The next item of business is a debate on motion S6M-05111, in the name of Jackie Baillie, on delivering the immediate removal of non-residential social care charges. I ask members who wish to participate to press their request-to-speak buttons or put an R in the chat function now or as soon as possible.
Like in the previous debate, there is only a very little bit of time, so interventions will probably have to be accommodated largely within the time allocated.
Every day, the cost of living crisis worsens. For a growing number of people, theirs is a choice between heating and eating, which is pushing people into debt and causing incredible hardship.
The United Kingdom and Scottish Governments say that they want to help people to mitigate those pressures, and rightly so, but there is so much more that they can do. Let me set out one of the things that the Scottish Government can, and should, do right now: it should end non-residential social care charges across Scotland. That was a pledge in Labour’s manifesto and in the Scottish National Party’s manifesto for the Scottish Parliament elections. It was also a recommendation in the Feeley report, which was commissioned and supported by the Government.
The cost of doing that is estimated by the Scottish Parliament information centre to be in the order of £51 million—a relatively small amount of money in the grand scheme of things, which will have a profoundly positive impact on those who require social care.
We know that disabled people are twice as likely as others to struggle to heat their homes. Nearly half—49 per cent—of all those living in poverty in the UK are either disabled people or live in a household containing a disabled person.
Then there are those who are elderly and receive home care. Many older people in my community have community alarms, so, should they have a fall, they can summon help quickly. It is a lifeline service that enables older people to remain in their own homes for longer, but as costs rose, so did the number of people giving up their alarms because they were unable to afford them on fixed incomes.
When I met unpaid carers recently, one woman described how her gas and electricity bills have gone up to £4,000 a year—and that is before the price hike that is due in October. She told me that her husband is not eating due to his illness, and she said that she was glad, because it means that she can save money. What a terrible position to be in.
Many of those in receipt of social care—the elderly, those with learning disabilities and those with physical disabilities—will pay charges, and they simply cannot afford to do so.
We all understand that heating cannot be switched off during the day for those who are housebound. Many do not go outside even if they want to, because Covid-19 cases are rising and new variants are posing a real threat to their wellbeing. However, we in this Parliament can do something about that.
Earlier this week, Labour-led West Dunbartonshire Council announced a £5 million support package to help residents with the cost of living crisis. That puts money into people’s pockets and saves them money as well. A central part of the council’s plan was to scrap non-residential social care charges, saving vulnerable people in my area £1.5 million. That is the difference that Labour makes in power.
There is absolutely nothing to prevent that from happening now in every council in Scotland. I will come on to describing how that can be done, but I first want to deal with the Scottish National Party’s notion that we need to wait for the national care service before doing anything. Of course, we will examine the detail of the national care service in the weeks and months to come, but there is absolutely nothing standing in the way of the SNP ending charging now. That does not depend on a national care service—care charging does not even get a mention in the National Care Service (Scotland) Bill—it depends entirely on political will and resources. I say to the minister: no more twiddling your thumbs; no more spin and distraction. Get on and do it now because those needing care are desperate. The cost of living crisis demands that you act now.
Here is how the minister can do it. Presiding Officer, it is amazing what you discover when you go looking for it. Eye-watering sums of money are currently sitting as reserves in integration joint board accounts across Scotland. Reserves started to build up in 2020-21. Much of that was Covid funding and was difficult to get out the door. I think that we all thought that that would be spent in the following financial year. However, rather than the reserves going down in 2021-22, they have increased exponentially, all at a time when services were withdrawn as a result of the pandemic and unpaid carers were left to shoulder the burden.
The Government, by creating a national care service, wants to tell IJBs what to do. I am suggesting that, given that the Government has given IJBs that money, it can tell them what to do with it—or it can at least encourage them in what to do with it. [
.] Let me tell members why. Those reserves have increased exponentially at a time when services were withdrawn. I will illustrate my point by referring to South Lanarkshire health and social care partnership, which, in 2020-21, was sitting on £30 million of reserves. In 2021-22, that figure is £85 million. The cost of scrapping care charges in South Lanarkshire is £2 million, which is a tiny amount. In West Dunbartonshire, the reserves are sitting at £32 million, while the cost of scrapping care charges is £1.5 million, which is an equally tiny amount.
The picture is the same across the board—the reserves in Glasgow, Edinburgh, Aberdeen and every other council have risen substantially. Scrapping non-residential care charges can be done now. The SNP has the power to do it. It does not require constitutional change; it simply requires political will.
For the people who get social care but need to pay for it, their struggle to make ends meet is becoming increasingly difficult. Older people are cancelling their emergency alarms because they cannot afford them any more. They are risking their health and wellbeing. Do not make them wait any longer. Scrap non-residential care charges now.
That the Parliament believes that the Scottish Government should end all non-residential social care charges in the current financial year given the growing pressure that the cost of living crisis is putting on the most vulnerable in society, and the level of reserves sitting with health and social care partnerships.
I thank Labour for bringing forward this critical issue for debate today and for providing me with a welcome opportunity to set out the Government’s key social care support policies.
Earlier this week, we set out our legislative proposals for the creation of the national care service. Through that, the Scottish Government has embarked on the most ambitious reform since the creation of the national health service.
The introduction of the National Care Service (Scotland) Bill, in line with the Bute house agreement, starts the process of creating the new service, which will end the postcode lottery in adult social care support in Scotland.
The Government is introducing those ambitious reforms, but we do not want to wait for the national care service to be up and running before we act. The Scottish Government appreciates that the costs of care can be high for individuals and we are absolutely committed to the removal of non-residential charges for social care support during this session of the Parliament. That is why it was an SNP manifesto commitment, as Ms Baillie already mentioned, and why it was included in the programme for government.
I will lay out some of the ways that we will do that as we move forward.
