Deputations to the December EIJB

The Edinburgh Integrated Joint Board met on Tuesday 13th December. There were deputations from Edinburgh TUC and City of Edinburgh Unison. We’re pleased to post the contributions from Des Loughney and Carmen Simon from Edinburgh TUC. You can find the board papers that are referred to on the council website and watch a video of the whole or parts of the meeting.

I would like to thank the Board for agreeing to hear our deputation from Edinburgh Trade Union Council. The deputation consists of myself as Secretary of Edinburgh TUC and Carmen Simon, who is vice chair of Edinburgh TUC. Carmen is a former social care worker of eleven years experience. Ian Mullen from UNISON was due to be the third member of our deputation: he sends his apologies and cannot attend today. He has other urgent business.

I have comments on three items which are on your agenda today. These items are the minutes of the meeting on 18/10/22, Item 6.2 and item 6.3.

The minutes of the meeting give an accurate recording of the key points made by our deputation but do not record any response to our points. If I remember correctly the EIJB was asked to approve measures to mitigate the Winter Crisis in Social Care which included recruitment of more staff, cuts in the care package of people and a Triage team which will decide on whether care packages for people even in the substantial and critical categories, shall be implemented  in whole or in part. Apparently the triage team were going to be able to overrule the assessments of social workers and occupational therapists. These would have been done in liaison with carers and relatives. If the triage system were agreed we think the public has a right to know.

I was interested in item 6.2 because although it deals with primary care issues it indirectly refers to the provision of social care services. I had not realised that the projected figure for the increase in population of Edinburgh was about 70,000 by 2030. It seems that there is a possibility that the figure may end up being over 100,000. There seem to be major challenges in obtaining finance for the construction of the new Health Centres required. It is not clear where the trained staff, including GPs, are going to come from to staff the new Health Centres are going to come from, never mind how their employment is financed. 

In 5.4 there is reference to an additional factor which has caused concern. This is the expansion of care homes across the city. I do not think it is clear if the writers of the paper consider that there will be a further expansion required of care homes in Edinburgh. Our fear is that any future expansion will be provided solely by the private sector despite the poor quality record of the sector. Another fear is there will not be enough GPs and other essential practitioners to provide the services that more care homes, whether public, third sector or private, require.

We would like to see an estimate of the total cost, not just capital costs, of expanding Primary Care Services up to 2030.

As regards item 6.3 we think that section 5 is correct.

“People are living longer at home which means that when they do need health and social care services, they are presenting with more complex care needs than previously seen. People are older and frailer than before, often with multi-morbidity and the current model of care is not designed to meet the needs of people presenting in this way.”

The current model of care has to change. We hope that the trade union movement and the public will be provided with the information that will allow them to express an opinion on the options. 

The trade unions consider that future social care requires a reasonably paid and trained workforce with a set of rights including sectoral collective bargaining. We hope that the consultation documents will provide options and costings on how workforce reforms can be achieved. A frank admission must be made that the race to the bottom over the last decade has undermined social care and brought us to the brink of disaster. It has to be recognised that the development of the so called partnership with the private sector and accompanying race to the bottom has not worked.

The consultation should not just consider meeting needs for substantial and critical care. It should consider more than the status quo. It should consider meeting low and moderate needs as an essential preventative strategy. There should be information on the implications of meeting some or all of low and medium care needs.

It is planned to ask people their views on the role of the private sector on delivering care. We hope that appropriate information will be made available such as the poor conditions of employment in the private sector, poor health and safety culture for both workers and clients. Has anyone studied the quality of private sector homes? Are they fit for purpose?

Are they fit to deal with a pandemic? is their staffing system fit to deal with a pandemic? Has the EIJB ever gathered information on the standard of health and safety within the private sector? Does the sector meet its statutory obligations? To what extent is the EIJB expecting the private sector to meet the increase in future social care demand? Is that extent dictated by the limitations of Scottish Government funding?

Thanks for listening to me. I would be happy to answer any questions or clarify points.

Des Loughney

13th December 2022

Carmen Simón speaking on behalf of the ETUC – 13/12/22

The ETUC is looking forward to the consultation on provision of social care in Edinburgh. We are glad to see that there will be trade unions  involvement in the preparation for this consultation. However, We are concerned about its limited scope. It seems that Social care provision and the crisis affecting social care is impacting only the senior citizens relying on care homes bed based care.  And we know that this is far from the truth.

While we think that tackling bed based care is important , we keep getting reports from members regarding the horrendous situations they are experiencing of long hours and unmanageable workloads at housing support and supported accommodation services.

This is the third deputation in a row that the ETUC have taken part in.  At the first deputation we  raised concerns about 24 hour shifts caused by the staffing crisis in the sector, the potential consequences for the quality of service that is provided and the very serious implications around Health and Safety . This created quite a lot of stir amongst the members of the Board and the local press. My Branch ( UNITE Not for Profit) , consequently produced a paper on this matter which was shared with the Board members. My Branch did not get a response to this paper. On the second deputation, we raised this issue again. We were told that the paper has not been received by some members of the Board so my Branch circulated it again. We are here in this third deputation and my Branch still waiting for a response on this paper.

A couple of weeks ago, one of our members contacted us because he had been asked to be on shift for 41 hours during the Christmas period supporting someone with learning disabilities and challenging behaviour. Let’s not forget also, this member gets paid £10.50 an hour, 

What are the EIJB doing about this issue, which is clearly  getting worse? 

We read in the papers prior to this meeting that Edinburgh has an ageing population , but it also has an increasing  population of all ages and circumstances that will need not only GP and primary care provision, but also social care provision.  What is the plan to recruit and retain staff in the social care sector? Where are the resources to meet need according to the principles of ……,, Early intervention and prevention 2. Tackling inequality 3. Person-centred care 4. Managing our resources effectively 5. Making best use of capacity across the system 6. Right care, right place, right time.

The ETUC. Is concerned about the private discussion of the Assistance program report which took place during the last EIJB meeting.  We were not able to “observe the democratic process” . We are aware that this was not a report done by the Board but commissioned by the Scottish Government. However we are in the dark on what the members thought about the recommendations on that report, recommendations that clearly supported the ideas that the main investment should be done by the private sector; that professionals are overprescribing and that the only way forward is to slash care packages even further than the 8% they were already slashed. .  A report that did not address the staffing crisis that is, in our opinion, the first issue that needs to be resolved. 

ETUC is concerned because of the winter crisis that we are facing. We would like to know how the EIJB will guarantee that the CEC will be able to fulfil its duty of care to their citizens in the current context.

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