At the age of just 29, Gordon Aikman was diagnosed with motor neurone disease. After years as a healthy and athletic young man, he is now in a wheelchair and relies on visits from care workers three times a day. He is dying.
I was in the room with the First Minister when she met Gordon and promised to look at the lack of MND nurses in Scotland, and I listened closely last January when she announced plans to double the number of specialist MND nurses in Scotland. We now know that that pledge has not been met—Nicola Sturgeon has not kept the promise that she made directly to Gordon Aikman.
As Nicola Sturgeon herself said:
“For people living with MND this is urgent, time is not on their side”.
Will the First Minister give a precise date for when she will deliver on her promise to double the number of specialist MND nurses who are working in our national health service?
I say to Kezia Dugdale, first that my admiration for Gordon Aikman, for the way in which he has confronted the dreadful diagnosis with which he was faced and for the way in which he has conducted his campaign, knows no bounds. As I have been over past months, I continue to be determined to work with him and others to ensure that we fulfil our obligation to improve healthcare and social care for people with MND and other devastating illnesses of that type.
My second point is that I genuinely do not think that it is fair of Kezia Dugdale to say that we are not fulfilling the commitment that we gave to Gordon Aikman. The funding is being provided and health boards are in the process of recruiting additional nurse specialists. The delays are to do with difficulties in recruitment and getting the right people with the right skills into post, but the process is continuing, progress is being made and over the next few weeks I expect health boards to do what they require to do to fulfil the commitment to double the number of MND nurses.
Of course, the commitment was to double the number of MND nurses and to ensure that MND nurses are funded by the national health service. Those are commitments to which I remain absolutely committed.
I am sorry, but the First Minister promised that that would be in place by the end of October, and it is now January.
I hear the First Minister talk about Gordon Aikman’s courage. All the party leaders in Parliament have had their photo opportunity with Gordon and have praised him for his bravery. However, he does not want our admiration and he did not let the cameras into his life for the sake of celebrity. He did it to leave this world a legacy for those who come after him.
There are thousands of people across the country who are coming to the end of their lives and who need support. Just yesterday, new figures were published that confirm that at least 276 people died while waiting for a social care package. It is a scandal that it took a dying man to make a freedom of information request to expose the scale of the social care crisis in this country. Can the First Minister tell me how her £500 million of cuts to council budgets will help to solve the social care crisis?
Let me take the two issues in turn.
First, on MND nurse specialists, to date this Government has invested £2.4 million of recurring funding in a new specialist nursing and care fund. That includes up to £700,000 to fulfil the commitment that from 1 April 2015 all MND clinical nurse specialists will be paid for from public funds. That is now in place and is fulfilling the first part of the commitment that I made to Gordon Aikman.
As I said in my earlier answer, we remain committed to ensuring that the number of MND specialist nurses is doubled and that that happens as swiftly as possible. We are seeing progress. I outlined the fact that this is not about funding but about making sure that health boards recruit the right people with the right skills into the posts. We have already seen progress towards meeting the goal in the five NHS boards that employ MND nurses. NHS Lothian and NHS Tayside have already increased capacity, and NHS Greater Glasgow and Clyde has appointed two new MND specialist nurses who will take up their posts later this month. All other NHS boards that employ MND clinical nurse specialists are in the process of recruiting additional nurses. That is the commitment that was made: it will be delivered in full.
On social care, what Kezia Dugdale did not refer to in her question—perhaps unsurprisingly—is the fact that, in the draft budget that the Deputy First Minister outlined to Parliament just before Christmas, we made a commitment to build on our work to integrate health and social care. That is the biggest reform of how we deliver healthcare that the country has seen since the establishment of the NHS. We committed to building on that by putting an additional £250 million from the NHS into social care next year, in addition to the extra money that we had made available to support integration of health and social care.
Kezia Dugdale talked about the number of hours of social care that are delivered. As the population ages and the needs of older people become more intensive and more acute, we must expand social care. That is the reason for the budget decision that was taken. Kezia Dugdale might be interested to know—if she does not know it already—that we have, over the past few years, been seeing an increase in the number of hours of social care that councils provide. In 2015, 706,000 hours a week of social care were provided by councils, which was up 4 per cent on the figure for the previous year, and up from 607,000 hours at the start of the current session of Parliament. We are also seeing the average number of hours of home care that are received each week steadily increasing. In 2000, the figure was 5.6 hours and last year the figure was 11.5 hours. That means that the intensity of social care is increasing, which is enabling more people with intensive needs to stay at home.
