Care in the Community

Developing the National Care Service – when is a covenant not a covenant?

Last week the Scottish Government announced that “a consultation document on a National Care Service is due to be published on 9th August and the consultation will run until 18th October”.  While Common Weal’s Care Reform Group, which was set up last year, is sceptical about the consultation, we are committed to engaging with the process as part of wider work to promote research, thinking and debate about what sort of National Care Service Scotland really needs. 

So far, to this end, we have published our Manifesto for a National Care ServiceStruggling to Care or why the role of Social Workers needs to be reformed, and Care in your Community, a paper which looks at how  Community Hubs could bring social work, social care and other services closer to local communities in the new National Care Service.  We have also published the main critical response to date to the so-called Independent Adult Care Review conducted by Derek Feeley.   A suite of further policy papers will be published over the next few months ranging from a critique of the Scottish Government Independent Care Review for Children, the Promise, to the health and safety of the social care workforce and the meaning of care.

The need for a critical response to the consultation is illustrated by the main item in last week’s news release, the Scottish Government’s creation of a social covenant steering group.  Establishing the Group was described “as a first step towards the creation of a National Care Service” and “a key recommendation” of the Adult Social Care Review.  It is no such thing.  While Feeley did recommend that a new social covenant was needed, as a means of realising a human rights based approach to social care, he stated this should involve “mutual commitment by citizens, representative bodies, providers, civic Scotland, and national government to set aside self-interest and each work together for the common good”.  He did not say HOW this should be done.

Whatever you think of this covenant idea, the new steering group is in no position to deliver it.  This is because it consists almost entirely of citizens with current experience of care services but excludes other groups mentioned by Feeley, such as Providers or representatives from bodies like Trade Unions. You need all parties present to negotiate a covenant.

This is not to argue that “the real life experts” on the group, people with direct experience of care services, should not play a role in agreeing the “underlying and unifying principles to help guide decision-making” which is part of their remit.  Indeed, Common Weal’s hope would be that the Steering Group adopt some, if not all, of the principles we have already developed.  These include that the new National Care Service should be cradle to the grave, not for profit and free at the point of use like the NHS.  Many of these principles, however, conflict with the recommendations of the Adult Care Review, recommendations which the Scottish Government has already said it has accepted.  That appears to leave little room for the Steering Group to agree a different set of principles or for the wider public to influence the outcome of the consultation process.

There is an important difference too between real life experts, people who can articulate how the care system has affected them or their relatives, and experts in the care system itself.  These include professional social workers and the people with specialist knowledge who can describe how care provision has become increasingly financialised and how profits end up in tax havens or who can articulate what resources are really needed if we are to care for people properly.  Our view is that in developing a new National Care Service the Scottish Government needs to take account not just of individual’s experiences but to analyse and understand the reasons for the current failings in the social care system, culminating in the meltdown during the Covid pandemic.  Despite there being considerable social care expertise in Scotland, there is just one such social care expert on the group and they are from Sweden.  Why?

While the Scottish Government’s apparent intention is that that the Steering Group will produce policy soundbites that provide cover for delivering the Feeley recommendations this may not happen.  The Steering Group may include three members of Derek Feeley’s Advisory Group but they don’t agree on everything, including the role of local authorities.  The Steering Group also includes some independent-minded critics of the Scottish Government, like Cathie Russell from the Care Home Relatives Group who has been campaigning for the rights of care home residents and their relatives during the Covid crisis.  The conclusions of the Steering Group therefore are not a foregone conclusion and it could yet provide some opportunities for promoting the type of debate about the shape and direction of the National Care Service that we would like to see.

Whether or not this happens, it is extremely important after all of what service users, carers and the workforce have been through over the last fifteen months, that as wide range of individuals and groups respond to the consultation as possible and argue for a properly resourced care service worthy of the name.  Besides producing further policy papers to support that aim, Common Weal’s intention is to produce a briefing on the consultation when it appears and to organise and participate in events which promote the sort of wider debate about the future of care that we think is needed.  Watch this space!  If you would like to get involved contact us at hello@common.scot.

Nick Kempe, Convener, Common Weal Care Reform Group

3 thoughts on “Developing the National Care Service – when is a covenant not a covenant?”

  1. Lesley Edwards

    I am fighting for better health and social care in Forres which has the highest level of elderly in the whole of Moray. I would like to see a National Care System. How do I GET INVOLVED.

  2. Ian Davidson

    The social covenant steering group is yet another spin device. Scot Gov used the same tactic in social security reform; they set up “experience panels” and then prepared “loaded” questions designed to elucidate desired responses. E.g. They asked existing disability benefit claimants to prioritise objectives of any new Scottish system. Unsurprisingly, most claimants voted for continuity of existing payments c.f. innovation, based on previous botched DWP reforms. This was then repeatedly quoted by the Cabinet Secretary to justify the new Scottish system replicating the structure of the DWP system in terms of qualifying rules, rates of payment etc! The views of an “expert working group” set up by Scot Gov were ignored and the group has magically stopped meeting! Kevin Stewart is in my view a mediocre Minister who repeats Civil Service statements ad nauseam; I have one such example from 2017 in file when I challenged withdrawal of an excellent supported living project used by my mum and other vulnerable elderly at six locations in Glasgow. I suggest the steering group members record what is said at these meetings as it will be twisted in to Scot Gov official-speak. Only today, the Herald reports on how the Care Inspectorate failed to investigate most complaints as soon as the Covid emergency began. I believe that Scot Gov will delay reform until it can be sure that the cost will be picked up by UK via Barnett consequentials resulting from any rUK social care reforms. This is their fiscal approach to most major changes, esp as they are committed to not raising Scottish income tax, avoiding Council Tax reform, not taxing Land values etc. Sorry, but a party leader/FM who cannot account for £600k of SNP funding being used for other purposes does not inspire confidence in a social care reform which will cost at least £1b (almost double Feeley’s estimate) to be done properly!

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