Good afternoon and welcome to the Equal Opportunities Committee’s sixth meeting in 2012. I remind everyone present, including members, to turn off all mobile devices. We have received no apologies for this meeting.
I am an MSP for West Scotland and deputy committee convener.
Good afternoon. I am the MSP for Aberdeenshire West.
I am an MSP for West Scotland.
Good afternoon. I am an MSP for the Highlands and Islands.
I am an MSP for Central Scotland.
I am an MSP for the Highlands and Islands.
I am head of policy at Aberlour Child Care Trust. We do not have a great deal of involvement with the Gypsy Traveller community per se, but we provide a range of services such as long and short-stay residential respite care for children with profound and complex disabilities, and in-home support and fostering support. We are here to offer some general comments on the issues affecting carers.
I am the chief executive of Crossroads Caring Scotland. Like Aberlour Child Care Trust, we do not have a specific focus on the Gypsy Traveller community, but we are very experienced in carer issues. We provide short breaks for carers in their own homes. We have 42 services across the country and we support about 8,000 carers each year to allow them to have a few hours to themselves or one or two hours to do the things that we all take for granted.
I am the director for Scotland for the Princess Royal Trust for Carers. I echo what my colleagues have said in that we are here really to talk about general carer issues. The trust supports carers through a network of 29 independent carer centres across Scotland. The one in north Argyll is a close partner in the pilot piece of work that the Minority Ethnic Carers of Older People Project—MECOPP—is carrying out with Gypsy Travellers. Each of the 29 centres supports carers of all ages and backgrounds in its locality.
I am a service manager for Alzheimer Scotland, based in Glasgow. Like my colleagues here, we do not have a specific remit for Gypsy Traveller carers, but we have a wide range of experience working with carers of people with dementia across all groups.
I am the director of MECOPP. We are the only dedicated minority ethnic carers organisation in Scotland and we specialise in supporting groups that are either historically or by default marginalised from mainstream services. We are managing and delivering the Gypsy Traveller carers project, which is funded by the Scottish Government.
Members have a variety of questions for the witnesses. To start us off, I would like Suzanne Munday to tell us a bit more about the inconsistent approach to care across the country. We have heard from Gypsy Travellers before that services are patchy—depending on where you are, they can be really good or really bad. That links with issues to do with hand-held medical records. I invite Suzanne Munday to kick off the discussion by talking a bit about that.
Is the question about carers in general or about Gypsy Travellers in particular?
Gypsy Travellers.
The project arose because the national carers strategy for Scotland recognised that there were still certain communities of carers about whom we knew very little. With the support of the equalities unit—through the race, religion and refugee integration fund—and the carers unit, plus additional funding from NHS Lothian, we put together a project with four members of staff. The project works in Edinburgh and the Lothians, which are treated as one site, in Perth and Kinross and in north Argyll. It has almost completed its first year, in which time it has gathered a lot of evidence on the nature and extent of informal care in Gypsy Traveller communities. We have identified and supported 60 Gypsy Traveller carers and the people who are in receipt of care.
In what way have you supported those 60 Gypsy Travellers? Have you helped them to access services?
Yes, we have. The project contains several strands, including the key strand of advocacy support, which involves enabling Gypsy Traveller carers to articulate their needs to providers or supporting them in a partnership approach and advocating on their behalf. We have provided a lot of healthy living activities for Gypsy Traveller carers, and offered a range of training opportunities for health and social care practitioners to raise their awareness of Gypsy Traveller issues. As you know, we are holding an event this evening to promote the project’s work.
We know that support for caring is patchy across the country. Have you identified any areas in which there is good practice in the provision of care and support?
No. To be fair, the project is the first of its kind in Scotland, so it involves a lot of learning not only for our organisation and for the communities, but for local authorities, health boards and the Scottish Government. It is viewed very much as a demonstration project.
What do you know about the use of hand-held medical records? How widespread is it?
The intent of using hand-held medical records was positive but, from speaking with colleagues who are involved in the project and those further afield, we have found that they have mixed reactions to it and are not aware of Gypsy Travellers using the records. The system has not done anything to address the underlying issue of the discrimination that Gypsy Travellers face in accessing general practitioners’ services. We know that families will travel for miles if they have identified a sympathetic GP, and we have evidence that some Gypsy Travellers have been turned away from GP practices.
Is that happening across Scotland?
Our evidence shows that it is happening across Scotland. It is probably just one or two practices—I am not saying that it is wholesale—but it is certainly a Scotland-wide issue.
I am interested in hearing from the other organisations, as Suzanne Munday has spoken about the support that her organisation provides.
