I am proud to lead a debate that calls for greater recognition and support for all those who provide care, whether by working in our overstretched social care sector or by providing unpaid care, and I am proud to commit to the principle that high-quality social care should ultimately be free at the point of use. I thank all those who have provided well-evidenced briefings, as well as the young and adult carers and staff who shared their experiences with me when I visited Edinburgh Young Carers Project this morning.
The introduction of free personal care for the elderly has rightly been regarded as a success, as it provides greater security and dignity to elderly people across Scotland. That is truly a case of Scotland leading by example. However, in previous debates, we have heard that social care charges for those who are under the age of 65 put people under financial strain and limit their independence. The Scottish Greens fundamentally believe that social care is essential to people’s health, dignity and control.
Recently, the Scottish Government has committed to making social care at home free for those who are in the last six months of a terminal progressive illness. There have also been proposals to make social care free for all those who have conditions such as dementia and other degenerative neurological conditions. I applaud all the campaigners, charities and constituents who have pressed hard for those changes—not least Amanda Kopel, who has campaigned for Frank’s law, and we cannot fail to pay tribute to Gordon Aikman, whose contribution cannot be overestimated.
Such steps are positive but, in the long term, we must be wary of moving towards basing entitlement to free social care on a particular medical diagnosis. Many people believe that that is discriminatory and cannot be justified. If a person needs the care, they need the care—it should not matter what condition they have or what age they are. That is why the Scottish Greens believe that we must commit to funding high-quality social care that is ultimately free at the point of use for all, regardless of age or medical condition.
We know that the Scottish Government has commissioned a feasibility study on extending free personal care to under-65s—initially for people with dementia, but with consideration of all conditions. The Cabinet Secretary for Health and Sport previously told us that she would be happy to use that study as the focal point for cross-party discussions on extending free personal care to under-65s. I ask the Government to update us on the progress of that study and to tell us when it will share the findings. It is time for the discussions on progressive changes to social care policy to begin and for the Government to make clear its position on the abolition of all social care charges. The integration of health and social care strengthens the case for moving towards a truly cohesive health and social care system that is free at all points of use.
The debate is about unpaid carers, too. According to Carers Scotland, unpaid carers save the Scottish economy £10.8 billion, which is close to the cost of providing national health services in Scotland. Three out of five of us will become carers at some stage in our lives, but the value of the work that carers do is not recognised. Nobody should face poverty because of the care that they give, but research by Carers Scotland shows that a third of carers struggle to pay utility bills, 47 per cent have been in debt and half of carers struggle just to make ends meet.
Carers UK’s caring and family finances inquiry found that, on average, carers lose £20,000 a year by choosing to care and about 35 per cent of carers who care for more than 25 hours a week are in poverty. The cost of caring goes on, because of lost earnings and lost opportunities to build up pension contributions. One of the young adult carers who I met this morning had to turn down a university offer because of caring, and another lost a job because of caring responsibilities. The impact of caring on earnings is very clear.
The Government made a manifesto commitment to increase carers allowance to the same level as jobseekers allowance and has been reviewing the “financial implications” of topping up carers allowance. We cannot allow support for carers to be delayed or reduced, so I invite the Government to make clear its plans to deliver that manifesto promise. That top-up does not go far enough—bringing carers allowance into line with jobseekers allowance does not recognise the vital work that carers do. That is why the Scottish Greens campaigned to lift carers allowance by 50 per cent, to £93.15 a week.
We want to secure a fair settlement with the United Kingdom Government and local authorities, so that any increase in the allowance will not interfere with the payment of other benefits or increase care charges that people pay. There should also be a premium for those who care for more than one person. The Government intends to increase carers allowance for those who care for more than one disabled child; I urge it to take a broader view and consider everyone who cares for more than one person, no matter what age they are.
I am glad that the Government has agreed to consider introducing some form of young carers allowance, because we must provide better support for young carers and young adult carers. There are at least 29,000 young carers in Scotland with significant practical or emotional caring responsibilities. The demands of caring can have a detrimental impact on young people’s mental health, educational attainment and overall wellbeing.
There is also strong evidence that the most financially vulnerable young people are disproportionately likely to have caring responsibilities. Recent research for the Children and Young People’s Commissioner Scotland indicates that 27 per cent of young carers come from the most deprived 15 per cent of areas of Scotland. The Carers Trust stresses that young carers are always children, first and foremost. We should minimise their practical caring responsibilities wherever possible and provide additional support in a way that prioritises their education and personal development.
