In this, the second of our series of posts on the care crisis, Kathy Jenkins looks at what we need from a National Care Service and how the Scottish Government’s planned service, currently before Parliament, fails in almost every respect.
A National Care Service for Scotland
Trade unions and others are expressing many serious concerns about the Scottish Government’s National Care Service Bill.
In responding to previous government consultations, both Scottish Hazards and my Unite Edinburgh Not for Profit branch have put forward the following 12 principles. I have added in italics our concerns about the Bill as it stands.
An NCS should provide care from the cradle to the grave. The Bill does not specifically include children’s services and justice services. It says there were be further consultation on this. The concern is that this might be a signal that they might not be included.
An NCS should be provided free at the point of need, as is the NHS. If this is not possible immediately, there should be a firm commitment to this as a medium-term goal included in any legislation. There is no commitment to this in the Bill, particularly with regard to care home provision.
Scottish Government should begin properly funding local authorities in order for them to build up the necessary infrastructure to absorb not only the current private/ third sector provision of social care in the medium term but also the increasing demand of social care in the long term. Eg building care homes, investing in training and recruitment, investing in community and community development resources. This is not being done. It appears from the Bill that the opposite may be going to happen. Local authorities may become just another provider which has to bid for funds alongside the third and private sectors.
An NCS should be a public service. All of it should be not for profit, most delivered through Local Authorities and some through the 3rd sector. There is no commitment or even mention in the Bill of moving toward a not for profit service.
The NCS at Scottish Government level should be tasked with:
providing adequate ring-fenced resources to provide good quality care to those needing it and fair pay and working conditions to those providing it; The bill makes no absolute commitment regarding funding. It says Ministers ‘may’ provide financial assistance to Care Boards.
establishing collective bargaining involving the NCS, employers and trade union representatives to agree national pay and conditions; although the Scottish Government has said in press releases and verbal statements that this will be done, there is nothing in the Bill that says it will.
design and provide good education and training for all those working in the sector, including a level of education prior to employment and then continued training and education throughout the time of employment; the Bill only says that Ministers ‘may’ provide training
Create a good single IT system including individual health and social care records and collection of data on need, provision, cost, etc; the Bill does largely commit to this
Set national standards for care and for social care contracts. This is not explicitly stated in the Bill although it does go some way toward improving governance
Within this national framework social care services should be the responsibility of democratically elected and accountable Local Authorities. The Bill takes away responsibility from Local Authorities and gives it to unelected Care Boards, a development of current Integration Joint Boards, despite the many problems that have been identified with them and despite this disconnecting care from other related local authority services such as housing, environment, education, leisure, community development…
Local Authorities should then further devolve provision of services to local community hubs which can actively involve service providers, those needing care and those with lived experience to create local, flexible, inclusive services. The Bill does say “services provided by the National Care Service are to be designed collaboratively with the people to whom they are provided and their carers“ but with no detail of how this would happen
The IJB / CHSCB model should be abandoned. Primary and community health services should continue to be part of the NHS and work closely at local level with LA services. The NCS and the NHS should be separate, parallel services working closely together. The opposite is happening with Care Boards positioned to take over much of LA services and some NHS ones
We agree that human rights should be at the core of the service, but they will only be meaningful if accompanied by resources that are sufficient to provide services which can meet need, clarity about where responsibilities lie and a system that prioritises the development of good, sustainable relationships between those providing care and those in need of it. The Bill gives no assurance that these 4 R’s will be met.
Regulation and enforcement are an important element of any service. The Care Inspectorate and SSSC should be merged and work closely with the Health and Safety Executive whose remit of protecting the health, safety and welfare of social care workers (and those being cared for) is equally relevant. The Bill does not say this, however, it does go some way to strengthening governance.
The NCS should fully incorporate and make real all dimensions of Fair Work. Social care staff must be treated as respected and skilled workers, have fair and secure jobs and access to good education and training. Although a commitment to Fair Work is included in the principles laid down by the Bill, there is no detail of how this might be made real, including, as stated above, no commitment to collective bargaining and national pay and conditions
Effective Voice will be crucial to a high quality NCS. Strong collective bargaining must be at the centre. Social care workers should be encouraged and supported to join trade unions, acknowledged in Scotland and internationally as the most effective way to ensure Effective Voice.” Nothing in the Bill recognises this. In fact in the discussion of ‘co-design’ of services it is not clear whether social care workers are included.
There is major concern that there will be no finance to properly fund a National Care Service. It was estimated that the NI increase would bring approximately £1.3bn to Scotland and this was meant in part to fund the NCS. This increase is now not going to happen and more cuts from the UK Government are anticipated.
I have a concern that there is a potential split among those unhappy about the Bill as it stands (including unions). Some are saying we should campaign for the Bill to be scrapped. Others that we should build an alliance calling for major amendments to the Bill. A compromise would be an alliance calling for major amendments and if that fails a call to scrap the Bill. It feels important that we develop a united response.
Kathy Jenkins Scottish Hazards and Edinburgh Unite Not for Profit Branch 27 October 2022
This post from Councillor Ross McKenzie is the first in a series which we place to publish on the social care crisis in Edinburgh.
The ‘Edinburgh Integration Joint Board’ (EIJB) also known as the ‘Edinburgh Health and Social Care Partnership’ (HSCP) was established in 2015 to oversee the planning and delivery of newly integrated health and social care services. At that moment the Council delegated to it significant functions and resources in relation to its responsibilities for social care. This meant a substantial dilution in democratic accountability of a large chunk of the Council’s budget and the running of these crucial services.
At its last meeting, the EIJB discussed a paper on NHS Lothian’s ongoing inability to discharge people from hospital in cases where people require further care upon discharge from hospital – whether that care is ‘care at home’ or whether it’s care in a ‘care home’. The discussion was held in private due to ‘commercial sensitivities’ – an absurd decision give the report had been circulating around trade unionists and journalists for days prior.
