They seek him here, they seek him there

Those Frenchies seek him everywhere

Is he in heaven or is he in hell?

That damned elusive Pimpernel

Famous words from Baroness Emmuska Orczy’s The Scarlett Pimpernel which described the heroic elusiveness of the main character as he managed rescue upon rescue of captured prisoners during the French Revolution.

Being elusive is the heart of the success of the Scarlet Pimpernel. It was a thought that came to mind this week as I reflected two weeks into the campaigning for the United Kingdom General Election about the prominence or maybe more accurately the absence of social care within the election. Now I fully recognise that social care is a devolved matter and that it’s delivery in the Scottish context is obviously the responsibility of the Scottish Government and concerns about it belong to debates amongst Scottish political parties. However, I think the nature of the fiscal relationship between the United Kingdom Government and the Scottish Government is such that whatever is discussed and decided about social care in England does have an impact in Scotland not least of which is any increased financial priority and spend.

So, what has been happening south of the border and indeed across the United Kingdom with regards to social care? Well like the Scarlet Pimpernel I seek some knowledge here,  I seek some knowledge there but the damn elusive social care seems nowhere. Not a mention not a whisper.

Writing in the Independent a couple of days ago Kate McCann said that social care was the issue that Sunak and Starmer won’t touch with a barge pole. Of social care she wrote that it was:

“currently the biggest electoral elephant in the room. It’s no surprise that neither of the main parties wants to touch this policy with a barge pole, after Theresa May tried and found herself tied to the drag-anchor of the dementia tax in 2017 – leading to that now-famous “nothing has changed” moment.”

…

“Problems with the social care workforce have fed into questions about immigration policy. A lack of available care places in the community means hospitals end up caring for people who are medically fit but unable to leave, clogging up admissions at the other end.”

Yet no commitment from Labour’s Wes Streeting to either social care reform or on the Dilnot proposals. Even greater silence from Labour on the impact of immigration on social care workforce sustainability. Only the Lib Dems seem to be actually talking about social care.

As McCann rightly observes of the two main parties:

“Neither is likely to propose wholescale change of the kind for which experts in the sector are calling, demonstrating a lack of ambition from both Labour and the Tories on this issue. There are clear reasons for this – not least the costs – balanced against the state of the UK economy. But, as political reporters, it makes it even more important to cut through the sales pitches and ask the questions that get to the heart of the problem, otherwise we risk serving voters poorly.”

So what of Scotland – well echoing absent silence here too and missed opportunity.

Last Monday Alzheimer Scotland published a report of the Commission on the Future of Long Term Care in Scotland. Set up in 2022 and chaired by former first minister Henry McLeish, the commission brought together a wide range of voices, including health and social care experts and those with lived experience of dementia. I was pleased to serve on the group.

Over the piece we heard first hand of the challenges facing those living with dementia and the lack of provision to enable people to live independently for as long as possible as well as the critical issues of lack of investment which would enable greater diversity and choice in specialist residential provision.

The report makes 16 key recommendations designed to safeguard and redefine the future of long term care in Scotland.

These include calls for the Scottish Government to:

• urgently work with health and social care partnerships to undertake a full strategic assessment of the provision of long term care facilities and resources in each area,
• establish agreed levels of care home and alternative care model places that should be equally available across Scotland,
• establish a citizens’ assembly to engage across society on the type of alternative approaches to care that people want to access to meet their long term care needs
• and engage in open, honest discourse around the reality of the current cost of care.

In commenting on the report I said that:

“Long term care matters for all of us. The way in which residential and nursing care is delivered today will inevitably change over the years. This report makes clear that people want to have a wider selection of choice about the care they may need and that they want more voice and control.

The Scottish Government urgently needs to prioritise social care and has to create an environment where external investment is able to support providers to innovate and develop new models of care and support.

In addition, the time has long passed for the inequity of people living with dementia having to pay for support and care which are essentially healthcare needs. There is so much that needs to change and no shortage of people wanting to support that change. The ball is well and truly in the hands of Ministers.”

So it’s an election – social care is devolved – will our Scottish Government take up the challenge and introduce fairness into the way we support people living with dementia? Will we properly invest in long term care  and support? Will we pay for a sector fit for the future?

