Speaking about care: the necessity of advocacy.

Social care has been much in the news in the last few months, and it will continue to be so – not always for the right reasons. For many people social care support is something they don’t often think about – that is until the services and supports are needed whether because of accident, degenerative illness, and disease or simply the realities of ageing.

In Scotland we have a very clear system for accessing social care support – at least theoretically – in practice it can be a bewildering world of confusion and lack of information. This is especially unhelpful because when people are at the point of choosing social care support provision they are often in a place of crisis and fatigue. The fact that things can go wrong, that information and choice is not always clear and that sometimes an individual or family just need someone to speak for them, are sadly all too common.

Over my professional life I have always been a supporter of the role of advocacy whether that be for those who use care supports to be able to self-advocate or for others to use professional advocacy at specific times of crisis and disagreement. For a period of time, I was part of the Board of an advocacy charity and got to know the life-changing work which a good advocate can undertake and the amazing difference that can result for someone when there is a person in their corner to speak for them and to fight their cause.

The definition of advocacy is the act of speaking on behalf of or in support of another person, place, or thing. An advocate is there not to speak for themselves but to represent another person. The word advocate has an obvious legal overtone and that is no accident because it comes from the Latin ‘advocare’ meaningto “add” a “voice.” The advocate adds their voice of support to a person. But the Latin word also carries with it the sense of ‘summoning’ – calling support to your side to make the change that is needed. Advocacy is not just talking – it is also about action; it is not just a vocal contribution but an active engagement that makes the change happen which someone wants and needs in their life, not least to protect their human rights, individuality and dignity.

There are many organisations which provide advocacy services across Scotland and you can find out more detail and support from groups like the Scottish Independent Advocacy Association.

In Scottish law there are also certain instances where an individual has a legal right to access advocacy services not least as part of the provisions of the Mental health (Care and Treatment) Act. It should be stated that the MHCT Act declares that people who are covered by the right to advocacy are those who have a mental health issue including those with a learning disability, autism or dementia. There are other specific instances, for instance for children and young people, and the new Scottish Social Security Act, where there is a right to advocacy in law.

My problem is that the right to advocacy simply is not being evidenced in practice and that as it stands the right to advocacy does not go far enough especially for those who access social care supports.

We are still celebrating World Alzheimer’s Month and many of those living their lives with dementia are individuals who would benefit from the automatic right to advocacy. The vast majority are unaware that they may in technical terms have such a right. They would benefit from being able to challenge practice which limits their choice and control, their abilities to live independently for as long as they can, and to challenge the financial choices and options they are often presented with.

Scotland has brilliant social care provision on paper but the reality falls far short of the dignified, rights-based, person-respecting social care supports we would want to see in place. If you are lucky enough to have someone in your corner fighting your case then you are doing well. But if you are not – and sadly we are still in a situation because of lack of fiscal priority and blatant discrimination where people have to ‘fight’ for their social care rights in the first place – if you are voiceless, have no family or close supports – who does the talking for you? You need and deserve an advocate.

The creation of the envisaged National Care Service gives us the opportunity to sharpen up and tidy our existing social care legislation, not least of which is the Social Care (Self-directed Support) Act. We should use this time as an opportunity to create equality of advocacy for every woman, man and child who find themselves needing to use social care support regardless of mental capacity or physical condition. We should create an automatic right to independent advocacy for anyone who needs it in Scotland’s social care system. Not everyone by any means would use or need such protection, but for those who might and do it would be a significant step forward in enshrining the human right to social care support as part of our national human rights framework in Scotland.

A society should be defined by the extent to which it protects the voiceless and those with no ability to assert, protect and advance their own human rights and those of others. For some that defence comes in the advocacy, passion, and voice of another.

A few years ago when I was more involved in the world of advocacy I came across a fantastic book of poems, ‘Absent Without Leave, Invisible When Here.’ by Jo McFarlane which was developed to support the work of Dumfries and Galloway Advocacy, and for me one of the poems captures the essence and passion of advocacy.

Advocacy NOW!

In the future

when it’s fashionable to listen

Everyone will have a voice –

the disadvantaged, disillusioned

All will have a voice


Not just to say what’s wrong

or could be better,

but to celebrate what’s good right now


In the future

people won’t be threatened by dissent.

We’ll welcome opposition to the status quo


In the future

when all voices speak as one,

we’ll challenge the hegemony.

We’ll seek the truth that speaks its name

regardless of authority or strength in numbers


In the future

we’ll drown out the volume,

separate the essence from the noise


In the present

we’ll keep fighting for a future

in which ALL shall have a voice




Donald Macaskill.