When the contract for the delivery of the Christmas markets was discussed in a private council session, there was a queue of councillors and journalists asking why. On Tuesday, the EIJB discussed something far more important in private, yet very few saw fit to ask the same question. The delivery of social care in this city is somehow beyond politics, beyond basic democratic accountability.
Compared to the rest of Scotland, Edinburgh has a particular problem with delayed discharges – it’s an outlier. And it’s no coincidence that Edinburgh is an outlier in another area: Edinburgh is an outlier in the extent to which social care is dominated by the private sector, both in ‘care homes’ and in ‘care at home’. For the most part, provision is determined not by need, but by profitability.
The only serious solution to NHS Lothian’s problem with delayed discharges is the expansion of publicly provided social care based on need. But that isn’t the solution being discussed by the EIJB. Instead, members are being asked to consider proposals to cut the number of hours of ‘care at home’ that people receive, and to approve the expansion of the use of beds in private care homes – private care homes that more often than not provide a very poor standard of care, and almost always provide disgraceful pay and conditions to their staff.
If it wasn’t so serious, it would be laughable to think that less than a year ago the EIJB was trying to close council-run care homes. At the time we heard the argument that the care homes weren’t needed anymore because people wanted to be cared for at home, and new technology would make it easier for them to do so. Yet now we are told that two thirds of delayed hospital discharges are due to a lack of beds in care homes, so we’ve apparently got no choice but to purchase more beds from the private sector.
Meanwhile, there’s a recruitment crisis in ‘care at home’. Again, the solution being proposed is not to expand public provision, it’s not to offer people decent pay and conditions, the solution proposed is to cut the amount of care that people receive.
All of this is apparently beyond politics, beyond democracy, beyond accountability.
That can’t be allowed to stand. Campaigners and trade unions stopped the EIJB from closing the care homes last year by putting the decision into the public eye. The decisions of the EIJB were not able to withstand public scrutiny when it came to closing care homes and I believe the same will be true of any attempt to cut the hours of care that people receive at home.
The privatisation of social care has failed, even on its own terms. Public provision of social care based on need is the only solution to delayed discharges, and it’s the only solution to the wider crisis in the sector.
The Edinburgh Integrated Joint Board met on Tuesday 18th October. One of the major items on their agenda – a Scottish Government report on health and social care in the city was discussed in private (point 11 referred to in the deputations that we post here). Another Edinburgh is Possible held a protest outside the city chambers while members of Edinburgh TUC delivered deputations to the meeting. We reproduce two of the deputations here.
Image by Pete Cannell CC0
Deputation from Edinburgh Trade Union Council
I would like to thank the Board for agreeing to hear our deputation today. It consists of three people. There is myself as Secretary of Edinburgh TUC and two delegates Kathy Jenkins and Carment Simon who have been on previous deputations. We are aware that we have asked not to comment on 11.1 as that item will be heard in private. I will say this that the Report of 11.1 does raise some issues of great public concern which the public need to know about.
Because of the overlap between 6.2 and 11.1 I think that most of our concerns can be raised under 6.2.
The trade union movement have long been aware of the problems of recruitment and retention of all types of social care workers. We raised this issue years ago. We predicted that the outcome of existing policies would be the crisis we face today. We note that 6.2 states that the Scottish Government is going to provide additional support and capacity. This initiative is welcome but we are afraid that additional support will not be enough and will not mitigate the current social care staffing crisis.
The crisis is well illustrated by a leaflet that was put through my door a couple of weeks ago by the Thistle Foundation. The leaflet says that “We’re recruiting!”. The leaflet refers to “Our highly skilled Personal Assistants and Wellbeing Practitioners supporting people in communities across Edinburgh…. helping people to lead full, active and socially connected lives”.
Is the Thistle Foundation offering a skilled wage to its highly skilled workers? No, it is not. The hourly rate varies from £10.89 to £12.02 per hour. It does not offer contractual sick pay nor what seems to be a good pension scheme. It does offer a welcome payment of £500.
Our view is that you will always have problems with recruitment and retention if you do not offer skilled workers appropriate wages, terms and conditions. If the EIJB and the Scottish Government really want to solve the issue of unmet need in Edinburgh then they need a strategy starting now if it is to have any impact during the next six months. The strategy is necesssary if the EIJB and the City Council are to meet their statutory obligations.
Paper 6.2 mentions that there is consideration of setting up what is called a ‘triage team’. To us this team will cut packages of care as assessed by social workers and occupational therapists in collaboration with patients, careers and relatives. Every means will be used by the triage team to reduce hours without any consultation with interested parties. It is a reactionary solution to unmet need. Instead of a bold plan to recruit more staff and create better facilities the EIJB plans to cut the social care service that is available to the people of Edinburgh. The intention is to reduce the average care package in Edinburgh from 14 hours to ten hours per person – and ignore professional assessments.
In August 2022 we had a deputation to the EIJB which described the growing health and safety risks to staff and clients through 24 hour shift working. Following that deputation we were asked to submit more evidence. This we did in a paper that was sent to the Chief Officer and the Director of Operations. We have yet to recieve a response to our paper but I see that there is an acknowledgement in paragraph 44 of 6.2. This says:
“It should be recognised however that, during these unprecedented times, there are likely to be occasions where the level of the demand we are facing temporarily overwhelms our ability to run services safely.”
We appreciate that acknowledgement but we would like to draw the EIJBs attention to the recommendation that we made in our paper:
“UNITE is very concerned at the current way in which 24 hour shift patterns are organised. We do not believe that such shifts are good practice. They are just an expedient way of dealing with financial constraints and staffing shortages. We hope we have made it clear that we believe that the context of organising these shifts needs to change. There needs to be more and better training for support workers and more support from management. Good health and safety needs to be a condition of funding.