The Government has an excellent record of improving the lives of the most disadvantaged in our society, as shown by the extension of free personal care to all adults who need it. I acknowledge the intention of West Dunbartonshire Council to remove non-residential social care support charges. However, to do it in a uniform, fair and consistent way across Scotland requires legislation and the Government’s intention is to do that within the next year.
I find it a little bit bizarre that, yesterday, Ms Baillie was talking about a power grab and centralised control in relation to the national care service but, today, she wants us to compel IJBs, health and social care partnerships and councils to remove non-residential charges. You cannot have it all ways, Ms Baillie. Your position on Tuesday is somewhat different from the position today.
I will set out our track record of actions that we have taken.
Through the budget for 2022-23, the Government has allocated almost £3 billion to a range of supports that will contribute to mitigating the impact of the increased cost of living on households. That includes work to tackle child poverty, reduce inequalities and support financial wellbeing, alongside social security payments that are not available anywhere else in the UK.
The Government has already committed itself to increase spend on social care by 25 per cent by the end of this parliamentary session. Funding of £846.6 million will be transferred from the health portfolio this year to local authorities for a range of investments in health and social care and mental health services.
We have provided funding of £200 million to local government to support investment in health and social care, embed improved pay and conditions and deliver a £10.50 minimum wage for all adult social care staff in commissioned services from 1 April 2022. That represents an increase of 12.9 per cent over the year. We are working with the fair work in social care group, which has developed a set of recommendations for minimum standards in terms and conditions that reflect fair work principles.
With our social security powers, we have improved support for Scotland’s unpaid carers as a priority. Our carers allowance supplement was the first payment made by Social Security Scotland and increases carers allowance by more than 13 per cent, with eligible unpaid carers receiving a payment every six months. Since the launch of the supplement in 2018, around 659,000 payments totalling £188 million have been made. Unpaid carers who are continuously in receipt of the benefit will have received over £2,270 more than equivalent unpaid carers in the rest of the UK.
We encourage everyone who is eligible to apply for the allowance. We will continue to review our policies on unpaid carers and will announce more on that in the near future in terms of our strategy.
We announced an additional £4 million in January to help organisations working with unpaid carers to put expanded services in place during winter. We have also invested an additional £20.4 million for local carer support in 2022-23, bringing total investment in implementation of the Carers (Scotland) Act 2016 to £88.4 million per year.
We recognise that the cost of living crisis has an impact on everyone in Scotland, including people in need of social care support, the workforce and unpaid carers. I call on the UK Government to play its part, as we have had very little information on how it intends to address the pressures not only on the social care sector but on communities across Scotland.
I have set out the ways in which the Scottish Government is leading the way in the UK in improving the lives of those who are most disadvantaged in our society, as well as the lives of those who care for and support them. The Government will continue to provide that support.
I move amendment S6M-05111.2, to leave out from “financial year” to end and insert:
“parliamentary session; welcomes the recent introduction of the National Care Service (Scotland) Bill, in line with the Bute House Agreement, and supports the creation of this new service, which will end the postcode lottery in adult social care in Scotland; regrets that the UK Government’s welfare cuts, and retention of 85% of spending on social security benefits, including low-income benefits, and employment powers, including the minimum wage remaining with the UK Government, is letting down the most vulnerable in society by failing to properly address the cost of living crisis and its causes; notes that the Scottish Government has increased eight Scottish social security benefits at double the rate that the UK Government uprated benefits within its control; understands that the overall budget available in Scotland is largely determined by the spending decisions of the UK Government, and considers that the Scottish Government is already investing in mitigating the impact of UK Government control, tackling the cost of living, and tackling poverty.”
It is nice to hear some details about the national care service from the SNP, but that has come after the photo opportunity and an announcement to the press. For such a big announcement, perhaps a ministerial statement would have been more reasonable than the matter being raised during Opposition business, but this is not the first time that that has happened, is it?
.] It seems that SNP members would like to have further conversations, but they have had their time to talk, and they did it in the press.
Seventy-six days ago, Scottish Labour published its local elections manifesto, and the motion that we are debating today appears to be consistent with most of Labour’s desired aims—I say “most”, not “all”, and I will come back to that.
Although we are sympathetic to the principle of ending non-residential social care charges, let us consider the financial facts. The SNP has cut local government funding by 20 per cent in real terms since 2013, and local government faces another real-terms cut of £800 million by 2027. Getting the financials right is vital for sustainability.
A commitment to focusing on driving up standards of care is also important. In a recent debate, a Labour front-bench spokesman underscored the importance of creating a national care service to deliver change, but we now detect some inconsistencies in Labour’s position. Yesterday, after the cabinet secretary unveiled to the press his master plan for a new service, Labour seemed to wake up and reject what would amount to the biggest power grab in Holyrood’s history since the introduction of the Coronavirus (Recovery and Reform) (Scotland) Bill. We are pleased to see Jackie Baillie roll back on what had been said.
As I said, Jackie Baillie rolled back on what was said earlier by a front-bench spokesman.
There is a crisis in social care provision in Scotland, but the last thing that we need right now is a major bureaucratic overhaul of the current system. I know that the SNP-Green Government has been on the end of some uncomfortable truths from Audit Scotland, but here is another one: Audit Scotland says that reform of social care “cannot wait” for the Government to set up its national care service. Front-line improvements to essential care services are well overdue; some things must be done now.
Some things are just way off the scale financially. Setting up the SNP-Green Government’s national care service will cost about £1.3 billion, which includes almost £0.5 billion to establish a new centralised body—that is, if the Government can actually deliver a budget, which is debateable. For context, I note that £0.5 billion would cover the salaries of 14,000 qualified nurses. Instead, the national care service is expected to hire up to 700 new staff—mainly managers and administrators. It will be staffed mainly by civil servants, not by social care professionals. We simply cannot afford for money of that magnitude to be diverted from front-line local services. That will be compounded by the loss of local decision making and accountability, financial instability and the risk that upheaval will have a negative impact on the most vulnerable in our society.
