The Scottish Budget was published on Wednesday and to say that the social care sector in Scotland was disappointed would be a massive understatement.

I think it is fair to say that regardless of organisation type, charitable, public or private most people involved in social care delivery in Scotland at this time are deeply troubled at the failure of the Scottish Government to own up to the crisis currently being endured by and the risks being faced by the sector.

The reality on the ground behind the rhetoric of claims of additional spend and funding for social care is that Health and Social Care Partnerships in order to balance their budgets are having to make horrendous decisions to cut services. It seems truly perverse that whilst there is significant additional funding going into the NHS (including into delayed discharge work) that the social care sector is facing some of the most savage cuts it has ever had to endure. That means only one thing – people will die.

Now that might sound like scaremongering, but it is sadly what has always happened when social care services are cut and withdrawn. I have written before about this, indeed nearly a year ago I shared the data which shows that every day two people die in Scotland whilst waiting for or not receiving the social care support they need to stay alive. Anyone at the frontline today knows that a year on the situation is so much worse.

The truth behind the fable of parliamentary debate is that care providers and employers will enter this winter not by increasing services and meeting the growing demand, including from delayed discharge in hospitals which are at record levels, but instead will be making staff redundant, closing units in care homes and handing back packages of homecare to local authorities who have themselves no capacity to meet the needs of those who are desperate to be supported. And this is all without the nightmare caused by the UK Labour Government through the changes in Employers National Insurance which unless mitigated risks whole system collapse.

If you turn on the television screens in the last couple of days you will hear frontline clinical staff in the acute NHS sector talk of the pressures being faced across the UK, and that includes Scotland, from what has been termed a ‘quademic’ of RSV, influenza, Covid and norovirus cases. Respiratory conditions at this time of year put inordinate stress and pressure on our social care and health systems so one would have hoped for a targeted and specific focus on social care in this week’s Budget.

What we got instead on Wednesday was the reality of a lack of priority. In a parliamentary debate lasting most of the afternoon social care was virtually invisible – it was mentioned 12 times in the thousands of words and only four times by the Finance Secretary who did, however, acknowledge that:

“social care funding,… is absolutely vital if we are to tackle delayed discharge and look at the system as a whole system, including both the NHS and social care. That is why we have put record investment into social care, including, of course, by ensuring that our social care workers get the pay that they deserve.’

No one is denying the record sums but if they are not enough, they are not enough no matter what records are broken. Equally no one is going to deny the importance of paying the Living Wage to frontline care and support staff though in truth that level is a very very low level to seek to be pleased to be achieving.

But it seems nonsensical to be faced with the reality that care staff and care home nurses are being laid off this past week not because there is no work to do but because organisations cannot afford to deliver the care needed by what they are paid, and commissioners cannot afford to allocate packages because they have run out of money. Knowing you are getting more money tomorrow rings hollow when you lose your job today.

Paradoxically today is Small Business Saturday which is now in its 12th year and has a focus every year on encouraging an increased awareness of the needs of small local businesses.

The vast majority of social care provision in Scotland is not delivered by large corporate organisations but by small businesses, whether charitable, not for profit or private. Many of these are small family run businesses with some being in families across the generations. They are often in remote and rural parts of the country but also in areas where in the town or village concerned they are the largest employer.

I find it increasingly ironic that we hear our political leadership emphasising the criticality of small businesses to our economic wellbeing as a nation, and yet at the same time one of the largest sectors in the small business world are our social care providers.

Indeed the Scottish Government recognises that small businesses are a critical part of the Scottish economy and the Government’s own national strategy asserts that:

‘We aim to grow our economy by making Scotland one of the best places in the world to do business. This means supporting and listening to small and medium-sized enterprises (SMEs) and working to deliver the right support at the right time.’

I find this fiscal silence around Scotland’s small business social care employers and providers truly baffling if only because it makes no economic sense whatsoever to say nothing of its lack of health whole system thinking.

Investing in small and medium-sized enterprises (SMEs) within Scotland’s private social care sector offers substantial economic and societal benefits. Indeed, the Independent Review of Adult Social Care in Scotland – the Feeley Report – emphasised that social care support is an investment that creates jobs and economic growth.

It makes complete sense to invest in small social care businesses not just as economic contributors and drivers in our communities, but critically as a key partner in the nation’s health and wellbeing. Instead of investment at this time we are faced with restriction and closure.

The Budget last week has failed Scotland, it has failed our small social care businesses and the sector as a whole, and shows that there is little or no understanding of the critical issues facing those who deliver care and support or indeed those who use social care services.

In the discussions and negotiations, the debates and deals before the Budget is settled in February, we simply have to put social care as a whole sector at the centre of our focus rather than the invisible sector it has been turned into.

Donald Macaskill