We believe that the Edinburgh Integration Joint Board needs to study the quality they expect. Once the quality standards have been established it should provide the resources so that the quality standards can be achieved for clients and social care workers. “
Contact Des Loughney at desloughney@blueyonder.co.uk if you have any questions about anything in this statement
Thank you for the opportunity to address you today. I was heartened by reading in the Systems Pressure Update that some action is being taken and welcome the fact that the Scottish Government has provided additional resource and support. However, I have some questions and many concerns. It isn’t possible to raise them all, but these are among them.
First, I want to echo what my colleagues have said regarding staffing levels and the pay and conditions of staff. One detail I wanted to add is that in para 3 of the paper you refer to the impact of cost of living increases and in particular note the loss of social care hours due to workers not using their cars. My understanding is that the NHS has increased mileage allowances. I assume this hasn’t been done for social care workers, or not sufficiently. If not, why not?
I have concerns regarding para 12 showing a reliance on ‘external care at home’ providers. I would ask what percentage of these are private providers. As you are aware we are arguing and campaigning for a not for profit care service. Obviously, this can not happen all at once, but we would like a commitment to move in that direction.
Para 13 talks about ‘cleansing the waiting list’ and and ‘over reporting’ – presumably of need. In other discussion I have heard reference to ‘over prescribing’ of care. We have concerns about what this means, as in our experience care provision is if anything not enough rather than too much.
Regarding para 15, we would be anxious to know what actions are being taken/proposed to address this shortfall in GP patient places. I have personal experience of the difficulty in finding a GP.
This and other discussions refer to Interim Beds, Reablement, the Community Resilience Programme with the third sector and Step Down services – all presumably part of your Discharge Without Delay programme. It would be very helpful if you could clarify what all of these are and how they all fit together. Additionally, we have major concerns about the fault line between free NHS services and care home services for which people pay. I am unsure how much all of these discharge without delay programmes run into this fault line.
The paper talks about the implementation of TotalMobile. I have looked at some of the online material, including videos. I can see some advantages in relation to the sharing of user and care information, but have major concerns about implications for continuity of care and increased isolation of social care workers. Our vision would be for locally based teams who could get to know local users, provide continuity and support each other. Trade union colleagues familiar with such systems would seek assurances that they would be used as intended and not for staff surveillance or micromanagement.
Para 42 I find it difficult to accept that no direct equalities issues arise from the report – in light of the fact that the vast majority of social care workers are low paid women.
There was an excellent discussion at the conference on September 10th, covering Care, Climate, Housing, Jobs and the Cost of Living. Sadly some people were unable to attend because of the disruption to travel in the city on that day. We were also very conscious that time didn’t allow for all the issues we would have liked to cover to be addressed. So these notes from the conference are work in progress and we aim to build on them over the next few weeks and months to create a charter for Another Edinburgh.
Report from ‘Our City – Our Future’ September 10th, 2022
The conference was organised by Another Edinburgh is Possible and co-sponsored by eleven other organisations (see Appendix for details). Thanks to the City of Edinburgh Unite and Unison branches, the Edinburgh Unite not for Profit branch, Edinburgh Trades Union Council and Edinburgh EIS Local Association for financial support which covered the costs of publicity and room hire.
Introduction
The first session was chaired by Carmen Simon (Unite and Edinburgh TUC) and Mike Cowley (EIS-FELA) provided some context for the workshop discussions that followed.
Another Edinburgh is Possible extends its warmest welcome to attendees this morning. We meet at a time when society stands at a crossroads. The banking crisis and a decade of austerity compounded already existing inequalities. The pandemic exposed ordinary people to still further pain. Neither event affected our communities equally. People working in essential services, the poor and people of colour suffered disproportionately from a virus the UK government saw not as a humanitarian emergency but as a means of enriching friends and Party donors. Now an energy and cost of living crisis threaten to tip millions of people over the precipice. We are in a national emergency. Yet with some honourable exceptions, the political classes behave as if the old, failed prescriptions can resolve the problems. The new Prime Minister, Liz Truss, elected by a tiny fraction of the UK population, proposes as ‘solutions’ tax cuts for the rich and an end to the moratorium on fracking. We have reached the stage where history repeats itself not as tragedy, but as farce.
We hope today will provide an opportunity to identify ways in which individual groups working to defend public services, support vulnerable members of the community or campaign around housing issues can work effectively together. Our core themes are Care, Climate, Jobs and Homes. The TU movement has once again demonstrated that determined collective action can win not only significant concessions for ordinary people in the shape of pay, terms and conditions. When people act in concert, their solidarity can shift the public conversation. What was once seen as impossible becomes a viable option.
We aim to emerge from today’s sessions with concrete ideas of how to share resources and experience, and to identify campaigning priorities which build enduring alliances across our campaigning bodies. Good luck, and solidarity, everyone.
The discussion that followed was organised around three themes: Care, Housing and Climate. Two additional themes, Jobs and the Cost-of-Living Crisis ran through all three sessions.
Workshop 1 – Care
Carmen Simon and Ross McKenzie introduced this session
Participants in the discussion made the following points.
Campaigning stopped the closure of 4 of the 8 remaining local authority run care homes in Edinburgh, last year. Another Edinburgh is Possible provided a forum where local authority trade unions and community activists could organise together.
Issues: public sector homes are set to close if action not taken. 2) national care service is not functioning as it should i.e., not balancing with private sector. 3) Poor pay and conditions. – campaign to focus on what the issues are and most effective way to address them. Unions, social activist can work together but workforce is not well organized because of conditions. Crisis is bigger than acknowledged. Assessments are not happening, and staff are not well trained and remunerated. The basis for the NCS is not sound. There will be opportunities to shape and respond to the proposal.
Problem is wider – need to tackle funding issues more broadly
People using care services need to be heard. It’s harder to get care in a crisis as advice is to refer to community / voluntary services.
Services stopped providing proper care during pandemic and never reverted back.
Brexit has had a negative impact on workforce – qualifications required are another barrier to entry.
The mooted National Care Service might make it easier to improve pay and conditions but ‘top down’ service model from central organization is not ideal. Acute services are priority and others left to flounder. Funding is one main issue. People kept in institutions when they need not be is another.