We have a network of carer centres, all of which are independent within our structure. The centres were set up independently so that they could respond to the needs in their local communities. The pilot in north Argyll is useful because it is an opportunity for the carer centre to reach out and engage.
Although we have not provided a respite care service per se to families in the Gypsy Traveller community, we have had contact through other services. Recently, our Scottish children and family assessment centre had referred to it a family with a young boy who had complex needs and was going to be rehabilitated back into the community, and we had to judge whether and how that should take place.
Even everyday carers—in other words, folk who live in communities—can find it very difficult to access our services. The majority of them are provided via an assessment by social work departments and it can still take six or seven months for those in the system to be assessed, to have that assessment followed through and to be able to access a service. Not being established in a local community creates another barrier and simply reinforces the difficulties that are faced.
I am not aware of any development in Alzheimer Scotland specifically for Gypsy Traveller carers. However, as Jack Ryan made clear, you have to work hard to provide a greater degree of carer support across the different carer groups and to allow them to access services. For example, carers of people with dementia find it very difficult to access services, particularly in the post-diagnostic phase, on which there is very little information. That area needs a lot of work, but I suspect that any developments in that respect will help carers in other groups.
In trying to produce our strategy, we need to remember that Gypsy Traveller communities are tight-knit and can be very sceptical of the people who come in. As a result, it is helpful to hear that the pilot will be used to decide how to move forward on this.
As most of Scotland is covered by a network of either carer centres or local carer services, I would hope that, if trust is built up locally with one group of Travellers, they will maintain that contact and trust with another centre or local service when they move into another local authority area. I know that it takes time to build up trust in the community, but the fact is that, irrespective of where those people are based, that network of support still exists. As members of the national carer organisations group, MECOPP and Crossroads Caring Scotland could jointly consider how to take forward the pilot in a way that delivers for Gypsy Travellers.
It is not necessarily true that the whole Gypsy Traveller community is transient. A number of Gypsy Travellers have had to settle in housing in order to access services; in doing so, they have lost part of their cultural life and heritage and are very vocal in articulating as much.
You have raised part of the point to which I was just coming. Many of the Gypsy Traveller people are not transient; some settle down and put down roots in a site or, indeed, in housing. That is partly to do with accessing services, but it is also sometimes partly to do with the fact that the people for whom they are caring become less ambulant and less mobile. However, you appear to be suggesting that there is still a huge cultural barrier and that barriers are put up unnecessarily, such as having to provide evidence that someone is a Gypsy Traveller, which is out of order.
That would work. It would help a great deal. It would need a lot of action, commitment and a change in practice on the part of the local authorities. They aim for an equitable distribution of resource across their areas, so a special case would have to be made and clear guidance be given to them on that.
Even with hospital discharges, is it not the case that, because the person does not necessarily have a fixed address, appropriate support for respite might not be provided?
There is probably a good chance that that would happen. I do not have any evidence that it has happened, but I can see the likelihood.
The case to which I referred was problematic because there was a dispute as to whether the child could be rehabilitated at home because there was no fixed address. We had to take all the factors into account. Aberlour operates respite care services around Scotland, so we see the disparate nature of provision of, or access to, social work and the varying ways in which different local authorities approach respite care, not only for the Gypsy Traveller community but for all communities. To answer Dennis Robertson’s question, any fast-tracking would be based on locality and would vary from local authority to local authority.
It is a matter of addressing the community’s travelling lifestyle. We see huge potential for development in self-directed support, direct payments and establishing the principle of the portability of care, whereby the money is allocated to, and follows, the individual who is in need. That would go quite a long way towards enabling the families to purchase care when they needed it.
Is the problem that the person will still require an assessment to establish their need and the level of self-directed support that they will get?
Yes, of course. To access direct payments—or any social work service—you need an assessment of need. We are very interested in considering the discretionary element of existing policy and guidelines to enable direct payments to be used to employ a family member. As members of the travelling community tend to travel with their family, if the opportunity was there to use direct payments to pay for a family member to provide care and, if that person was travelling along with them, particularly during the summer months, we think that that would be a step forward.
Although Aberlour is very supportive of the SDS agenda in terms of empowerment and patient choice—it is certainly part of the picture—it is not a catch-all. In fact, there are certain problems with SDS, particularly for parents providing round-the-clock care to profoundly disabled children. I was speaking to a mother this morning in Aberdeenshire who has a profoundly disabled son and says that several times she had felt almost bounced into the SDS agenda. She does not want a part of it; she is exhausted and does not have the time to consider budgeting, contracting or interviewing. She would just rather know that the care was there when she needed it.
