Marlyn Tweedie shares some thoughts on the Feeley report into the provision of Care in Scotland. The report was published on 3rd Feb 2021 – compiled by Derek Feeley, a former director general for health and Social care within the Scottish Government.
The enquiry raised a degree of hope that perhaps a Care Service – adequately funded and resourced – would be a possibility. Unfortunately, despite the report ‘s remit as being “to recommend improvements to adult social services” and good, researched evidence that highlights the lack of services and the suffering caused to service users, it’s recommendations won’t, in my opinion, deliver.
Firstly, the call is for a national care service not a nationalised one. It rules out a nationalised service because it would be too expensive. It usess the example of the case of the care home for the elderly in Skye – Home Farm – where 10 residents died of Covid, saying it would cost £900,000 to nationalise. And that is unaffordable. They argue it would be more productive to try to get the service providers to improve.
There is no acknowledgement that the priority of the Private sector is to their shareholders not to meeting the needs of the residents.
Also, the report recommends centralising responsibility for the care service within the Scottish Government and appointing a Minister for Social Care. This would take it away from the control and accountability of Local Authorities. Not a move in the right direction, in my view.
Throughout, there is as a “given” the idea that integrating the Social Care Service with the Health Service is logical and would lead to efficiency and improvement. But it doesn’t say how this would automatically happen. I think we should be wary. When it was first mooted – 10? Years ago, saving money was an explicit goal. And “bed blocking” was seen as an expensive cost. There is nothing to say that staff or service users will benefit. We love our NHS – especially now – but many staff are underpaid. And, in any case, the report talks of procuring services; continuing commission which means the staff employed will be employed by the outsourced companies rather than the NHS.
By contrast, the care staff employed by the Local Authority have secure conditions – sick pay, holiday pay etc and a wage £18,000 – £21,000 annually and they have overtime rates for unsocial hours. It’s not great but much, much better than the Private Sector.
The report is full of talk of Human Rights; allowing everyone to develop their potential etc. It acknowledges that this can’t happen when care is restricted and when it’s paid for as opposed to being free at the point of need. It does, to its credit, recommend that all care is free. At the moment it’s only free for over 65’s.
But it doesn’t commit to a set sum per hour. Campaigning groups argue for £15.00 an hour. Nick Kempe argues for parity with Local Authority wages. The report talks of a national job evaluation. There is no guarantee that this would give a reasonable wage to Care / Support workers.
In line with ruling out nationalisation, the report talks of “ethical procurement”. We have that at the moment. Bidders promise the earth to get the contracts – then, as we know, it unravels.
All in all, the report has good evidence and could make a great case for nationalisation delivered by a workforce which has decent pay and conditions.
It, at least, acknowledges the problem – but falls far short of providing a solution.
Nick Kempe has written very astute articles on this issue (see below). I’d highly urge reading his views on it.
Marlyn Tweedie 18th March ‘21
Nick Kempe talking about Social Care at a meeting of the Edinburgh TUC Covid subcommittee
An article by Nick Kempe on Care and the Pandemic
and an article on the case for a national care service