Who will sit at the bureaucratic pinnacle of this huge new Government entity? That is not entirely clear. We can only assume that it will be the same cabinet secretary who presides over the worst accident and emergency waiting times, cancer services in crisis, dentistry on a cliff edge and failed workforce planning.
Surely even fans of centralisation should be worried. The Government’s own policy memorandum accepts that there is a risk that the proposed national care service could lead to more bureaucracy, less input for people who are accessing care and a poorer service for rural and remote areas. In addition, concerns exist regarding “staffing ... retention and morale”, which seems all too familiar from the general practitioner contract.
Before charging ahead with a national care service, would it not be more astute for the Government to learn lessons from the conclusions of the Scottish Covid inquiry? We need the SNP-Green Government to abandon the national care service plan, which would scrap local accountability and impose total ministerial control, as a direct attack on localism. The Scottish Conservatives would fully support a local care service that would ensure that support is delivered as close as possible to those who need it.
The SNP-Green Government should be putting every penny into local care services, and supporting councils with proper funding so that they have more freedom regarding non-residential social care charges. We believe that that is real devolution.
I refer members to my entry in the register of members’ interests, as I am a practising NHS GP.
I move amendment S6M-05111.1, to leave out from “believes” to end and insert:
“calls on the Scottish Government to properly fund local authorities so that they have more freedom when it comes to non-residential social care charges; regrets that the Scottish Government’s proposals for a National Care Service could cost up to £1.3 billion to deliver, and that much of this will be spent on establishing structures and administration when what the care sector needs right now is stability to get back on its feet; understands that the Scottish Government’s proposals will leech funding away from the frontline; regrets that the National Care Service represents a direct attack on the competence of local authorities, and calls on the Scottish Government to scrap these plans and introduce a local care guarantee that would ensure that care is delivered as close as possible to those who need it.”
I am grateful to rise to speak for the Liberal Democrats in the debate, and I am grateful to my friend Jackie Baillie for bringing it to the chamber. I thank her, and Scottish Labour, for confirming yesterday that the Labour Party will join the Scottish Liberal Democrats in our opposition to a national care service. It should say a lot to the Scottish Government that the Labour Party, which has long campaigned for a national care service, does not recognise, in this Government’s ill-thought-out plans, the vision for which it has campaigned for so long.
I must make progress; I will draw the member in shortly.
In 2019, Nicola Sturgeon, in her keynote speech at the SNP conference, said that the principle of free personal care is the same as that for healthcare: “if you need” it, “you should get it.” She went on to say:
“However, despite that principle many people—of all ages—still have to pay for non-residential ... care services.”
I agree with many of the findings in the Feeley report, but I do not think that the solutions to what it contains will be found in the Government’s ill-thought-out measure for the creation of a national care service. I will come to that in my remarks, if I am allowed to make progress.
“charges can be a barrier to people accessing the support they need ... if people can’t get that support in their ... homes, they are more likely to end up in hospital.”
I agree with her. She went on to pledge that the SNP, if re-elected, would scrap those charges for everyone. That was not just a one-time promise—the First Minister said it repeatedly in last year’s election campaign. As we speak, however, thousands of people across Scotland are being forced to pay for care.
We are talking about care that is essential to people’s wellbeing day to day. Non-residential care includes personal care such as help with personal hygiene and getting dressed and help with preparing food and eating it. It also means help with housework and community alarms. Councils currently have the power to charge for many of those services, and every year they bring in more than £40 million by so doing.
I will give one example. In Glasgow, some people are forced to pay £17 an hour for home care services. That financial barrier can sometimes lead to people going without the care that they need, or even foregoing other basic necessities to be able to afford the cost. Amid the cost of living crisis, that is sadly not surprising, and it serves to underline the need for those charges to be scrapped without further delay.
Many people would have been relieved to hear the First Minister promise to do something about the situation and yet, despite the SNP being re-elected last year, there are no signs of action on what was one of its key election promises. People are forking out sometimes hundreds of pounds a month for care. They must be wondering what this Government is waiting for. One could not blame them for questioning how the Government has found the time to satisfy its obsession with a second independence referendum but not to help people meet their most basic needs without suffering financially.
This Government has a habit of kicking the can down the road when it comes to reforming social care. For this Government, the pot of gold at the end of the rainbow seems to be a national care service—the Government thinks that people just cannot wait for it, when in fact it is the wrong thing for them to be waiting for.
I have said before, and I say to Gillian Martin now, that the national care service is dressed up in the clothes of our most treasured national possession, the NHS—an institution that was forged in the rubble and poverty of the second world war and which is free at the point of delivery. However, it is part of this Government’s mission to centralise things, and the service will not be free at the point of delivery. There is no comparison with the NHS.
The Government needs to get on with taking the obvious action that would benefit our constituents today, not in an indeterminate number of years as part of a reorganisation that shackles services to Government ministers who have already proven their incompetence in this area.
Thousands of our constituents receive non-residential care. For their sake, we must not wait a moment longer to end the financial burden that they have been lumped with for far too long.
The Government does not often want to debate issues such as this—issues that it has made commitments on but that it is not prioritising, and issues that it could easily achieve.
Everyone in Scotland knows that social care is really being held together by the hard work of overworked and underpaid carers across the sector, and that they hold it together every day with little support from central Government. If you talk to workers on the front line, you feel that there is very limited support from this Government.
On top of that, those who require care are often some of the worst-hit by inflation and the general increase in the cost of living. Unfortunately for them and so many others, we are now well into the depths of the cost of living crisis, which is already biting hard for families all across the country. Those same people are asking for help.