It does not take cognisance of the respite that is required to some extent either.
With self-directed support, it is the same for Gypsy Traveller carers as it is for any group of carers. It is about the choices that are available to carers. Self-directed support and the financial payments that come with it should be based on someone’s needs as a carer or as a family. The choices through SDS should be available to the Gypsy Traveller community in the same way as we are hoping they will be available to all carers in Scotland. SDS is probably a bit further down the line, given the issue that Dennis Robertson raised of how we begin to identify the Gypsy Traveller carers. The identification of such carers and their coming forward or engaging in some way is how we will begin to get them the information that they need. The centres find with all carers that the first point of contact is about giving them the information they require once they have been identified or have self-identified and then beginning to consider which package of support is flexible enough and tailored to their needs as a carer and to those of the household.
Has MECOPP engaged with the Scottish Government on the bill that is coming into the Parliament and on the issues that have been raised today?
Yes. We sit on the SDS implementation group and a number of the sub-groups, too.
On the question of site provision and how that affects individuals, we heard in a previous session about the lack of sites, the poor quality of some of the sites and how that affects individuals, particularly carers. In her opening question, Mary Fee asked about the level of site availability in the country. Are there any examples of good-quality sites that provide assistance to people in the Gypsy Traveller community who act as carers in their families?
I will take that point back to my colleague and respond to you after the committee session. To my knowledge, no specific site puts in aids and adaptations for Gypsy Travellers who are carers. Equally, when aids and adaptations are sought within a caravan on a site, we face attitudinal problems. In a recent example, a family had applied for aids and adaptations for somebody with physical disabilities for whom they were caring and the occupational therapist refused to acknowledge that the family might know what aids and adaptations would be better in the caravan environment than the professionals. The sense was that, if they were given the money for the aids and adaptations, they would not spend it on the aids and adaptations.
I do not know whether this is a legitimate question, but I will pose it. Have there been any discussions between MECOPP and the caravan manufacturers about what aids and adaptations could successfully be implemented? That information could be provided to occupational therapists, the national health service and social work departments for future use and reference.
No, but that is a good idea and I will take it back.
Thank you.
I have a supplementary question, which, again, is probably for Suzanne Munday. We heard from the Gypsy Travellers who were here that there are certain cultural sensitivities around who does the caring when people get social work services. For example, a woman would need to be the carer for a young girl who was doing swimming therapy. Can you give us some examples of where cultural sensitivities have been taken into account in other ethnic minority groups?
More broadly, our work with black and minority ethnic communities has developed the idea of cultural competency. That was built on the work that was done under the fair for all Health Department letter. We have worked across Scotland to train health and social care practitioners in the idea of cultural competency, particularly to ensure that the single shared assessment identifies the specific needs of black and minority ethnic carers and looks at ways in which to address those needs.
Your final report makes it clear that, in some cases, significant barriers have been overcome and a level of engagement has been achieved between the carer, the family, the environment and the provider of services, and MECOPP explains how it has been an important facilitator in achieving that.
I suppose that the log that you suggest would be similar to the hand-held medical records. In order to access a social work service, the person goes through an assessment, which is usually based on the single shared assessment. If there was a mechanism for one local authority to accept another local authority’s assessment, I could see that such a log would be helpful but, at present, every time somebody goes into a new local authority area, they have to go through the assessment process again in order to receive services. As my colleagues have said, that can take weeks and months.
I was struck by the section of the report that is devoted to the engagement of social work departments, which makes it clear that there are some issues. What I am driving at is that we could surely begin to address those issues by having basic empirical information recorded. The next social work department would be told, “This is what the previous social work department was doing, and this is where it had got to. This information should help to inform you about what is required.” The moment mobility intervenes, it seems that a relationship that has been struck up in one location is away. That is a waste of the Gypsy Traveller family’s time, because they have invested trust in the people whom they are dealing with, and it does not help service providers, who start with a blank sheet each time they are asked to intervene. We are missing an opportunity.
Communities tend to travel in the summer months. When they are static, they might build up the relationship that you describe. They might then travel for X months, but they will return to their starting point. There might be a gap in interaction, but the skills, knowledge, expertise and relationships are not lost. As communities move on, they leave the social workers more skilled, and I hope that the opportunity could be taken to use those skills in developing relationships with new Gypsy Traveller families who come into the area. However, I take your point that it seems to be a waste of time that, every time people move, they have to start from scratch again.
The single shared assessment can move, but it is worth bearing it in mind that an assessment is carried out at a time and place. The day after that, another assessment might be needed.
