SNP reforms may make social care service worse, MSPs told

They along with officials from the Convention of Scottish Local Authorities (Cosla) called into question whether restructuring the service was needed and instead called for more investment in current services.

The National Care Service Bill is designed to set up a new service which is intended to “oversee local delivery of community health and social care”, end the “postcode lottery” in standards, and improve conditions for care workers.

Under the planned reforms social care services would come under a new national body, which would then be divided into regional boards in a set-up similar to the NHS.

But much of the detail of the new system is not included in the Scottish Government’s bill, and will instead be developed using secondary legislation, which should see staff, care users and others involved in “co-designing” the service.

Tracey Dalling, regional secretary of Unison Scotland, told MSPs the bill's "priorities were all wrong".

"The priorities are all wrong. Spending upwards of half a billion on set up costs for new quangos is I don't think the right time when we have so many vulnerable people waiting to receive a service.

"The biggest issue we've got with the bill is what it doesn't say," she told the local government committee.

"We have been very clear in our submissions to you that we think the bill should be withdrawn."

She also went on to cast doubt whether there was a post code lottery of care.
"Does [care] differ from place to place because social pressures might be different from place to place?"

Simon Cameron, workforce and corporate policy team, Convention of Scottish Local Authorities (Cosla), raised fears that improvements made under recent reforms of social care could be undone.

He said: "We understand there is a need to advance our services. It is the risk that it will undo an awful lot of the good work that is happening.

"The fact we have got integrated joint boards, the fact that they are still relatively new and that the cultures are still developing. But there is a lot of good and well embedded practice now happening that we risk unravelling some of that."

Roz Foyer, the general secretary of the Scottish Trades Union Congress, highlighted fears that reforms “could end up costing an awful lot of money for the Scottish Government at a time when that money could be better used to deal with a system that is in crisis in a much more immediate way”.

Last week the STUC wrote to ministers, urging for the bill to be put aside to “take more time to get it right”.

Cara Stevenson, of the GMB Scotland trade union, said, as it stands, workers in social care are being asked to “take a leap of faith”.

Ms Stevenson said: “Looking at reforming the social care sector is welcomed and I think great things could be done with social care if it is done properly.

But Ms Stevenson said: “There has to be more to the bill that gives the workforce faith this is going to work.”

She told MSPs on Holyrood’s health and social care committee: “I was, actually, a home carer in a local authority and worked all the way through the pandemic.

“Obviously, at the moment, we feel the bill is not fit for purpose and the reason for that is we are dealing with a workforce, and I will try to not get emotional when speaking about this, they are broken, they are exhausted.

“Now we’re giving them the National Care Service Bill which doesn’t give them any sort of job security, any sort of value, and any sort of feeling of worth after the nightmare they have just been through for the last two years.”

She added: “We want reform, we want to make social care better, but we feel what they’re being offered right now is not good enough.”

Her concerns were echoed by Ms Dalling who likened the legislation to “buying a house but without ever having seen it”.

She added: “We don’t even know how many rooms are in it, or where it is located.”

She told the health committee: “We genuinely do not know what the future looks like for around 75,000 council staff, and then all the social care staff that work for private contractors, what the future looks like for them.”

Ms Dalling continued: “In such a critical area of the lives we lead, to have our social care workforce uncertain about who they work for, where they’re going to be, I just think it has all the hallmarks of this being a bit of disaster at this stage."

Ms Foyer argued that “what we need here is a bit of time to get this right”, telling the committee that the co design process “needs to happen now before we’re asked to back a bill that we don’t understand what it is actually going to deliver”.

And she added: “Ultimately, there needs to be more investment in the frontline, particularly at this time where we’ve got a huge workforce crisis. We’ve got a crisis coming this winter.”

Mary Alexander, deputy regional secretary for the Unite union, told MSPs social care workers were feeling “extremely undervalued”.

She added: “Given everything they did during the pandemic, to keep vulnerable people safe, they are just disheartened.

“There is a huge crisis. If you look at places like Aldi which are paying £10.50 an hour, a lot of people are leaving because, frankly, it is not so emotionally draining, it is a better job, you don’t have to worry about what happens when you leave the vulnerable service user.”

Social care Minister Kevin Stewart rejected claims the bill was a “leap of faith”.

Mr Stewart, speaking to MSPs on the local government committee, insisted that no-one had suggested “the wholesale transfer of staff from local authorities to local care boards or the National Care Service”.

The minister said: “I see local government as being important delivery partners as we move forward. And that’s why I want them at the table co-designing.

“There has been a lot of talk of transferring of assets, again, that is not something that is necessary. That has to be something that is looked at in terms of the co-design.

“But some of the witnesses that have been at this committee and others have suggested there will be the wholesale transfer of staff and assets. That is not as we envisage it.”

He told MSPs that many of those raising concerns had a “vested interest in terms of where power, accountability and resource lie at this moment”.

Mr Stewart said: “What would be really good to see would be committee taking evidence from those folks who are receiving care, carers, their families and from frontline staff.”

Spending watchdog Audit Scotland said the financial memorandum accompanying the bill “significantly understates” the cost at up to £1.3billlion over the parliamentary period because of outdated inflation figures. 

Ms Sturgeon has previously described the NCS as “arguably the most significant public service reform since the creation of the NHS” in 1948.