The Scottish Government: do they care about care?

The past few days has been full of events, from the 75th 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 5th July was also the 75th 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 18th 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