I seek clarification. My impression from reading MECOPP’s report is that many of these terms are jargon to Gypsy Traveller families. They do not know what they have had or what the outcome is, but they know that they sought help and that, after a great deal of difficulty, something was put in place.
We have examples of families who have travelled and have had to have a new assessment of needs. I take Dennis Robertson’s point that the assessment establishes the need for services and that the care plan delivers services, but some families have had to have another assessment of needs when they have moved from one local authority area to another.
Dennis Robertson is dead right to say that a single shared assessment can travel with a person. As I said, not many Gypsy Traveller families use our services but, in general, carers and families who move from one authority area to another can find that although their recognised level of need means that they get X hours of service in one area, when they move to the next authority, they are no longer eligible for that level or they are eligible for more. There is still a patchwork around the country, so I can see how that would be exacerbated for the Travelling community.
I echo what Jack Ryan said. Once an assessment has been done, it is regularly reviewed, which keeps the care plan on track.
Over the past five years the level of ring fencing of local authority funding has been reduced. Local authorities can now allocate resources as they see fit, because they know about the issues that affect their area, instead of the resources being allocated by diktat from whichever party or parties are in power in this Parliament.
If I may say so, the cost of the end of ring fencing for provision for disabled children can be measured in what was colloquially referred to as the missing millions. The sum of £340 million was made available south of the border for a strategy for disabled children in England and Wales. A Barnett consequential of approximately £34 million came north as a result of that and, because of the presumption against ring fencing, it went straight into the grant-aided expenditure of local authorities. Local authorities were not made aware that that new money was for funding for children with disabilities or for a strategy for children with disabilities. As a result, it went to filling potholes and delivering other local authority services.
I would not suggest that local authorities were not aware of that issue, because I am sure that, in discussions, the Convention of Scottish Local Authorities would have raised it on behalf of local authorities. I therefore do not fully accept the argument that local authorities were not aware of the issue.
I have a follow-up question. We have heard previously that Gypsy Traveller sites are often in very poor locations, and often on the boundary between local authorities. Does that make it even harder for Gypsy Travellers to access care because both local authorities say that they will not provide care? Does it become a bargaining process between the two authorities?
I am about to embarrass myself as I will show that I have no knowledge of geography at all. I think that one site in the Lothians straddles East Lothian Council and Midlothian Council. As far as we are aware, the issue has been worked out between the local authorities and does not present any problems.
You mentioned support provided by your project in Edinburgh and the Lothians, Perth and Kinross and north Argyll. What was that support, and how did the project come about? Did you invite all local authorities to support the project, or did you target those areas because there are more Gypsy Travellers in Perth and Kinross, for example, than in other areas?
We were very fortunate to recruit to the post a colleague who had substantial experience of working with Gypsy Traveller communities, so we took our steer from her. She already had very good relationships with the local authorities that we had identified. Because it was only a one-year project at that point, we felt that reviving existing relationships was the most pragmatic way to go. That said, the carers centre in north Argyll has been very helpful, and there has been positive feedback about the work that the two workers are doing and how it is building the capacity of the Princess Royal Trust for Carers itself.
Inevitably, our questions are going to be directed towards Suzanne Munday, although my next question is also for Alex Cole-Hamilton. It relates to the shocking life expectancy figures for Gypsy Travellers and the impact on the likelihood of people surviving long enough to be diagnosed with Alzheimer’s or dementia. Is there much experience of dementia sufferers in the Gypsy Traveller community? What particular challenges are associated with that?
We work with a handful of carers who care for a family member with dementia. One of the key issues is a lack of information about dementia, because in Gypsy Traveller communities there are issues around literacy and the ability to access information via a computer or the internet. If someone cannot get access to information straight away, they are at a disadvantage. That can impact on people’s ability to spot tell-tale or warning signs, which means that an illness might not be diagnosed until even later on. Alex Cole-Hamilton has said that even in the absence of such issues it can take quite a while to get a proper diagnosis. That lack of information and awareness around certain health conditions in Gypsy Traveller communities is one of the fundamental barriers.
What about the mobile lifestyle of the carers? I appreciate that there are some settled Gypsy Travellers. Is that issue likely to come up in your project? Will you examine its implications?
We could certainly discuss it, but there are a lot of contributory factors. I was involved in work on the dementia plan and strategy for Scotland. We looked at a host of preventative health measures that might reduce or delay the onset of certain types of dementia. For example, we considered issues such as a healthy and active lifestyle, mental stimulation and physical activity. We know that all those things are not so well established in the Gypsy Traveller community, so there is a whole area of health promotion and prevention work to be done in that community.