This Government’s record of supporting local government is very poor. I think that we should have some honest debate and discussion around that. This Government has presided over the slashing of care packages and the withdrawal of respite care. It has failed to immediately implement a number of key Feeley review recommendations, including that of universal non-residential care. All of those things would have made such a crisis much more bearable for those with care needs and their families. Let us not forget that it was this Government that set up the Feeley review, so why are we still awaiting its implementation? Far too long a time has passed.
The reason why we are awaiting implementation is because we consulted on the recommendations of the Feeley review. Some 78 per cent of the folk who responded to that consultation back the Government in terms of its aims.
They back the Government implementing what is in the Feeley report, and so we must move to make sure that those things are implemented for people at pace.
It is a question that I ask in this chamber almost weekly: when will the Government implement the commitments that it has made?
That is why Scottish Labour is calling for the end of all non-residential social care charges across the current financial year, and we are calling for it to happen right now. We simply cannot expect people to bear the brunt of the Scottish Government’s constant hand wringing for much longer. We are in the midst of the worst cost of living crisis in living memory, and people need support from this Government now. That is not too much to ask—it was, after all, in the SNP’s manifesto last year. I remember the days when breaking a manifesto promise was considered to be unacceptable, both from the Opposition benches and the Government back benches.
As my colleagues have already mentioned, this is not simply a request from Scottish Labour that we are not willing to do ourselves. Only this week, as we have heard, Scottish Labour-run West Dunbartonshire Council unveiled an ambitious cost of living plan, which includes ending non-residential social care charges. Imagine if that replicated on a national scale.
Here we see forward-thinking work going on at a local level, and yet the SNP’s proposed vision for a national care service strips councils of most of their powers in this regard. I have heard it said that, before long, under this Government, local government will hardly be able to cut ribbons, never mind anything else. The commitment that this Government gives to local government is a disgrace.
It is clear that we should be doing more. Today, we should be backing Labour’s motion to end non-residential care charges.
I note that West Dunbartonshire’s Labour-run council has said that it will do what the Labour motion proposes. I do not know whether that means using reserves or whether the money is just in its budget.
Obviously, I would be interested in Aberdeenshire’s integration joint board looking to any reserves that it has to ease a number of burdens on my most vulnerable constituents and topping up the assistance that the Scottish Government has already given to ease the cost of living burden that was outlined in the previous debate, so
I did a bit of digging.
The integration joint board in Aberdeenshire has £49 million in reserve. I asked myself what contingencies that money was for, and I have the answer here. The money is for a number of things: staff wellbeing, money in reserves, some mental health programmes, a primary care improvement fund, and alcohol and drug service work has been earmarked. The largest sum is £25 million for on-going Covid response contingencies. I do not know the detail in that and, once I do look at the detail, I might not agree with all the budget decisions that have been made. However, that is about my SNP council group disagreeing with the Tory-Liberal Democrat administration in its own setting, because that is local democracy.
An SNP administration would certainly have done things differently than our Tory counterparts. Indeed, in SNP-run Perthshire, the council immediately put a £700,000 package in place to ease the cost of living strains of vulnerable people there. In a previous debate, Ruth Maguire pointed to North Ayrshire Council, which is doing something to ease child poverty. However, I will bear in mind Aberdeenshire IJB’s reserves for conversations that I will have with it in the coming weeks about things that I think that it should be doing.
Here is what really bothers me about the Labour motion. It is not about what Labour wants to do with regard to helping people, which, as I said to Jackie Baillie, is laudable. However, it proposes that we should tell IJBs around the country what they should spend their budget on after their budgets have been set. Say that we did that—what happens next year? Do the charges come back in? Do we decide that for them too?
IJBs manage their services within their budgets. Is Labour saying that we should tell them that the Scottish Parliament and Government should interfere in what they do with their budgets, and tell them what they should do with their reserves?
We have never told them how to use their reserves. Yesterday, I read a newspaper quote about the proposals for a national care service—a national care service that was recommended by the Feeley review and that Jackie Baillie tweeted last year was Labour’s idea. The quote says that
“What this represents is nothing less than the biggest power grab in the history of Holyrood—one that threatens the very existence of local government.”
Who said that? Jackie Baillie, again. Is the motion the sound of a power grab being advocated by Labour? Although I have sympathy for IJBs taking decisions to remove care charges—I commend those who might choose to prioritise that—that is their decision, not ours.
What is this really about? We are very used to Labour asking the Scottish Government to spend money without giving detail of where it should come from. I have a list here: free residential care for over-65s is £412 million; expanding eligibility criteria is £436 million; non-residential charging is £51 million; £15 an hour wage for all social care workers is £1.75 billion; increasing respite support is uncosted; re-opening the independent living fund is £52 million. The total is £2.68 billion, with never any idea about where that money should come from. [
.] It is one thing to do that. [
.] That is the shoogly peg that Labour puts its duffle coat on every time that it has a debate, but telling local authorities how to spend their budget is even shooglier in my mind.
The debate is, of course, about what we can do now given the challenge that we face, to support some of the most vulnerable in society with the level of reserves that sit with health and social care partnerships. There seems to be a consensus across the chamber that there should be a removal of non-residential social care charges, which have sometimes been called a care tax, but the debate seems to be about when that should happen.
We need an extensive debate about the Scottish Government’s proposals for a national care service. I remind Gillian Martin and others that, as proposed, it will be a centralised service. I have campaigned for a national care service but the national care service that I campaigned for would be a not-for-profit care service that respects the role of local government.
That is not primarily what the debate is about. We know that there has been a slashing of care practices, that care charges are an issue, and that there has been a withdrawal of respite care. The motion proposes an end to all non-residential social care charges in the current financial year. It is not about the future configuration of care in Scotland, but it is about priorities and what we think that the Parliament should be prioritising.
