?

But despite numerous asks – the current Scottish Government has not even been able to give to employers and staff a timetable for the introduction of the £12 an hour which the First Minister promised in one of his earliest speeches away back on 18^th April. So why the ability to find urgent response to a crisis amongst the NHS and a bending over back response to alleviate their challenges and yet deafening silence and inactivity for social care staff and providers? One rule for the NHS and a completely different response to social care.

Is this an administration characterised by delay, dither and dysfunction or is there a ‘cunning’ strategic plan which they are just unable to share? Social care providers and frontline staff have probably already made up their own minds on that question. Is this a government that really cares about care or is it only a pretence for photo opportunities and political grandstanding? Is there any genuine attempt to deal with a crisis which is happening now or are we simply witnessing a desire to hide heads in the summer sands in the hope all troubles will blow over?

The care sector has had enough of the political promises, the empty words, the feigned sympathy and understanding; we need action, decision, and determination to really make the changes that will value our workers and maintain our organisations.

I hope with the opportunity to reflect that we can really move things forward in the next weeks and months. The alternative is a deepening social care crisis made all the worse by avoidance. The alternative is quite frankly more care homes shut, more homecare organisations lost, more staff leaving for ever , and most importantly more lives diminished and devalued amongst those supported and cared for.

Donald Macaskill

Photo on Unsplash