On Wednesday 1st March I was delighted to be able to attend the virtual launch of the Scottish Care led social care campaign which runs the month of March. It is a campaign which whilst led by Scottish Care is involving a range of others – its primary purpose is to raise the profile of all the key issues facing the social care sector at the present time. In a week which has witnessed so much debate and discussion around social care the need for this campaign has never been more necessary and urgent.
There are several main themes in the campaign and one of them is to help us all have a greater understanding of what social care is. Regular readers of this blog will know how much I bemoan the way in which social care is continually – not least by the media and by our political leaders – seen through the lens of the NHS. Yes social care when it is functioning at its best is able to reduce the demand on our acute and secondary health services. Yes, social care can help to address the huge number of people who are unnecessarily delayed in hospital. But in truth if you only see social care through an NHS lens then you will effectively be blind to its extent and to its promise.
Social care is many things but at its heart it is a set of services and supports, whether for children, adults or older people, which enables people to live to their fullest; allows them independence, purpose, control and choice and helps all our communities to flourish and thrive.
To achieve this, we have some of the most progressive policy and legislation anywhere in the world but have sorely failed to implement these in practice. This week we have heard that the plans to create a National Care Service are now on pause which in itself was an attempt to address the gaps between aspiration and implementation, rhetoric and reality.
But in truth social care in Scotland has not been reaching its potential for a very long time – the patient has been in intensive care and in need of resuscitation – and the major reason for that is the lack of appreciation and value which has for years resulted in a woeful inadequacy of financing and investment in not only the workforce but in the organisations that employ them. It is reflected in the fact that there are hundreds upon hundreds of individuals living in our communities who have social care needs, some assessed , many not. The high level of unmet need is just as critical and dangerous as the delayed discharges in our hospitals but receives a tenth of the attention and focus it deserves. The inadequacy of treatment is especially seen in the way in which we reward, recognise and pay our frontline social care staff. I think it is frankly obscene at a time when the massive recruitment challenges facing social care are talked about so openly and so frequently that we have in the last few weeks created such a chasm between social care and the NHS.
The pay offer which has been negotiated for NHS colleagues and which has been much lauded (even if to date not formally accepted) has rightly valued our nurses and health care workers. But what might have escaped those patting their own backs is the real world effect which means that from April 2023 a social care frontline carer will be paid nearly 20% less for doing the same job as a frontline healthcare assistant in the NHS. This chasm is shameful. What about all the talk of integrated services – of one system – of co-dependency, and an appreciation that the NHS without social care is like a one-sided coin? What are we going to do about this arithmetic of disgrace?
We find ourselves in the midst of a leadership battle within the SNP and in the weeks up till the 27th March we seem to have entered into a no-man’s land of decision paralysis – meanwhile social care organisations are losing staff hand over fist and frontline workers are looking over at colleagues in the NHS and wondering why is there such unequal treatment. After all social care staff are registered, regulated and require to be qualified. Why no equality? Why no level playing field?
And lest someone reads this and falls foul of the easy trap of blaming charitable or private providers they need to be reminded that over 70% of social care is paid for by the public purse at rates of contract that make it impossible to pay staff what they deserve and still remain sustainable as a charity or a private provider. That is why every week in the last few weeks I have had owners and directors of charities, care homes and home care organisations in tears telling me that they will have to close, hand back work, refuse to accept any more Council funded residents because they pay at least 40% less than what the true cost is, or indeed stop receiving any new residents. You cannot ever reach the land of fair pay for workers if you do not have fair contracts and commissioning. We are reaping the harvest of fiscal neglect and a lack of strategic priority.
The responsibility for the enduring long-term crisis in Scotland’s social care system is the culpability of national and local government. What else can you call a 20% differential between the NHS and social care? What else can you call the reality that in-house local authority care homes on average spend £1,200 plus a week to support a care home resident and yet the same authorities pay private or charitable care homes around £830 a week for nursing care and support which is about £5 an hour to care for some of our most valuable citizens.
There is a deadening hypocrisy which has for years corrupted the social care landscape and we have now reached a stage where unless central Government funds an adequate pay reward for frontline social care staff, invests resource in meeting the energy and cost of living crisis, works with the sector to make Scotland’s small often family run private care businesses and smaller care charities sustainable, then we might as well say goodbye to any local social care provision, forget about economic growth because families will have to give up their jobs to support their relatives, and start accepting the reality of an unsafe NHS. And let us not forget the neglect of the thousands of unpaid family carers for so many years.
Everyone will rely on social care at some point in their lives, and it is a truism that the sector only becomes important when that happens. But in truth the urgency of this hour means that there might not be a sector around to provide the support you and I might need in the future unless we act now. We want to see action taken to tackle the social care crisis.
I dearly want the leadership candidates for First Minister to start telling us what they are going to do to rescue social care because it is going to be, whether they recognise it or not, a top priority in the early weeks and months of their time in office. I want them to tell us beyond campaign soundbite how much they value social care staff – and let it not be £10.90 an hour. I want them to show me how much they value social care away from the shadow of the NHS? I want them to show me they really understand why hundreds and thousands of talented professionals are leaving the sector and to commit to working with with us to support the organisations that employ them. If a factory closes or a major employer ceases to operate we set up a Task Force – we urgently need such priority in virtually every community across our land. A slick paid-for TV campaign to recruit people to work in a sector that cannot afford to retain them won’t cut it.
Now is the time to #careaboutcare. Now is the time to #shinealight on the social care sector; to get beyond the myths and discover the amazing women and men who are the cradlers of compassion within all our communities. They deserve so much more than Scotland has given them. They and the charities and private organisations that have kept social care afloat in Scotland are weary, tired and exhausted but they know that now not a future land of promise, is the time to save social care in Scotland.
Join our campaign and find out more at https://scottishcare.org/social-care-campaign/#1669210952025-1e98646a-819e