Campaign could focus on changing perceptions of care service workers to acknowledge skill and professionalism. More effective than striking – public perceptions of strikes is generally positive right now. Can a campaign capitalize on this?
Lack of care workers in the community is inefficient as hospital care has to cover for shortfalls.
Main forms of training – HNDs and HNCs in care work are not working – many new entrants to care work are lost to the sector within a year of first entering employment after achieving their qualifications – this links to low pay, poor conditions, and low morale.
Important to involve care workers in the conversation, encourage them to join unions and fight their corner for the sector. Government and local authorities are part of the problem as outsourcing to private providers leads to further inefficiencies / loss of resources.
So many people in the community have negative experiences of care sector – important to find ways of involving them in campaigning for a system that puts people before profit.
Win battles to fight the war – story about 99 y o on a trolley in a corridor in ERI.
Health service workforce is not highly unionised. Campaigning at community level could change this. Need to defend the core principles of a welfare state. Demand public consultation – this is likely to happen. Too many managers – UNISON coordinator for Edinburgh campaigns on this issue – need to reach out to councillors and MPs, and to unionise and unite different workforces and campaigns.
Disabled people need to be central to campaigns around care especially (and other issues too – we are disproportionately affected by everything!) and there needs to be more links with disabled people’s groups
A lot has changed over the last three years and the impact needs to be more public. Quantify what has changed in terms of pay and conditions for workers and service user experiences. Research already being done in this area could be shared more widely and used as a basis for involvement in decision making and preparing a response to the proposal Provide an alternative proposal based on user and worker narratives. Societal problem is that people are not valued unless they contribute economically).
Workshop 2 – Climate
Mike Cowley and Johanna Carrie introduced this session
We hear from scientists how advanced the climate problem is.
On Saturday 17th September at the Augustine church there’s a meeting with break out sessions on climate. Individual use of energy in the home can make a difference collectively. Community heat networks are a proposal on the table – to be encouraged. Edinburgh Community Solar Coop – an ongoing investment initiative and the Hydro scheme in Balerno are examples of renewable sources.
Scottish Government Net Zero strategy is short on details of what it means in practice.
During the discussion the following points were made:
Doing major work on Victorian tenements will need council support (like refurbishment grants of 1970s / 80s?).
The way tourism operates is a problem as so much useless rubbish is produced, sold and binned. Individual action is important but so is leading by example for the council.
District heating schemes / collective refurbishments / other community initiatives a better approach than individual improvements. Building standards need to change for insulation and heating (passive house standard).
Join with young people taking direct / autonomous action against climate change.
Local activism in a global context. Campaign in Muirhouse an important victory with experience to share.
Building 60,000 houses in Edinburgh but not linked to energy centre – cooperative solution is worth promoting. Need a climate plan for Edinburgh.
Other countries (Pakistan) are suffering the effects of our actions.
The cost of electricity is linked to cost of gas for no reason. Scotland produces a lot of renewable energy, but citizens do not reap any benefits from this.
Support for renationalization of energy companies is growing. It’s nonsense that the PM is handing out money that will end up contributing to profits of big energy companies.
Granton housing development will be net zero – council should be pressured not to approve developments that aren’t.
Renationalization is working in France – why not here?
New builds should be required to use environmentally sound materials (not concrete).
Net subsidy to the North Sea oil industry over its lifetime is £250bn and this is about to rise by more than £100bn in just one year. Stop this madness!
Campaign for a district works dept in Edinburgh – connect to colleges to develop a skilled workforce. The council argues that major building / renovations projects need to be outsourced and skills are not currently available in the private sector. Direct works and good training is the answer.
Cost effective solution is to insulate not build passive houses which are expensive.
Eating meat, driving cars are climate crimes.
E-Bikes are a solution to transport problems.
Workshop 3 – Housing
This session was introduced by Robyn Kane,Ruaraidh Dempster from Living Rent and Maddie Lou Barink from Shelter Scotland.
Maddie Lou Barink: Housing relates to all other topics under discussion today. Living Rent has run successful campaigns in areas of Edinburgh. Only 1/3 of all new developments are social housing so the problem will never be resolved. There are 25,000 people on the waiting list so it’s hard to see how the problem will ever be resolved. Students and tourism exacerbate the issue as it takes many houses out of the long term, affordable residential market. UNITE and UNISON members working in council have power to influence. Thousands of people get turned away from homeless services in Edinburgh every year. If council can’t meet their obligations for whatever reason, they need to state what they need ask demand government provides. Solution is to build and buy more houses – ScotGov has money – it’s a political choice not to spend it on housing. Shelter Scotland has explored ways (e.g. Cables Wynd) to build community support / activism and get council involved in plans. October – six-week program on building activism / campaigns – aim is to build networks / groundswell to spread the impact.
Ruaraidh Dempster: rent freeze and eviction ban even for 8 months is a small step but still a victory to be celebrated. One person (woman in Glasgow with autistic son) started a campaign that resulted in a blanket ban on evictions during Covid. Rent freeze campaign used research and outreach to generate 5-6K submissions in support of rent freeze. Local campaigns linked into national campaign gives power. Rent should be tied to amenities in property and the area. Keep pressure on government to introduce rent controls. Living rent has worked for 5 years to won positive results and will continue campaigns.
Robyn: Culture in council is a problem – employees treat people with contempt when they complain about problems the council has an obligation to fix. The Moredun protest wasted council money but won the case against new housing development on the green.
The following points were raised in the discussion:
Some council housing is sub-standard and being allowed to run down leading tenants to resort to dangerous practices to heat uninhabitable homes.
Everything is intertwined – can’t separate issues out – and even though we individually can’t be involved with everything, it’s important to be aware of what else is going on and to find ways of supporting other campaigns when it’s useful
We need to do research e.g., how many unoccupied homes in Edinburgh – to support demands
We need to see commonality and not get divided – e.g. my experience of divisions between council tenants versus home owners in my high rise made organising very tricky. We must watch for that sort of division “it’s alright for you lot!” sort of thing.