I do not really have time to take an intervention. I am happy to take interventions but I do not think that there is time.
Scottish Labour is prioritising, and is saying to the Parliament that we should prioritise, this particular action, given that we see it as one of the priorities that we should be setting.
We already know that there are many good examples of councils that are taking steps to address the issue. For example, as has already been mentioned, while it was under a Labour administration, North Ayrshire Council brought forward flat rate charges regardless of income to include meals at homes and telecare. As has been said, earlier this week, West Dunbartonshire Council unveiled an ambitious cost of living plan that includes ending non-residential social care charges and which would put more than £1 million back into the pockets of some of the most vulnerable people.
We know from SPICe that the cost of removing charges would be in the region of £51 million, and we already know that charges for services that are not considered to be free personal care vary tremendously across Scotland, with different councils having very different charging policies.
The national care service will address many of those issues, but as we also all know, it will be a number of years before any national care service is in place. The debate is about what we can do in this financial year, within the budgets that exist, that will help people who are in real need and support some of the most vulnerable against a backdrop of a massive cost of living crisis. I ask colleagues to support the motion.
The reality is that many of us will have care needs at some point in our lifetimes. At other points, we might need to deliver care to a loved one. However, it is clear that the status quo in social care cannot continue. We have seen several initiatives from this SNP Government to address the worsening situation, but social care has suffered from a gap between what was promised and what has been delivered.
Just this week, a GP from Laurencekirk healthcare centre in my region reported that social care shortages mean that
“things are becoming potentially unsafe.”
A general manager from NHS Grampian added:
“the biggest challenge we have is access to care packages ... That gap of unavailability of care packages for these patients slows down the whole of the system.”
Figures show that in Aberdeen city, 38 per cent of care services are reporting vacancies. In Aberdeenshire, the figure is 34 per cent; in Dundee, it is 37 per cent; and in Angus, it is 21 per cent. The main reason why services find it hard to fill vacancies is that there are too few applicants with experience.
The social care system is under immense strain from a pandemic, but, as the Feeley review emphasised,
“the vast majority of the challenges we are addressing ... pre-dated Covid-19 and will outlive the pandemic”.
That has happened not just under the SNP’s stewardship; but under Scottish Labour’s.
Scottish Labour’s proposals and the SNP-Green Government’s National Care Service (Scotland) Bill failed to measure up to the significant social care challenges that face us, from an ageing population that is putting more pressure on supply to poor workforce planning. The income from non-residential social care charges is invested in high-quality social care services.
In its guidance, the Convention of Scottish Local Authorities cautions that eliminating charges will “restrict” the quality of support that is provided to the general population who rely on such services. Simply put, Labour’s plan risks taking money away from the front line.
Meanwhile, the SNP-Green Government’s National Care Service (Scotland) Bill will pave the way for a centralising, bloated bureaucracy that will be established by the end of the current session of Parliament, years from now.
At an estimated cost of £1.3 billion, the creation of such a bureaucracy will divert precious resources away from the front line. Hundreds of back-office staff will be employed to oversee a top-down system that scraps local accountability. [
The minister might not be interested in what I have got to say, but it is respectful to at least listen to contributions.
Why should care in Aberdeenshire, Angus, Aberdeen and Dundee be dictated from St Andrew’s house in Edinburgh?
Earlier this year, Audit Scotland stated firmly and unequivocally that
“A clear plan is needed now to address the significant challenges facing social care in Scotland based on what can be taken forward without legislation”.
The Scottish Conservatives have published commonsense policy recommendations for how care can be improved now, without top-down reform, which include a local care guarantee to make sure that no individual has to access care miles away from their community. It is important that individuals have access to care that is not miles away from their community, family and support networks.
At the very least, I hope that there is consensus on that point in the chamber this afternoon.
Yet again, we are debating a Scottish Labour motion that completely fails to recognise the fact that the Scottish Government does not have fiscal autonomy. Ending all non-residential social care charges in the current session of Parliament will be a huge achievement, and it is a bold ambition. I can respect Labour saying, “We like what you’re doing, but do it faster.” That is a healthy pressure for an Opposition party to put on a Government. I think that we all want to get support out as quickly as possible to people who need it here and now. It is just a shame that Labour will not lend support to the SNP’s calls for further fiscal powers to be devolved to allow borrowing and other decisions that would make more money available for public spending or, otherwise, say what spending in other areas it thinks should be cut. That is what makes Labour’s demands unrealistic.
I am disappointed that the member did not listen to my earlier words. We set out exactly where the Scottish Government could get the money. We explained that it has all the powers that it needs to end all non-residential social care charges now, and that no further constitutional change is required.
Later in my speech, I will address the issue of taking money away from IJBs to pay for that.
Labour’s motion also completely fails to recognise that the money that we are able to spend in Scotland is tied to public spending in the rest of the UK, which is overseen by a right-wing Tory Government. This year alone, more than £770 million is being spent by the Scottish Government simply on mitigating harmful Tory welfare decisions that have been taken down south. We could have spent that £770 million on other things.
Does Emma Roddick welcome the Chancellor of the Exchequer’s intervention to supports Scots through the cost of living crisis? When Kate Forbes asked for £1,000 for the most vulnerable households in Scotland, the chancellor brought forward £1,650 for those households. Will Emma Roddick join me in thanking the chancellor and the UK Government for the full support that they have provided to Scotland for the cost of living crisis?
I welcome any measures to help people with the cost of living crisis, but I take issue with the way in which such action is taken by the UK Government. I take issue with the fact that we can never rely on how much money we will get from down south, which means that we have to change our budget accordingly.
