The Parallel Universe Of Care

Colin TurbettThis week, Colin Turbett of the Common Weal Care Reform Group has written up some personal reflections after attending the Scottish Government's National Care Forum and how the expectations of the care sector are clashing against the parallel universe of the vision being offered by the Government.Our Care Reform Group (CRG) was established over four years ago to try and ensure that if Scotland was to have a National Care Service, it would be worthy of the name, and sort out the inequities and anomalies of present systems. Sadly, as the government’s proposals have taken shape after the introduction of the first Bill in June 2022, that prospect has shrunk to its present beleaguered form. Most recently the major trade unions, UNISON and GMB, have withdrawn from the discussions, and just last week, COSLA voted by a majority to pull out and end the Verity House Agreement. This week the STUC have joined the chorus of opposition to the vague and tattered remains of the original ambitious promise of an NCS.It was therefore with some trepidation that I attended the annual National Care Service Forum held in Glasgow (and online) on Monday 7th October. I was there with some 200 others (including a large number of civil servants supporting the event) and as the day wore on it became clear who the audience were, and why they were there. Main speakers included the two ministers principally involved: Cabinet Minister Neil Gray, and Maree Todd, Minister for Social Care, Mental Wellbeing and Sport. Those present were given opportunity, amongst the keynote presentations and a panel discussion, to focus in small groups on questions posed by the SG team. One might have thought this should include basics like “Are we getting it right?”, but no: they were carefully prescribed around human rights and their embedding in the new NCS – who could disagree with that? Human rights are important and should not be dismissed, but this did not reflect the realities surrounding the proposals.Back in 2022, the CRG expressed concerns that the consultation exercises that preceded the then proposals had involved an over-emphasis on the “lived experience” of users and carers, and little on the social care workforce and others involved in service delivery. For a while there seemed an effort to correct that, others became better involved including trade unions and other representative organisations. The shape of this week’s forum suggested that having lost any buy-in from workforce representation groups, including trade unions, we are back where we started. Neil Gray’s speech only mentioned the workforce after emphasising the primacy of users and carers, a sentiment echoed by Maree Todd. Her remonstration that “… if we care enough, we can make it right for everyone” will strike little resonance with workforce, users and carers beset by a lack of resources and hope for improvement. No mention was made by Gray of recent setbacks, until a question about COSLA’s withdrawal was asked by an audience member. His response was that the “door is open” to further discussion on differences. This conciliatory note was not echoed by Maree Todd, who spoke despairingly of having experienced “real resistance to change” over the previous week – which can only refer to COSLA and the unions – a rather insulting put-down on their role and aspirations. She, however, remained doggedly determined to bring about the change she said was wanted by those of us being let down by current arrangements. Is this the way forward – setting users and carers against Scottish local authorities and the workforce in a game of divide and rule?The ministerial message was clear – it’s full steam ahead because, as they regularly reminded us, no one wants the status quo to continue. Maree Todd at one point explained her “love” of social workers as “human rights champions” – an aspiration many social workers would “love” to attain, but which is far from their typical crisis-led mopping up role in a landscape of diminishing resources. She told us that this love of social workers might not find an echo in the audience – a statement that perhaps gave away the general identity of those present - whom she obviously assumed had experienced social work negatively. Last year there were workforce representatives at the Forum, but clearly few this time outside the Third Sector. Maree Todd also told us that prior to her gaining responsibility for the NCS proposals, no one could agree about anything, but she had averted concerns about a ministerial power grab and huge progress had been made, despite the “tough times and wee bump in the road”. Given the end of the Verity House Agreement this brings new meaning to the term wishful thinking.In her closing remarks Maree Todd assured us that this year’s forum had pleased her. So, the object was clear – the event will be used to prove that all is going well. However, in reality, it’s foundering in a sea of confusion about why the NCS Bill and proposed amendments offer anything different from current arrangements, and uncertainty about what it might end up looking like.From early on, we in Common Weal pledged support for the idea of a cradle-to-grave service based on a clear set of principles: these included removal of the private sector and profit from service delivery, an end to the disastrous policy drive surrounding integration between health and social care, a service provided through local authorities (where accountability should lie at local level) and an understanding of what “care” should mean in society. We published Caring for All in 2022 to demonstrate our beliefs and that with commitment and resources a real NCS could become a reality. It is hard to see any of this within the proposals that are slowly moving forward. We still believe in a National Care Service, despite the deaf ears turned by government to the voices of many of those involved in consultations and discussions to date. Onwards and upwards towards a real NCS, but not through the current Bill and its vague and unsupported proposals.Image Credit: Colin Turbett