Ross McKenzie Campaign for market rents – compile stories about sub-standard homes and council refusal to accept responsibility. Rent control and rent freeze – ScotGov has finally accepted responsibility now need to be held to account. Housing supply – council remedy is to promote mid-market rents but outsourcing to housing associations results in high rents, sale of houses and unfair redistribution of wealth.
Tourists and residents see different sides of Edinburgh. Most resources get directed to tourism and the city centre. Residents should share wealth generated from tourism. Council claims to deal with most requests effectively but experience suggests otherwise.
We live in one of the richest countries in the world – but where is the wealth? (Concentrated in a few greedy hands). Working people want hands on the knife to cut the cake as they choose.
Proposals going forward
Nothing inevitable about weak voices in council or government and we need to keep pressure on our representatives. Money wasted by hiring private companies to fix things. Spending a lot of money but not wisely.
All topics intersect. Progress does not rest in any one area. Maintaining status quo must be socially unacceptable to those sitting on councils and committees for change to happen. Shift the metrics.
Wrap up
Social justice across the areas – can different groups collaborate / network to build strength?
Build a charter of demands for housing to bringgroups and organizations together.
Stop outsourcing of public money to private interests.
Stop outsourcing jobs via a direct labour / Dept of Works
Stop outsourcing of in temporary accommodation to vote – it empowers them
Tie rent to quality of property
Demand long term rent freeze and no evictions policy
Rent control / accommodation standards with enforcement plan
Push for more council housing to be built and an end to homelessness
Regulate landlords (some are skimming from the public purse)
Link housing problems to human rights issues
About Another Edinburgh is Possible
Another Edinburgh is Possible was formed in 2022 when activists from existing campaigns, including Edinburgh East Save our Services and North Edinburgh Fight Back met together to discuss what could be done about the long-term crisis in the provision of local services in Edinburgh. The latest version of our campaign statement reflects the shared perspective that was developed at the early meetings of the campaign:
It is time to end the cycle of cuts to vital local services in our city. Austerity, outsourcing and privatisation has been legislated by Westminster via Holyrood and implemented by the City Council for too long.
Edinburgh has the lowest expenditure per capita on local services in Scotland.
Since 2012/13, Edinburgh City Council budget cuts have amounted to more than £300 million. If nothing changes, more huge cuts will inevitably follow over the next three years.
The cuts have already had a terrible effect on essential services. The most vulnerable, already exposed to cuts in social security benefits, have suffered most.
Covid19 added to an already bleak picture with increases in unemployment, child poverty and mental distress. The pandemic shone a harsh light on the gaps in local services and underlined the importance of key workers and provisions for health, social care, housing, and education.
Now huge increases in gas and electricity prices and the rapidly rising cost of living are tightening the screw further. This is not sustainable. We can’t go on in this way.
There is money to fund the services we need. The Westminster government paid more than £30 billion to private companies during the pandemic for outsourced services and equipment that was mostly wasted. Westminster, Holyrood and Edinburgh are all committed to outsourcing services to private providers who then rake off a large percentage of our local and national taxes to pay dividends to their wealthy shareholders. We need an end to outsourcing and the rebuilding of publicly run and democratically controlled local services. The wealth generated by our workers, service providers and service users could be sustainably invested to rebuild our city’s essential infrastructure.
For too long our city has been undermined by Westminster cuts, and a compliant Holyrood parliament, and meekly implemented by Edinburgh City Council. We call on elected councillors, MSPs and MPs to join us in linking the local with the national picture and campaigning for a reallocation of resources to transform lives and livelihoods for the better.
The day is designed to be participative so that individuals and campaigns can share ideas and strategies and learn from each other.
The conference is co-sponsored by Edinburgh Campaign Against Poverty, Zero Covid Scotland, Edinburgh Climate Coalition, Unite (City of Edinburgh Council), Unison (City of Edinburgh Council), EIS-FELA Edinburgh College, Edinburgh Trades Union Council, Unite Edinburgh Not For Profit, Muslim Women’s Association of Edinburgh, Edinburgh North and Leith Labour Party
The outline programme is: 10am Registration
A chance to register, grab a cup of tea and check out the stalls
10.30am Introductions to the conference
This first session is chaired by care worker Carmen Simon and will include some short contributions to set the context for the rest of the day
11.am Workshops on each of the 4 themes of the conference
The 4 themes are Care, Housing, Climate and Jobs – you’ll need to choose which one you want to start with. After 2 or 3 very brief introductions from different campaign perspectives the rest of the time will be spent in discussion on sharing knowledge and experience and discussing priorities and possible strategies.
12pm Feedback and discussion
There is then plenty of time for feedback from each of the groups and the chance for further discussion.
1pm Lunch
There’ll be tea (including non-caffeine options) and coffee available all day. We will also supply biscuits and fruit. There are food outlets a short distance from the venue but we’d encourage you to bring a packed lunch and/or food for sharing so that discussion can continue over the lunch break.
1.30pm Workshops on each of the 4 themes,
The aim is to build on the mornings sessions and focus on action. You can continue with the same theme as in the morning or switch to another.
The hall at the Greyfriars Charteris Centre is large and airy. However, if you have any symptoms or have been in close contact with someone else who has Covid please test before you come to the venue. If you’re positive or if you’re negative but have active symptoms please keep others safe by staying at home. We are committed to sharing as much as possible of the discussion and outcomes via video and text and will also be organising follow up events to take the campaign forward.
The Edinburgh Integrated Joint Board met on Tuesday 8th August. It seems that the proposed public consultation on closure of publicly run care homes will not begin until December 2022. Members of Edinburgh Trades Union Council (ETUC) submitted deputations on care and we reproduce them here. ETUC would welcome comments from social care workers, carers and clients. Email us at edinburghjustrecovery@gmail.com and we’ll pass your comments on.