The Tories have complained about money being spent on an independence referendum. The estimated spend on a referendum next year is £20 million. That means that we could hold 38 referendums for the cost of mitigating one year of harmful Tory welfare policies such as the bedroom tax and still have change left over for a Scottish Tory leadership election. Therefore, I suggest that the Tories should have a look at their own priorities.
I am sorry, but I think that I am done with interventions.
The Feeley report presented huge challenges, and the Scottish Government is rising to those challenges. Free personal and nursing care payments have had above-inflation increases over the past two years—an 18.3 per cent increase since April 2020.
That is not the action of a Government that does not recognise the cost of living crisis and the increasing cost of care. Nor is the introduction of the Scottish child payment and its doubling and then increasing again the action of such a Government; nor is the raising of benefit rates, and nor is the genuine request for further powers over our finances, energy policy and employment, so that the SNP Government can do even more to help the people who most need help.
The national care service is the most ambitious reform of a public service since the NHS was introduced. I represent the Highlands and Islands and I know that there are concerns that are still to be addressed and views that are yet to be heard and explored about how the system will work. There is work to be done to consider the needs of remote and rural areas and how we can protect high-quality provision that is built on local knowledge, where it exists, and reassure people who are happy with the care that they currently receive that the policy will be good for them.
That brings me to an important aspect of the title of Labour’s motion: the word “immediate”. It is not appropriate to rush the measure through without proper consideration. That would put the people that I represent at risk of not receiving the standard of care that people elsewhere receive. They would be at risk of the postcode lottery that the national care service is being brought in to get rid of.
The cost of living crisis is placing incredible pressure on people across Scotland. Inflation hit 9.1 per cent today. People are being plunged into poverty by cuts to universal credit and the benefit cap. They face rising energy bills because of the Tories’ failure to implement price controls or transition away from unsustainable fossil fuels such as gas, as well as rising food prices, due to Brexit.
Just today, the Resolution Foundation published a study that reveals that Brexit is making the cost of living crisis worse, with the average worker in Britain on course to lose £470 in pay each year by 2030, after rising living costs are taken into account.
I have spoken in this chamber about the impact of the cost of living on unpaid carers. As co-convener of the cross-party group on carers, I have heard from carers about the effect on them and the people they care for. Carers are facing rising living costs, but many carers do not have the option of taking on more work, due to their caring responsibilities. The situation is exacerbated by the fact that, earlier in the pandemic, many people’s care packages were reduced or stopped and carers took on more responsibilities as a result.
Carers might face additional costs that relate to home adaptations, personal protective equipment and other equipment, transport and cleaning supplies, the cost of which is also rising.
People who develop care needs as a result of a new diagnosis will experience the double pressure of having to reduce their working hours or leave their employment while incurring new, care-related costs. Research by Marie Curie found that being terminally ill and reaching the end of life can substantially increase the risk of poverty, not just for the person who is terminally ill but for the carers and family members who look after them.
Current social care charging arrangements can be difficult to navigate. Rules around free personal care can cause confusion, particularly where they relate to the eligibility criteria and what qualifies as free personal care, which varies across the country. For example, personal care can cover personal hygiene but not laundry.
Not just the charges but the systems that are behind them create issues for people. That is why we need the large-scale reform that the national care service will deliver. The independent review of adult social care found that charging for services and the support that is needed presents major issues for many people, as it reduces their income and limits their options and their control over what they want to do with the support that is put in place.
That is why the Greens and the Scottish Government have committed to the abolition of non-residential social care charges as part of a national care service that is built on human rights and lived experience. We are working towards that as a priority and the policy will be implemented during this parliamentary session. I am confident that if it can be done more quickly, it will be.
I welcome the commitment from West Dunbartonshire Council. We in this Parliament often talk about sharing best practice. We heard this afternoon from members such as Gillian Martin and Ruth Maguire about other things that councils are doing to help with the cost of living crisis. I hope that all those measures, including the approach of West Dunbartonshire Council, are being shared, via COSLA, to ensure that councils share best practice and ideas that benefit their constituents.
The Scottish Greens remain committed to the ending of non-residential social care charges. We will work with the Scottish Government to bring the measure forward as soon as possible.
I will take a different perspective on the issue that we face. It is important to acknowledge that improving health and social care outcomes for patients relies on two things: ensuring that people who require those services can access them, regardless of income or location, and ensuring that the workforce is supported to carry out its jobs.
The Scottish Government has already expanded free personal and nursing care to everyone who is assessed as needing it, and the national care service will go even further. The National Care Service (Scotland) Bill, which was introduced this week, proposes a national wage for carers to ensure that the value of the wages of our social care workforce better reflects the work that they do. However, we need to consider how the continued impact of the pandemic, and now the impact of the cost of living crisis, as indicated in Labour’s motion, affect health and social care staff.
As fuel prices soar, people who rely on their own transport for work, such as carers and home care staff, have to absorb the additional cost of fuelling up. That is why I have written to the Chancellor of the Exchequer asking for the mileage rate to be uprated for health and social care workers until such time as fuel prices reduce. The 45p rate is set at UK level, and the Chancellor providing a limited and focused measure to increase the 45p mileage rate would have a positive outcome for my constituents, the constituents of every MSP and all constituents across these islands.
Willie Rennie and Alex Rowley spoke in the earlier debate about targeted measures. What I propose is exactly that; it need not be a constitutional matter. The idea came about at one of my regular surgeries, when Frances Poole came to raise a range of issues with me. Frances is a home care worker who receives the 45p mileage rate, and she told me that it covers less and less of the fuel that she needs to visit patients in their homes, never mind the wear and tear on home care workers’ vehicles.
We all know that staff recruitment and retention is an issue in the social care sector, largely due to Covid-19, and in some areas, Brexit. Without an increase in the standard mileage rate, I fear that some social care staff may have no option but to look for employment elsewhere if they cannot afford to get to work due to fuel costs. If the standard mileage rate is not increased, it will also be harder to recruit staff.