Or like Sunak and Starmer with heads in the sand – will both commitment to and real change for Scotland’s long term care sector be as elusive as the Scarlet Pimpernel?

Donald Macaskill

Photo by MontyLov on Unsplash

I am writing this in New York City at the end of a week when I have had the privilege of being an accredited participant at the Open-Ended Working Group on Ageing (OEWG). OEWG has met every year over the last 14 years and was established by the United Nations General Assembly because of a growing clamour from some nations who wanted to see the development of an internationally binding legal framework to protect the rights of older persons. This was nothing new – indeed from the earliest years of the UN Argentina and others had continually campaigned for such a Convention to be created. Yet consistently there had been failed attempts to get it off the ground. OEWG was set up to identify whether there were any ‘gaps’ in existing human rights protections. At various points over the last 14 years, it felt it had done its work only to be sent away again to do more … until this week.

This year in a historic moment on Tuesday a decision was taken ‘by consensus’ to put forward a report suggesting that there were gaps which needed to be filled and to offer some solutions including the creation of a new instrument, a Convention. Yesterday it was decided that this decision should be passed to the UN General Assembly session. So significant progress. I was honoured to be part of the week and to have played a small role in the events by addressing the Session on Tuesday morning. Throughout the week I heard moving and passionate speeches from people who evidenced the harrowing harm and abuse that so many older people are suffering across the world, of the economic harm and abandonment of millions more, and of the desire for millions to be allowed their voice and to find their seat at the table of decision-making and government. But I also witnessed the art of political negotiation, international compromise, vacillating excuse, and blatant national self-interest.

At the end of such a momentous week I am left in a reflective mood about whether or not all this matters. Does any of it have any consequence for the experience of older people anywhere never mind in Scotland. And I am reflecting on all this at a time when a UK General Election has just been called during which I really hope that we will have debates and discussions on the experience of older people and most especially the nature of social care.

In short, I really do believe that for the advancement of all older people and their human rights that an International Convention on the Rights of Older Persons is urgently needed (and I hope the Human Rights Council in Geneva will soon start working on it when the General Assembly so instructs). I would argue that this is the case because as citizens of a global world we cannot but be connected to one another. The passionate Argentinian advocate Alex Kalache spoke of a visit to a favella on the edge of Rio where he stood talking to a woman knowing that 800 metres away the houses of the rich and wealthy meant that their residents were likely to live 20 years longer than the residents of the favella. The old woman Nina asked him ‘Do you know where my parents are?’ And he responded, ‘No I don’t.’ and she said ‘They are underneath your feet. We could not afford to bury them elsewhere, we could not afford it – so they are here.’ This sad encounter is indicative of the grinding poverty and socio-economic injustice which faces many older people; from those who lose their properties when they get old, to those who are abandoned by their families and made homeless because they have ceased to be useful and economically contributive. All of this might seems light years away from our lived experience in Scotland, but if there is anything about the Scottish character that is worthy of acclaim, it is our awareness that we are all ‘our brother and sister’s keeper’, we are all linked to one another in a common humanity and co-responsibility.

We could just rest in Scotland, struggle even more for the rights of older Scots, fight to ensure a better social care system, work for a reduction in discrimination and ageism; we could and will continue to campaign for an Older Persons Commissioner and the rights of older persons to be explicitly evident in any new Human Rights Bill; we could and will continue to call out the economic injustices which treat older people less favourably, to highlight the grinding poverty so many of our older Scots endure. But we also I believe have to do more. Putting our own house in order without sorting the mess of the world in which it is set is simply a retreat from responsibility. Human rights matter for all, everywhere and at all times.

In the coming weeks during a General Election political parties of all colours will engage in an appeal to self-interest – that is almost an inevitability of the political struggle and class. But I earnestly hope that we will also be able to ask questions, make challenges, and raise the voice of those not here but with whom we are global citizens, because what we decide and the government we elect makes a difference to them. Sustainability of our planet is not just an ecological question it is a profoundly demographic challenge and as the population of the world ages the way we address that reality matters.