DEPUTATION TO EDINBURGH JOINT INTEGRATION BOARD 9/8/22
Since the end of the lockdown, social care providers in Edinburgh have been experiencing a problem of recruitment and retention of staff that is increasing exponentially. Many social care workers have left the sector because of traumatic experiences during covid ( lack of PPE and guidance, stress etc) . This problem of recruitment and retention has been amplified by the consequences of Brexit and the cost of living crisis.
Social care workers don’t want to remain in a sector that pays low wages and demands a high level of responsibilities, a sector that is not able to meet inflation when it comes to annual pay raises. A substantial number of care workers are moving to other sectors like retail, where terms and conditions are similar and even better , and they have less responsibilities.
Union reps and members are reporting staffing levels so low that social care workers are expected to work 24 hours shifts, as many as three per week. Sometimes the provider is not able to supply enough staff to cover shifts ( ie. If two service users who are in a two to one support plan leave nearby, sometimes instead of having 4 workers available for the whole shift, they have three workers, one of them floating in between flats). Social care workers are exhausted.
We are aware that in many cases new staff members don’t receive adequate induction to the job, in some cases no induction whatsoever. We are talking about workers who support adults in the community with high levels of care and support needs, including challenging behaviour, learning difficulties , mental health issues, addiction problems etc.
It is easy to see this low level of staffing and lack of adequate induction/training has also other major implications in terms of Health and Safety.
Exhausted and /or under trained workers make mistakes, mistakes in this field can have huge implications for the wellbeing of the people receiving the service and the care workers. ( ie, mistakes with medications, accidents/incidents with the use of appliances like hoist.) Our reps are reporting an increase in the number of care workers being assaulted in the workplace by service users and an increase in stress-related sickness absence. No wonder, many new staff members don’t last in the job because there are no resources in place to enable them to do the job with confidence and safely.
Even more worrying from the union’s point of view, is the increase of disciplinary processes and dismissals taking place in workplaces when incidents occur because of the reasons we just listed. Workers are being punished by employers who have not been able to provide proper training and who have asked workers to do 24 hours shifts. In essence workers are being made responsible for their employer’s failure to manage a service. Workers are being punished because there are not enough resources available in the sector to make it possible to work safely. This is the last turn of the screw, for many workers in the sector.
We call for the EIJB to commit to properly fund social care services in the city to sort this problem.
Carmen Simon
Edinburgh Social Care Consultation and the current crisis in Social Care
I wish to thank the Board for agreeing to hear our deputation from Edinburgh Trade Union Council. My name is Des Loughney and I am the secretary of Edinburgh TUC. The other member of the delegation is Carmen Simon who is the vice chair of Edinburgh TUC and who is a social care worker. She has over ten years experience of being a frontline social care worker in Edinburgh.
We wish to comment under two headings of your agenda. The first is item 6.3 which is the Lothian Strategic Development Framework which we believe encompasses the forthcoming public consultations on the future of the four care homes and the future of social care in Edinburgh. We also wish to comment on the current worsening crisis in third sector social care provision in Edinburgh. We wish to comment on the letter we were copied into dated 2nd August from the Edinburgh Health and Social Care Parnership and signed by Jacqui Macrae, who is a non voting member of the EIJB.
I will be addressing the Board on the public consultation issues, as we perceive them, and my colleague will talk about the current crisis in social care which is having a detrimental effect on the quality of social care and the terms and conditions of the workforce.
As we had not heard for some months about the consultations we thought it would be worth saying to the Board how we expect the consultations to be conducted and what information we will need to come to a view on the consultation options. As we have said in previous deputations the information the public and the local trade union movement receive should help with answering our questions and not just the questions of the Board and management. We do not want options to be curtailed by financial assumptions which beg political assumptions about the funding available.
The report in 6.3 touches on the shortage of workers due to demographic changes. That is one factor but there are other factors which influence the availability of social care workers. We hope that the consultation will provide full information on how BREXIT has affected labour availability; on the lack of skills and training,on poor terms and conditions, and the absence of attractive career progression that might result in a higher income, and on the physical and mental health impacts of understaffing and lack of good support and supervision. We hope that the form of the consultation will recognise that trade unions are essential stakeholders in the provision of a quality service and their concerns need to be addressed. We hope that the consultation will address the stark contradiction that workers in the third sector and the private sector who do similar work to those employed in the public sector get paid much less per hour and do not enjoy the benefits of contractual sick pay and similar pensions.
We hope that the consultations later in the year will apply the same analysis of the private sector as it applied to the public sector. The EIJB accepted that that the four care homes were not up to modern standards and could not be refurbished to those standards. There was no analysis of the standards in the private sector which the COVID period showed were often inadequate. We refuse to accept the view of the EIJB that the private sector are ‘partners’ in the provision of social care. The main concern of the private sector is all about making profit. The private sector has an ethos and system of values that is far removed from being part of the welfare state and providing a quality service to the public and employing skilled workers on decent terms and conditions. This has always been seen as inappropriate for the NHS and should be seen as inappropriate for social care.
The trade union movement, and we believe the public, will want the consultations to be frank about the future role of the private sector in Edinburgh. We believe that the forecast increased demand for low level social care, for moderate social care needs, for substantial social care needs, for critical social care needs, should be met by public sector or by third sector provision. We want the consultations to provide the public with the information to choose this option if they wish. The option should be not be removed because the officials believe that the private sector are essential partners whose role cannot be altered or must increase. We do not think it is right that it can be suggested by the EIJB that there is no practical alternative to handing over social care in Edinburgh to the private sector.
We have some questions regarding the letter from Jacqui Macrae. We would ask why the trade union movement and the public should have confidence at all in the Consultation Institute. I have looked at their website and they do not claim any expertise in consultations that deal with complex workforce issues or critically evaluating the role of the private sector. The letter later refers to ‘stakeholders’ and the long term care options they would wish to see. We would like specific reference to and acknowledgement to be made that key stakeholders are the social care workforce and their trade unions. Why is the summer needed to identify the concept that the workforce and their unions are key stakeholders?