My Greenock and Inverclyde constituency will be one of the constituencies that are hardest hit by home care challenges. Inverclyde has an older population that is forecast to continue to grow older for the next two decades, so improving the working conditions of non-residential home care workers is vital. Christine Grahame was correct when she said in the earlier debate that decreasing the VAT rate is “a sticking plaster”. I agree with her, and I accept that increasing the mileage rate is also a sticking-plaster approach, but home care workers cannot wait until Westminster fundamentally changes its funding approach.
The SNP Government has taken a number of important steps to improve social care through the introduction of health and social care integration, self-directed support and the Carers (Scotland) Act 2016. In addition, on 1 April 2019, free personal and nursing care was expanded to everyone under 65 who is assessed as requiring it.
Many measures have been taken, but it is clear that there is still much more to do. I believe that members across the chamber value our home care workers. The chancellor has an excellent opportunity to make a fundamental change that could help home care workers across these islands now.
This has been a full debate, and I thank colleagues for their contributions. I start by focusing on Labour’s calls for the removal of non-residential care charges. I heard what Jackie Baillie said about reserves but, given the savage SNP cuts to front-line budgets, whether that proposal is achievable during a cost of living crisis is questionable. Front-line services are suffering as a result of SNP mismanagement but, rather than raiding the reserves of cash-strapped IJBs, would it not better for the SNP Government to fund Scotland’s councils fairly?
In a spirit of localism, I ask Labour whether it should be the role of the Parliament or of democratically elected councils to make the final call on charges. That is just a thought.
As our motion makes clear, we believe that councils should be given the financial headroom to fully fund services. Only by doing so can we ensure that they have the funding to remove non-residential care charges wherever that is prudent and possible—[
In addition to the issue of non-residential care charges, the debate has focused on wider and very important issues. The SNP has spent years hollowing out Scotland’s councils. Budgets have been cut by 20 per cent in real terms since 2013. With its plans for a national care service, the SNP is mounting a full-frontal assault on council powers. As COSLA has said, the proposed legislation on that removes local democratic accountability and passes to ministers complete control over social care, children’s services, social work and drug and alcohol services.
The SNP is punch drunk on centralising power. However, as Sandesh Gulhane and Tess White made clear, we want to see a policy that is based on global care provision, with a local care guarantee at its heart. Only through localism can we meet future care needs, including the issue of non-residential care charging.
Social care in Scotland is in crisis and so, too, is our NHS. Many of the problems in our NHS stem from SNP problems in social care. Record levels of delayed discharge are impacting on patient flow, and the real risk now is that we waste the next four years by diverting precious resources away from the front line.
I am sorry, Presiding Officer. I invite the minister to take his seat.
Yesterday, the accompanying notes to the National Care Service (Scotland) Bill showed that ministers propose to spend up to £1.3 billion in order to set up a national care service, and that it will involve 700 new civil servants and hundreds of managers at a time when the front line is in crisis, and hard-working care staff and carers are burned out. Today, I pay tribute to their heroic efforts.
The proposed legislation is a power grab, but it also goes beyond control to the issue of the competence of the Government and the cabinet secretary. How can someone who has failed our national health service so badly say that a national care service would be safe in his hands? Members should make no mistake—this is Police Scotland mark 2, and Humza Yousaf is at the wheel.
In the past 24 hours, the Government has also revealed its contempt for the Parliament. Given the scale and scope of the proposed legislation, we might have expected a statement in Parliament yesterday but, as always, the SNP was running scared of scrutiny, so it announced the plans to the press corps rather than in this chamber.
The national care service is simply the wrong plan at the wrong time, and that is why the SNP must ditch that proposal and put every penny into front-line social care.
I thank Jackie Baillie for bringing the debate to the chamber. It has been helpful to air some very important issues. I reiterate what my colleague Kevin Stewart said in his opening contribution: of course we want to scrap and end non-residential care charges and we intend to do so in this parliamentary session. As he outlined, we will introduce legislation next year to that effect.
However, we will not raid every IJB’s reserves. Some IJBs do not have reserves, and we will not raid the funds of the IJBs that have them, because that would be a one-off funding source for a recurring spending issue.
More importantly, it is vital to put some of the facts on the table. The latest set of accounts that have been published for 31 March 2021 show that the integration joint boards’ reserves totalled £558 million. Jackie Baillie is right that, on the face of it, that sounds like a staggering sum. However, if we were to dig into that figure, we would find that £464 million of it is already earmarked for specific purposes, particularly the on-going response to Covid. I say to Jackie Baillie that we are having this debate in a week in which Covid cases and infection levels are rising.
Shortly. Transmission levels are also rising. To then raid the budgets of IJBs when they are facing challenges in relation to Covid infection would be foolish. I suspect that, if I did so, and left IJBs with no money to deal with Covid, Jackie Baillie would be the first person to drag me over the hot coals.
The cabinet secretary knows me well—I would indeed do that. However, he is misrepresenting the situation, because there are sufficient unearmarked reserves that are not for Covid but for other things and that would cover the £51 million that is required to end non-residential care charges. If the Government is to be believed—I do believe it—it intends to end those charges. We are suggesting that it should do so now, and there is the ability to do it now. If the cabinet secretary is as good as his word, it seems that he is intending to do it at some point later, but he could start now—the money is there.
I wish that Jackie Baillie had listened to what I said. Five IJBs have no general reserve funds whatsoever, and 23 of them have less than 2 per cent of their available funding in their general reserves. Jackie Baillie and Scottish Labour have therefore misrepresented the position in relation to IJB reserves.