In my speech at the United Nations, I tried to argue that the creation of a Convention certainly would offer protection for the world’s older people (protection and safeguards which are not there) but that just like the UN Charter in 1948 it also offers us potential. It offers us the ability to recognise the inherent dignity which comes with being old, it offers us the ability to celebrate the giftedness of age with all the richness of its diversity and experience, its creativity and contribution. We have to challenge the ageism which suggests that the old are yesterday’s humans and that the future belongs to a younger generation. Such ageism is rife across the globe. I heard this week that even in a document which is being drafted at the UN about the future – there is barely a mention of the old.

The older generation are as much the future as they have been the past. To deny their contribution, their capacity, their inventiveness, their entrepreneurship, is to limit all our futures. I hope in our own General Election we will not witness such stereotypes and stigma but will witness acceptance that the future belongs to us all, old and young alike. I also hope that our own political parties will come out and clearly state that they are in favour of a UN Convention on the Rights of Older Persons, so that we affirm our belonging one to the other.

During the week I spent some time getting away from the noise and heat of the debate and discussion, the politics and politicking and I wandered around and found a place in front of a painting which had been gifted to the UN by El Salvador in 2019. It was titled Mi Pueblo by Camilo Minero. Minero was a prominent Salvadoran painter, muralist, and engraver. The colourful painting has two themes, one is peace, represented by the light of the sun and the abundance of the natural world. The second theme is human rights, represented in the faces of children, the labouring hands of workers, and the hopeful look of the population that works for a better future.  All living their lives unimpeded under the guarantee of peace.

That should surely be the aspiration of us all, a world where we can live our lives with no discrimination. I am pleased to leave the UN knowing that the struggle for the rights of all including older people lives on but that it is also one that is worth the fight. For me rights matter today more than ever.

Donald Macaskill

The following is based on an address given yesterday at the Scottish Care, Care at Home and Housing Support Conference, ‘Care Revolution: Time to Act’ held In Glasgow.

 

I suspect I won’t be the only one in this room for whom the words of the song from Tracy Chapman were the wallpaper of their teenage years or twenties. First launched in 1988 ‘Talkin’ Bout a Revolution’ became the anthem of disenchanted and disaffected youth and social campaigners at a time of high unemployment, industrial unrest and growing poverty. It was a clarion call not just to be passive and talkative but to do something and to be someone.

The lyrics are illustrative of the whisper that becomes a shout for change:

Don’t you know

They’re talking about a revolution?

It sounds like a whisper

Don’t you know

Talking about a revolution?

It sounds like a whisper

 

Don’t you know

Talking about a revolution?

It sounds like a whisper

 

And finally the tables are starting to turn

Talkin’ ’bout a revolution

Yes, finally the tables are starting to turn

Talkin’ ’bout a revolution, oh, no

Talkin’ ’bout a revolution, oh, no

Talkin’ ’bout a revolution, oh, no

Many of you will know that I love words and languages and their root meanings and in my first language which is Scottish Gaelic the main word for revolution is ‘ar-a-mach’  and is similar to the Latin word revolvere which means  “a revolving,” “turn, roll back”.

All of these have the connotation of return and orientation and so I love the way in which Tracy Chapman‘s song uses the same metaphor that the tables are starting to turn …

Revolutions don’t necessarily mean throwing the baby out with the bath water, of engaging in violent and dramatic destruction and removal of the past. There is no need for any heads to be guillotined in the social care revolution that I want to suggest to you urgently needs to happen in today’s Scotland.

Going back to the way things used to be, a turning of time, is and can be revolutionary in itself and that’s what I think we need in social care not least in-home care we need a turning of the tables – we need a decision and a time to stop what we’re doing and rediscover the essence of what social care and home care is all about.

And why do most revolutions or renaissances or rediscoveries happen? – well usually because people or communities have simply had enough. They become tired of accepting the givenness of things, of settling for third or fourth best, of the status quo which limits and imprisons them.

Whether the civil rights cause in the United States, the disability rights movement of the1970s and 80s, the Dallits or Untouchables in India, – there is a time reached when people say enough – there has to be a better way.

And have we not got to that stage in terms of homecare and housing support in Scotland? Despite the warm rhetoric of political mantra and the delusion of massaged figures and budgets what we have arrived at is a state of affairs that cannot be deemed to be human rights based social care and cannot be seen to embed dignity in the lives of people.