This Government has taken, and will continue to take, action to ensure that we have good-quality social care that protects individuals, and to ensure that we are protecting our national health service.
In that long answer, there was one simple fact: the First Minister has put £250 million into the budget but has taken £500 million out. That is the classic sleight of hand that is the SNP Government’s style.
In the past 24 hours, we have seen a massive debate open up about the future of our council services. From Moray to Dundee, councils are taking tough choices because the Scottish Government has left them with no alternative, and one of the most important services that our councils provide is social care. Last night, on “Reporting Scotland”, the Cabinet Secretary for Health and Wellbeing gave the game away when she admitted that there is a social care recruitment problem. I see her nodding her head in agreement—she is absolutely right. We know that, each year, one in five care workers leaves their job because of low pay, poor conditions and insecure work. Payment of a living wage would fix that, and it would improve the care that people receive.
Before Christmas, the SNP Government voted against Labour’s plans for a living wage for care workers. The first minister could reverse that decision today. She could make a pledge to the 39,000 care workers who would be guaranteed a living wage for the first time, she could make a pledge to the thousands of people who are waiting for a social care package, and she could make a pledge to the families of the 276 people who died last year while they were waiting for the support that they needed. Will the First Minister today guarantee that she will introduce a living wage for care workers?
On the living wage, a fact of which Kezia Dugdale is either not aware, or is aware of but chooses to ignore in her questioning, is that this year this Government is investing £12.5 million in partnership with local councils as part of a £25 million package to improve wages and conditions in the social care sector. We are determined to continue to make progress towards payment of the living wage in the social care sector. If Kezia Dugdale wants us to go faster, she is quite entitled to bring forward costed proposals as to how we could do that in the context of next year’s budget, and to say clearly from where the money would come.
I return to the overall question of local government funding. The reduction in local government budgets that is proposed for the next financial year amounts to 2 per cent of its total revenue expenditure: 2 per cent. That is before we take account of the additional £250 million in social care, which is of course on top of the £500 million that we are already investing over three years to support integration of health and social care.
The council tax freeze is fully funded: the Scottish Government gives councils money to compensate for not increasing their council tax rates. Indeed, a recent Scottish Parliament information centre report said that the council tax freeze is possibly overfunded, with an estimated [Interruption.]—
This is from a SPICe report. Labour members are very keen to quote SPICe reports when it suits them, so they might want to listen to what this one says. It says that £164.9 million extra is going to local government. Those are the facts.
These are challenging times for everyone because of the cuts that are being imposed on the Scottish Government’s budget. There is a question that Labour has to address. We are in a budget process right now, so if Labour wants local government to get more money in next year’s budget—that is what we are talking about—it has to set out where that money will come from. Is Labour going to break its own commitment to freeze the council tax or is it going to take money from other parts of the budget? Which is it and when on earth is Labour going to tell us?
Let me give the First Minister some facts. We brought forward proposals for a living wage for care workers, but the SNP voted them down. I hear the First Minister make commitments on lots of things. She can promise a £250 million tax break to big airline companies, but she cannot promise care workers a living wage. [Interruption.]
That says a lot about the priorities of this SNP Government.
The problem of council cuts is not going away and the social care crisis is not going away. Despite all the waffle from the First Minister, people are dying while waiting for support. Is that really the Scotland that the First Minister wants to live in?
There we have it: the last vestiges of credibility that Kezia Dugdale and the Scottish Labour Party had have just disappeared. We are back to the mythical air passenger duty money; today we hear about the fourth thing that it is going to be spent on. First it was education, then it was restoring tax credit cuts, then last week in this very chamber we heard that it was for first-time buyers grants, and today it is for the living wage in the social care sector. It is absolutely dire: that lot over on the Labour seats are clearly not fit to be an Opposition, let alone an alternative Government.
This is where it gets real for the Opposition—a matter of weeks away from an election. I know that Labour does not think that it has any chance of winning the election and that it is still trying to scramble into second place over the Tories, but it has a duty to put forward detail. I have outlined our plans on social care and I have outlined how we will work towards the living wage in social care. If Labour wants us to do it faster, it has to tell us how. I challenge Kezia Dugdale in the context of this budget process over the next couple of weeks to bring forward costed proposals for how all her plans are to be funded. If she does not do that, she does not deserve to be taken seriously by anybody.