The letter refers to ‘ we will share our vision, and present and show data providing context on the Edinburgh picture we now know and in the future’. We hope that this will be true and will take account of the impact of Long Covid and the postponements and delays in treatment/operations that were an outcome of the ongoing Covid epidemic. The experience of COVID has redefined future social needs. We hope that a full account will be taken of the growing impact of the cost of living crisis, fuel poverty and child poverty.
Thank you for listening to me. I would be pleased to answer any questions that you might have.
The Scottish Government has published plans for a National Care Service. The new service would rely on outsourcing to the private sector. We believe there is no room for profit in care. The recent report Profiting From Care shows how private providers siphon off money to investors that could and should be spent on care. See our draft letter below which you can download, adapt and send to your MSP.
Our care service needs to be improved.
It is urgent to
Take profit out of care
Improve pay & conditions for workers
Make care local & accountable
Ensure adequate funding
Make care a free service
The social care bill is going ahead without taking crucial issues into consideration.
The legislation focuses on centralisation.
It misses our chance to make any real improvement to care & care work.
The Green manifesto and the Labour manifesto committed to halting the privatisation of the care service.
The STUC report, ‘Profiting from Care: why Scotland can’t afford privatised social care,’ explains how making care a business for profit adversely affects the quality of care and care work. The links between privatised care, poor outcomes and excessive profit extraction are set out in the report.
People in Scotland want to keep the NHS as a public service and when surveyed people have the same opinion about care. Many of us have experience of the shortcomings of the present approach.
We need to take the profit out of care. We must make caring a respected job. We need to make the service kind and humane.
As one of your constituents, I am writing to draw your attention to the STUC report ’Profiting from Care: Why Scotland Can’t Afford Privatised Care.’ It considers the problems of the current care system and suggests ways to make it more effective and humane.The links between privatised care, poor outcomes and excessive profit extraction are set out in the report.
I ask you to use your influence to take profit out of social care.
It is time to act. The social care consultation and bill are going ahead in Scotland without taking this crucial issue into consideration. The legislation seems to focus on centralisation and misses our chance to make any real improvement to care & care work.
Have you read the report?
Do you agree the profit motive adversely affects the quality of care and [care] work?
Do you think it is something that has to be changed?
In Scotland the prevailing view is for keeping the NHS as a public service and when surveyed people have the same opinion about care.
It is a popular issue. Many already have direct experience of the shortcomings of the present approach.
You are in a position to clarify the care issue and coordinate the widespread desire for a humane service. Any party working towards this would benefit. The Green manifesto committed to halting the privatisation of the service as did the Labour one.
As my MSP I would like you to lead the way on this. I think it would increase your popularity.
I rely on you to take these suggestions forward with urgency. I hope you will agree this is vital for the wellbeing of the people of Scotland.
A new report ‘Profiting from Care – why Scotland can’t afford privatised social care’ was launched in Edinburgh today. Here we share a short summary of the report’s findings and provide a link to the PDF version. It’s well worth reading in full. We’d love to publish longer reviews of the report or short reflections on the issues it raises. Email us at edinburghjustrecovery@gmail.com if you’d like to make a contribution.
The report, commissioned by the STUC, finds that Scotland’s large private social care providers are associated with lower wages, more complaints about care quality, and higher levels of rent extraction than public and third sector care providers.
Written by Christine Berry, Sara Mahmoud and Mike Lewis, the research finds:
• Nearly 25% of care homes run by big private providers had at least one complaint upheld against them in 2019/20, compared to 6% in homes not run for profit.
• In older people’s care homes, staffing resources are 20% worse in the private sector compared to the not-for-profit sector.
• Privately owned care homes only spend 58% of their revenue on staffing, compared to 75% in not-for-profit care homes.
• Over the last six years, the public sector has paid on average £1.60 more per hour to care workers.
• The most profitable privately owned care homes take out £13,600 per bed (or £28 of every £100 received in fees) in profits, rent, payments to the directors, and interest payments on loans. This compares to £3.43 in every £100 in fees for the largest not-for-profit care home operators.
The report argues that a truly transformative National Care Service must be based on a not-for-profit public service, delivered through local authorities with an ongoing role for the voluntary sector. It calls for the Scottish care home estate to be transferred out of private ownership gradually over time – for instance, through a multi-year plan backed up by Barnett consequentials from the UK government’s NI tax rise, Scottish National Investment Bank loans, ‘care bonds’ or capital borrowing. With ‘financial leakage’ in the region of £100 million per year, the report argues that, for the most extractive providers, this could pay for itself within a matter of years.
Over the last few weeks we’ve been working on an update to our campaign statement. This version was approved at the campaign meeting on 9th June 2022. (You can download the statement here).
Another Edinburgh is Possible
It is time to end the cycle of cuts to vital local services in our city. Austerity, outsourcing and privatisation has been legislated by Westminster via Holyrood and implemented by the City Council for too long.
Edinburgh has the lowest expenditure per capita on local services in Scotland.
Since 2012/13, Edinburgh City Council budget cuts have amounted to more than £300 million. If nothing changes, more huge cuts will inevitably follow over the next three years.
The cuts have already had a terrible effect on essential services. The most vulnerable, already exposed to cuts in social security benefits, have suffered most.
Covid19 added to an already bleak picture with increases in unemployment, child poverty, mental distress and the long term effects of Long Covid. The pandemic shone a harsh light on the gaps in local services and underlined the importance of key workers and provisions for health, social care, housing, and education.
Now huge increases in gas, electricity and fuel prices and the rapidly rising cost of living are tightening the screw further. This is not sustainable. We can’t go on in this way.