What we have arrived at is a shameful abandonment of the essence of good social care which is about enabling people to be independent, to have control and to manage the living of their lives so that they reach their potential.

What we have arrived at is eligibility criteria set so high that you need to be close to death before you get a package of support, for which it will have taken you weeks and months to get an assessment organised. Then once you do you will get the bare minimum of support.

What we have arrived at is a system stripped of humanity, commissioners arranging an approach to care which is about providing maintenance not furthering life. Keep people alive but no more – and do it cheaper. Let us save money at the cost of living life to the full.

When someone in their nineties gets stripped of the care and support, she has had for 4 years; when someone who is imprisoned in their house by their mental illness has a care package removed with 2 days’ notice; when more and more workers are faced with the impossibility of packing all their compassionate care into 15 minute monitored time slots then …

what we have arrived at is a state of affairs which requires revolutionary change not just a tinkering or a slightly increased budget here and there – we need a re orientation and a rediscovery of the essence of who we are as one another related in our common humanity.

That’s why we need a care revolution and I’m sorry but I simply do not believe that the mechanistic reorientation of the system also known as the plans for the National Care Service will bring that revolution about.

But for a revolution to succeed we do not just need anger and frustration. We have that in abundance. We don’t just need a desire to change for the sake of change – but revolutions firstly succeed when you have a vision of what you want to become as an individual or as a society. And secondly, they succeed when causes are able to garner sufficient support so that there is a collective desire to change the way things happen.

And of those two starter ingredients we have the vision – we don’t need to search or look for it. It’s in the very description we have of social care at Scottish Care – it’s in our DNA – it’s about people being supported to lead the lives they want and need to – it’s in every report we have ever written about homecare.

Homecare as:

‘The enabling of those who require support or care to achieve their full citizenship as independent and autonomous individuals. It involves the fostering of contribution, the achievement of potential, the nurturing of belonging to enable the individual person to flourish.’

And how do we create a collective? – well for home care that means the coming together not just of those who work in the sector, not just organisations which deliver care and support, but all people in our community, not just those who receive care and support and their allies who are themselves drained and exhausted and so often without the energy to fight, to struggle for more than themselves and their loved ones.

We need Scotland to waken up – we need the tables to turn – we need a care revolution so that it becomes the concern of every person, every community, every politician and every individual who considers humanity to be of worth.

We have to stop fighting in our own patch, sometimes sniping at one another, we have to collectively come together and organise. We have the vision – we have the dream – it’s time to act – and the time is now.

But any journey needs strength especially to make that first step – to go outside of the known and venture towards an uncertain future.

I truly believe there is an inevitability that compassion will win out over contracted concern, that reality will replace rhetoric, that possibility can become the norm, that dreams and visions can become the familiar and the ordinary of our lives.

 One of my favourite singers who is very different to Tracy Chapman is the 1960s singer Judy Collins and one of her most poignant and beautiful songs was one that she sang having heard it first from Pete Seeger -a man who knew more than a bit about revolutions and change – who wrote the music to some very well-known ancient religious lyrics – You might also know the version by The Byrds.

To everything there is a season

To everything (Turn, turn, turn)

There is a season (Turn, turn, turn)

And a time for every purpose under heaven

A time to be born, a time to die

A time to plant, a time to reap

A time to kill, a time to heal

A time to laugh, a time to weep

To everything (Turn, turn, turn)

There is a season (Turn, turn, turn)

And a time to every purpose under heaven

A time to build up, a time to break down

A time to dance, a time to mourn

A time to cast away stones

A time to gather stones together

 

To everything (Turn, turn, turn)

There is a season.

 

For social care and for homecare there has to be a season,  this is it,

a season of revolution, a return to care without calculation, to times when relationships mattered more than records, when compliance wasn’t a monitoring system but the relationship between supported person and carer.

a season for everything under the sun

the time is coming when the tables will turn

 

when the talk of revolution will result in change

because the season of compassion, the season of care, the season of regard, the season of prioritising support for all has surely to come.

Enjoy being the care revolution in season and out.

 

Donald Macaskill

 

 

Donald Macaskill