The Carers (Scotland) Act 2016 is a good step forward; there was broad cross-party support for that important piece of legislation, which put carers’ entitlement to support and respite on a statutory footing. Regardless of a carer’s age, the importance of access to respite and the positive impact that respite has cannot be overstated, and we have a duty to make sure that those rights are delivered in practice. Many people do not realise that they are carers and do not know that they are eligible for support.
I call attention to the role that employers can play in supporting carers. Juggling work and providing care is tough and, all too often, it gets too much. The organisation Employers for Carers points out that there are costs for companies when they lose staff because of their caring responsibilities. As our population ages, we need to develop more forward-thinking employment policies and make paid leave for carers widely available. So far, only five employers in Scotland have been awarded exemplary status by Carers Scotland and the power company Centrica is the only one in the private sector to have received it. It is therefore clear that employers of all kinds have a way to go.
I turn to the need to strengthen pay and conditions in the social care sector. The Government’s commitment to paying social care staff the living wage was welcome and I am glad that it has extended that commitment to personal assistants and social care workers in day centres. However, I am concerned—I would welcome clarification from the cabinet secretary or the minister on this—that there is no guarantee that social care staff who work with children will be entitled to the living wage. Moreover, the living wage does not reflect the incredible value of such work, its emotional demands and the deep commitment that carers bring to every care visit in every home and by every bedside.
Scottish Care’s report “Trees that bend in the wind: exploring the experience of front line support workers delivering palliative and end of life care” provides an insight into the challenging role of social care staff who support people with progressive illnesses or people who need palliative care. Not only do those staff deliver increasingly complex care for the most vulnerable, but many have direct experience of being by people’s sides as they die. Social care staff are a vital support for bereaved families and they have to manage feelings of loss themselves, but they are not afforded the recognition that they deserve. That is why the Scottish Greens want to pay all social care staff a living wage plus of £9.20 an hour. If we are serious about building a sustainable and compassionate social care system, pay for staff must reflect that.
I believe that the Government’s long-term goal is for sleepovers to be paid at the living wage rate, but it would be helpful if we heard about a timescale for achieving that. I have heard from constituents who work in the social care sector that they are still not fairly paid for all the time that is spent travelling between shifts or for all the handover shifts that they do.
Appropriate pay and better working conditions are badly needed to help us to recruit social care staff and retain people with experience. Good pay progression and training opportunities for people who work in more senior roles are essential. Roles in social care should be seen as positions to aspire to. Carers should have more opportunities to specialise in particular forms of care and to work collaboratively with other health and social care professionals.
Carers and third sector organisations have told me that they are not adequately represented on integration joint boards. More joint planning is needed across the sector to ensure greater stability. Many of us will be aware of the worrying example in Kirkcudbright where a private sector provider pulled out of providing day care services in a care home, which left service users with nowhere to turn. The provider was able to exit the contract with 90 days’ notice. It is wholly inappropriate that crucial services can be pulled away like that.
The rate of nursing vacancies in our care homes is incredibly high—up to 28 per cent of posts are vacant. In the past, NHS workforce planning has not reflected the need to fill posts across the social care sector, too. I hope that the new national health and social care workforce plan will change that, because we need more stability, especially when Brexit could throw this already precarious sector into jeopardy. Immigrants make a huge contribution to our social care sector and we must protect their rights to live and work here. We cannot forget, either, the need to improve pay and conditions for all the other staff, such as the cleaners and cooks who support the social care sector, which could not function without them.
Without carers, the independence and quality of life of many is diminished, human rights are not realised and the burden on our national health service becomes even greater. Few jobs are more important. Let us make it clear that we understand that by making sure that carers and all who work in the care sector have the recognition and support that they deserve.
I move,
That the Parliament believes that there remains a vast gap between the value of care and the support or pay that carers receive; further believes that nobody should face poverty because of the care they give; supports calls for the Scottish Government to provide more practical support to young carers, greater financial support to young adult carers in education and a carers allowance for unpaid carers that is increased in value, available more widely and does not count as income when assessing benefits and care charges; believes that quality social care is essential to many people’s health, dignity and control; agrees to ensure that all who work in social care, including people working with children, are paid at least a "Living Wage Plus"; considers that better conditions and career opportunities are essential to recruiting and retaining experienced staff, particularly in light of Brexit, and commits to funding high-quality social care that is ultimately free at the point of use, and paid for by local tax reform and progressive national taxation, and not by care charges.
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