There is money to fund the services we need. The Westminster government paid more than £30 billion to private companies during the pandemic for outsourced services and equipment that was mostly wasted. Westminster, Holyrood and Edinburgh are all committed to outsourcing services to private providers who then rake off a large percentage of our local and national taxes to pay dividends to their wealthy shareholders. We need an end to outsourcing and the rebuilding of publicly run and democratically controlled local services. The wealth generated by our workers, service providers and service users could be sustainably invested to rebuild our city’s essential infrastructure.
For too long our city has been undermined by Westminster and a compliant Holyrood parliament with cuts meekly implemented by Edinburgh City Council. We call on elected councillors, MSPs and MPs to join us in linking the local with the national picture and campaigning for a reallocation of resources to transform lives and livelihoods for the better.
The elections for Edinburgh City Council take place on May 5th. You can find the list of candidates on the council website.
Over the last eighteen months Another Edinburgh is Possible has been developing a list of actions and ideas which we think would contribute to the transformation of public services in the city. We’ve turned these into a series of pledges (see below) which we are asking candidates to consider and sign up to. The list of pledges doesn’t cover every area of the council’s activities, it’s work in progress and we welcome your contributions.
We are also holding an online hustings event on Thursday 21st April from 6.30am until 8pm – register for the event here. We are aiming to make this event as participative as possible – we want candidates to hear your voices. We’d like to group questions together by topic, so while there will be the possibility to ask questions on the 21st, priority will be given to questions notified in advance. If you have a question for the candidates please email it to edinburghjustrecovery@gmail.com and let us know whether you’d prefer to ask the question yourself or to have it read by one of the co-chairs.
Pledges
Introduction
Tonight, in one of the wealthiest cities in the world, children and families in Edinburgh will go to bed cold and hungry. The Edinburgh Poverty Commission reports that in some areas, 27% of residents are officially designated as living in poverty. Meanwhile, according to Oxfam, global billionaires increased their wealth by $5 trillion during the pandemic. In the same period, the collective wealth of the ten richest men in the world doubled. Clearly, we are not all in this together.
Another Edinburgh is Possible is a grassroots campaign linking up community activists, trade unions and Edinburgh Trades Council to build public support for defending and extending local government services. Campaigners have come together to oppose privatisation and wealth flight out of our city. We have surveyed the Edinburgh public on what they think their Council’s priorities should be. Our results showed a clear demand for elected representatives to be closer to the people who elect them, and for officials to be accessible and responsive to residents’ concerns.
We support a rent cap on private rented properties and a windfall tax on energy companies making tens of billions annually while avoiding taxes which could pay for a move towards sustainable provision. We argue for bringing local government services back in house. We want elected Councillors, not unelected quangos such as the Edinburgh Joint Board, to make transparent decisions on care that affect families, residents and staff across the city. We argue for restoring democratic accountability to the running of our city’s infrastructure.
We argue for the extension of free transport, the maintenance of places for parks and people and not commercial activity, and for care to be removed from the marketplace and made freely available to all in need.
The Pledges below summarise the key commitments we hope and expect candidates of all parties standing in the May 2022 elections to sign up to. They have been developed from the responses to the OU City survey which we conducted at the beginning of 2021 and at the meetings that we have held over the last 18months. They do not represent a completely comprehensive list or represent the entirety of our ambition for the city. They describe the least our communities should expect. The Pledges are based on values we think the provision and running of Edinburgh’s services should be firmly based on. If these Pledges are consistent with your ambitions for our city, we would ask that you show your support by putting your name to them.
Local government finance
If elected
Will you commit to reviewing the regressive council tax with a view to replacing it with a progressive alternative?
Will you support calls to in-source services to ensure wealth created in Edinburgh stays in Edinburgh?
Will you commit to building a campaign to force Holyrood and Westminster to provide a settlement consistent with the needs of our city?
Will you support calls to end out-sourced public services and to severely limit the use of, and expenditure on private sector consultants?
Transport
If elected
Will you campaign to extend free public transport?
Will you limit the number of tourist on/off buses allowed to operate?
Will you retain & maintain ‘Spaces for people’ as introduced during Covid?
Green spaces
If elected
Will you argue for stopping use of public spaces and parks for commercial activities?
Will you argue for disincentivising and controlling the hard surfacing of private green space i.e. garden space?
Hospital parking
If elected
Will you commit to ending parking charges for all staff, patients and visitors in hospital carparks
Save our care homes
If elected
Will you campaign to keep the four threatened council run care homes open?
Will you argue for the council to borrow from the Public Loans Board to finance a first-class care service in Edinburgh?
Social Care
If elected
Will you argue that social care is a public good?
Will you campaign to take profit out of care?
Will you commit to Improve pay & conditions for workers in social care?
Will you commit to making care local & accountable?
Will you campaign to ensure adequate funding for social care in Edinburgh?
Will you commit to making care a free service?
Will you commit to campaigning to enusre that the proposed National Care Service is based on the principles outlined above?
Council Housing
If elected
Will you commit to improving the system to help prevent the formation of mould, damp and condensation in tenancies?
Will you monitor whether the new resolution team is improving the complaints procedure and if not commit to further action in the interests of tenants?
Housing
If elected
Will you campaign for the return of council housing at volume with a focus on warm, well-ventilated homes, for the reuse of empty homes and for tax policies that encourage the repair and reuse of old homes?
Climate action
If elected
Will you commit to rebuilding a direct works workforce that is well trained and secure and can take the lead on home insulation, retrofitting and district heating?
Will you ensure that regulations for new building in the city requires that new houses are built to passive house standards?
Local Democracy and accountability
If elected
Will you campaign for the reintroduction pf the public petitions committee?
Will you commit to the council ensuring that its systems for responding to the public are fit for purpose? (In response to the Our City Survey many people reported difficulties in making contact, lack of response and failure to deliver on commitments made)
Ventilation in schools and other public buildings
If elected
Will you ensure that the council develops and implements policy on healthy working environments so that CO2 monitors, filter systems and good ventilation is the norm?
Another Edinburgh is Possible 