Kevin Stewart mentioned—as has almost every single member who has spoken, other than Ms Baillie’s back-bench colleagues—the contradiction that is at the heart of Scottish Labour’s position. Twenty-four hours ago, Ms Baillie was demanding that the Scottish Government should not interfere in local spending and decision making. Twenty-four hours later, she is demanding that it should interfere and intervene in them. I am afraid that that illustrates the contradiction and hypocrisy that we are only too used to from Scottish Labour.
There will be a debate on the national care service and a parliamentary process that we will go through, as we would with any other bill and as would be expected by the committee on which Sandesh Gulhane and other members sit. It does not surprise me that Dr Gulhane and the Tories do not want a national care system because, in the bill that we published yesterday, a national care service would have at its heart collective bargaining, ethical commissioning, fair work for social care workers, and the human rights of care home residents’ relatives.
The national care service would therefore stand for and embed everything that the Tories oppose. I will take no lectures—none whatsoever—from the Tories about social care. They are the party that dragged Scotland out of the European Union against its will, causing untold damage to social care up and down the country.
To conclude, the Scottish Government is not waiting for the NCS before making changes. We have recruited more than 1,000 healthcare support workers, many of whom are based in the community and are assisting with social care. In my time as health secretary, we have introduced two pay rises for adult social care workers in the past year. We will not wait for the national care service to be established before we make improvements to our social care system. However, we will do so in a way that is thought out and based on the facts and figures and the evidence. We will continue to invest in social care and, of course, the people who provide it, who are so vital to such services right across the country.
In closing the debate on behalf of Scottish Labour, I reflect that the Parliament has again used Labour time to debate the ending of all non-residential care charges in Scotland. We have heard from colleagues across the chamber about what that would mean for the many people who rely on such support, but also for the unpaid carers who are at breaking point, both in terms of their physical and mental health and financially.
It is disappointing that the Government has not given clarity on timescales or meaningful plans about how it will remove those charges. It can do that now. The minister said that it will take legislation, but I would challenge that. Will he give a cast-iron guarantee that non-residential care charges will be ended before the National Care Service (Scotland) Bill is debated at stage 3?
I will be happy to give way to either the minister or the cabinet secretary if they can confirm what will come first. People who are in receipt of adult social care cannot wait for the Government to get its act together—nor should they have to. We are in the midst of the worst cost of living crisis in living memory, and many households are already panicking about the looming winter. We need to act now.
Unpaid carers have told me about the impacts of the cost of living crisis that are being felt already—for example, through energy bills for vital equipment skyrocketing. As Jackie Baillie mentioned, we have heard about one instance of a bill increasing to £4,000 per year. We must act with haste to make life a bit easier for those carers.
Of course, each time that we call on the Government to deliver on its own pledge, it makes excuses. It is someone else’s fault—as is outlined in its amendment. The last time that the minister and I had an exchange in a debate about social care, it was COSLA and IJBs that were the issue.
I am coming to that point. My colleague Jackie Baillie made the point that there is already ministerial direction on ring-fenced spending and that ministers are the final arbiter on decisions that are made by IJBs. IJBs are not just councils; they are also health boards and they have health board members.
Colleagues on the Labour benches have set out, time and again, how charges could be ended immediately. Indeed, we provided a costed budget in December, which allowed us to implement the recommendations in the Feeley review using consequentials. Today, because of ministers’ inaction and their unwillingness to use consequentials, we have set out how that can be done with the vast level of reserves that sit in health and social care partnerships.
For people who pay those care charges, the policy will be transformative, as it will lift a heavy burden from their shoulders. However, it seems that the SNP and the Scottish Greens are not willing to support such a measure, which would make a real and tangible difference to life for so many people. It is a case of them, once again, sticking their heads in the sand, despite the promise that the SNP made in its manifesto for the council elections last year that it would end the costs of non-residential care.
The cabinet secretary will see Labour councils making a real difference on the ground in relation to the cost of living and non-residential care charges. We will not take any lectures from a cabinet secretary who is unwilling to act.
The cabinet secretary has spoken about the national care service, which is another opportunity to kick things into the long grass. I say to members who have talked about Scottish Labour’s position on the national care service that we have been consistently clear about what our tests for a national care service are. Now that the bill has been published, there are serious concerns not only among Scottish Labour, but among trade unions and councils. Indeed, Keir Greenaway of the GMB said that there is much detail on
“new executive boards of bureaucrats... but” there is
“no mention of how care workers can improve their pay. It’s unclear how, if at all, care staff will benefit from these fag packet plans.”
That is the trade unions’ view: “fag packet plans” is how they describe the bill.
It is not just the SNP and the Greens who, with their amendment, are letting down Scots . Conservative members have failed to respond, or mention in their amendment, the cost of living crisis, which has been caused, in part, by the Conservative UK Government—a Government that is totally failing the economy and failing to tackle inflation, which is what has spurred this crisis on. It comes as no surprise to see the Scottish Conservatives pivot away from the real matter that is at hand, which is the need to take action straight away to end all non-residential social care charges. Instead, its amendment does nothing to address the pressures that people who are in receipt of social care are facing now.
Scottish Labour is putting ideas in place that will benefit people across Scotland, and we are putting those ideas into practice. We have heard that in the examples that were relayed about West Dunbartonshire. We are tackling the cost of living crisis head-on with a £5 million package, which is making a real difference, particularly in relation to non-residential care charges. I have yet to see the same ambition to tackle the cost of living crisis from members on the benches opposite me. Let us remind ourselves that the Scottish Government’s own report on adult social care recommended that all non-residential social care charges come to an end. When the First Minister announced the review, she said that
“it is time to be bold.”
I say to the Government: what you have before you from Scottish Labour is bold, and we will continue to be bold until the timid Government does the right thing.
That concludes the debate on delivering the immediate removal of non-residential social care charges. There will be brief pause before we move on to the next item of business.