In the Chamber: Investing in Social Care for Scotland’s Future.

Investing in Social Care for Scotland’s Future
David’s speech in the Scottish Parliament debate
14 November 2018
This has been an excellent debate, with well-informed and passionate contributions from across the chamber.
Many members, including Alex Rowley, Jackie Baillie and Alex Neil, made powerful statements about the reality of social care by providing vivid examples of vulnerable constituents, many of whom rely on unpaid carers—the backbone of our social care network.
I suspect that few members would disagree with the change in philosophy from hospital-based care to community-based health and social care.
The key is to have a health and social care system that is based on human rights, in which people receive care based on need and not on the ability to pay.
As we have heard in the debate, we have several key challenges, including the high levels of turnover in the social care sector, which are exacerbated by low pay and the uncertainties of Brexit.
By 2035, a quarter of Scotland’s population will be aged 65 or over, which is an increase of nearly one fifth since 2010.
Just over one third of over 85-year-olds received care at home or as a long-stay resident in a care home, hospital—
John Scott:
Will the member take an intervention?
David Stewart:
I am sorry, but I do not have enough time.
As we would expect, older people are more likely than younger people to be admitted to hospital in an emergency and to have multiple and complex needs.
Let us not forget that there are 657,000 unpaid carers in Scotland, half of whom are aged over 65.
Technology and innovation are also crucial.
The Health and Sport Committee, of which I am a member, published an excellent report on the subject earlier this year.
The report says that technology
“presents an opportunity to ensure innovation in health and social care flourishes and that Scotland is a leader and is not left behind.”
I will give an example. In my Highlands and Islands region, the Inverness city region deal is developing a very imaginative project called fit homes.
The homes are future proofed to adapt to changes in residents’ mobility and have a series of sensors that collect data that can be monitored and responded to by, for example, health and housing agencies.
The model is designed to create a viable, lower-cost alternative to full-time residential care and prolonged stays in hospital. I hope that that best practice will be picked up across Scotland.
Of course, it is a truism to say that good homes support good health, but I believe that that project could allow people to live independently in their communities for longer, which is very much the point that Alex Neil made in his insightful contribution.
The fit homes project is being developed by Carbon Dynamic in conjunction with Albyn Housing Society and NHS Scotland, and I am delighted to say that it landed the Saltire award.
I am constrained by time so I apologise to those whose contributions to the debate I am not able to mention.
Alex Rowley made an excellent speech about the treatment of social care workers. He quoted Enable Scotland, which I, in turn, will also quote. It says:
“The Joseph Rowntree Foundation reported in 2016 that 15% of the social care workforce are in in-work poverty.
This means that we have Scotland’s most vulnerable people being cared for by Scotland’s most vulnerable workforce.”
He went on to talk about the differential rates of pay and conditions that care workers experience, and I highlight to all members the excellent Unison study and survey of the area.
Miles Briggs made a useful point when he talked about delayed discharge being a key factor; he said that the problem is getting worse.
I also endorse his comments about social care internships as a factor in trying to reverse the problem of recruitment.
Alison Johnstone made a useful point about the important role that unpaid carers play in Scotland, and Willie Rennie’s comment about 500,000 lost bed days per year was insightful.
Social care is the very heart of our welfare state.
It embodies the Beveridge principles that created the system of welfare protection that looks after our vulnerable, our ill, our old and our sick.
However, as Alex Rowley said, we need a significant shift in resources for social care services so that we can achieve a sustainable financial model and provide long-term stability for health and social care in Scotland.
To conclude—on time—I note that the famous American anthropologist Margaret Mead once said:
“Never believe that a few caring people can’t change the world. For, indeed, that’s all who ever have.”