A decision for local authorities and the Scottish government to share accountability in a new national care service was taken “behind the backs” of those who use social care services, a parliamentary committee has been told.

Members of Holyrood’s Health, Social Care and Sport Committee heard that the announcement has made members of Inclusion Scotland feel “used” by the very process that was created to make sure their experiences and opinions are taken into account.

Questions were raised in the evidence session over which parts of the National Care Service will be genuinely co-designed and which are subject to “veto” by local councils and ministers.

Meanwhile, social care representatives told the committee that a challenging summer is destined to transition into an ever more challenging winter, after a failure of ministers to fully consider them in their winter planning.

Co-design

In the summer, the Scottish government announced ministers had agreed with local councils and the NHS to share accountability for people’s care in the National Care Service.

Inclusion Scotland Convener Dr Jim Elder-Woodward told MSPs that, despite members being “keen” to engage in the co-design process, they have been left “disappointed” by the announcement.

Dr Elder-Woodward, who has previously written for healthandcare.scot on the shortcomings of local councils’ delivery of social care in Scotland, told the committee: 

“We thought the people with lived experience were supposed to the central pillar upon which the National Care Service would be delivered. We thought that this agreement has not taken any cognizant of the co-design process and was taken without reference to any stakeholders other than the Scottish government and [local government organisation] COSLA.”

“This decision was taken behind our backs and we are not truly part of the system which takes our experiences and knowledge into consideration. 

“We have been used by this co-production and we are really disappointed.”

Meanwhile, other social care representatives agreed they had been “taken back” by the decision, which they all say was done without their input.

Rachel Cackett from CCPS told the committee that the vision of what Scotland wants social care in Scotland to look like has been lost, and things are reverting back to upholding the status quo:

“We were deeply disappointed that to bill which purports to be about co-production and engagement ended up with a deal done quietly behind closed doors which we were certainly not in involved in.

“It’s very hard to understand quite how that statement will actually relate to changes in the bill and its proposed structures.

“If the point of social care is so that people who require care and support can genuinely thrive, then I almost feel like that we’re starting the conversation from the wrong end. We’ve gotten very caught on political ownership, but actually if the point is choice and control at the front line, then actually that’s what we should be looking at and that should be underpinned by the principles of good governance, which includes transparency and participation.

“None of this is clear in the deal that was done in the summer.”

Minister for Social Care Maree Todd told the committee last month that the government is “still in the thick of discussions” around governance arrangements for the NCS.

Her civil servants told MSPs that input from co-design sessions will “inform early improvements, including the Bill itself” but work on service provision in the new service has not yet begun.

The ALLIANCE’s Rob Gowan this week told the committee members are sceptical that the co-design process is anything more than a “well-resourced consultation”:

“We’ve encouraged people to take part in the co-design sessions over the summer, but a number of our members have been sceptical or concerned partly because there’s been much engagement around what the issues are with social care, which they feel they have told people many, many times before.

“A concern is that if this is becoming a well-resourced consultation, that this risks letting people down, many of whom have told us that they felt let down and unheard by the current accountability arrangements.”

 

Social care needs support now

The evidence session comes days after Rachel Cackett, together with Scottish Care CEO Donald Macaskill, released a statement criticising the Scottish government’s winter plan for a lack of focus on social care.

Speaking to the committee this week, Dr Macaskill told MSPs that this summer has been “really difficult” for people delivering social care in Scotland which has made engagement in plans for a national care service near impossible:

“We had a summer of real care disenchantment. There is not [the] energy out there to be engaged in the development of an NCS. Our members are firefighting. It feels rather like saying to a passenger in a lifeboat at the Titanic “what’s your next holiday going to be?” because at the moment they’re struggling to survive”.

“We are scunnered and we are knackered. We are scunnered because we have offered solutions and been disappointed.”

Trade union representatives told the committee a focus on the NHS in health and care workforce planning must be “turned on its head”, to ensure those working in the sector can access training to allow them to progress.

Cara Stevenson, from trade union GMB, said protection for the care workforce must feature in the Bill:

“There isn’t any pace on any guarantees, amendments, any clarification or any guarantees to our members that we are going to be protected in this process.

“We need funding, we need investment and we need support for the social care sector so people can access the care that they need and so there’s well-trained staff there to provide that care.”

Read More: National Care Service: ‘Revolution to evolution’; Winter plan offers "no hope" to social care or nurses; Ready to fail - or already failed?

 

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