On the diagnosis of dementia, I manage a service for younger people with dementia and that group is perhaps similar to the group that has just been considered because it is a small group—there are not many of them—and there may be similar needs in the sense of getting information to people. It is important to get information to people not only at the pre-diagnostic stage or when they are going through diagnosis but immediately at the post-diagnostic stage. There are lots of horror stories about people being given the diagnosis and basically being told “Goodbye now. You’ve had your diagnosis.” On-going support is needed after diagnosis.
As it is unlikely that a diagnosis would be made following one visit, is continuity of contact with a health professional important?
To get a diagnosis, someone would have to go through a number of tests, and other causes of the symptoms would have to be ruled out. Very often, people are told to begin with that they have depression or some other condition, so those things must be ruled out before a diagnosis of dementia is reached. There are real difficulties in getting a diagnosis anyway, but the time that it takes exacerbates the problem.
Would it be possible for health checks to be done on sites—especially established sites? The health board could go in every six months or so and do a health check for the Gypsy Traveller people on site. Should we consider that?
The issues that affect carers in the Gypsy Traveller community in terms of access to healthcare or provision to meet their needs are much the same as those that affect carers across the board.
My point is whether you think that we could pilot an exercise in which health services went into the community to do a health check. Such a preventative step could help to identify potential health issues or people with a disability, a mental illness or whatever. People in the community are not accessing healthcare, and many are turned away from their GPs, so we have to look at ways of trying to bring the health service to them.
I do not know—I am not an expert on the community—but there is an issue around perception. The community may view it as something that people have to have done to them or that we are taking to them. In order to build up trust between certain communities and health professionals, any approach would have to be handled very sensitively and over a long period of time.
Does Jack Ryan want to come in on that as well?
No. I was going to make pretty much the same point.
Alex Cole-Hamilton indicated that he wanted to speak. Has your point been covered?
It has been covered very well.
The question about what the barriers are is being avoided. What do the witnesses perceive to be the barriers?
I can speak about dementia, about which there is a lack of knowledge in society in general, but also among healthcare professionals at times. The health improvement, efficiency, access and treatment—HEAT—targets that were introduced a few years ago have done a good job in trying to identify people with dementia at an earlier stage. That is an important development, but the case remains that there is a lack of knowledge and skills among many people who work with and come across people with dementia. One thing that has come out of the national strategy for dementia is the promoting excellence framework, which aims to increase people’s skills and knowledge levels.
I want to pick up Alex Murphy’s earlier comments about carers having similar needs. I concur with that, but the responses in meeting those needs may be markedly different. A concern that has come across clearly in our project from people in the Gypsy Traveller community is that they feel that they are being pathologised because of their lifestyle. In essence, they feel that they are being blamed for the health problems that they have. That is very different from how carers in the mainstream or majority community feel.
Have any studies been done on the reasons behind the low life expectancy of Gypsy Travellers?
I cannot name those studies off the top of my head, but there are a number of them. I think that they have tended to be based mainly in England rather than Scotland, but we could certainly send the committee what we have.
That would be helpful. Thank you.
To raise awareness of carers’ needs and health needs in the Gypsy Traveller community and to try to get a wider and better understanding of all the issues, particularly the health issues, would it be feasible for one NHS board to work closely with a site and start to build up a relationship with the people on it and those who manage it? Could that be used as a case study, with the information then disseminated across all the other health boards and areas in which there are sites? Would that be feasible?
Yes, it would. Once we have confirmed what our funding will be from 1 April, we will develop annual work plans. That is a really good idea, which I would be happy to take forward.
What about local authority areas in which there are no sites? I know that there are a few authority areas in the west of Scotland in which there are no sites. How can we try to help where there are no sites?
What a good question. I am no expert on this but my sense is that, although certain local authority areas have no sites, there might be Gypsy Travellers in housing or in roadside camps that they have set up because no site was available. It can be very difficult to engage with the Gypsy Travellers in those camps, because they are there illegally and will be moved on very quickly. As for the population that has settled in housing stock, we would be able to establish relationships with that community based on our current practice.
Thank you.
To pick up on Stuart McMillan’s point, I know that, in my area, NHS Highland provides a general practitioner and other medical support for the homeless population in Inverness. The analogy might be unfortunate, but it shows that there is a precedent for trying to reach hard-to-reach people, including substance users whom some practices are not prepared to treat. Of course, the challenge for medical practices should be to deliver care, but they are commercial businesses beyond the reach of boards and that level of direction. Of course, I am happy to refer people to the right place if they want to get in touch.
As we know, Gypsy Travellers have been subjected to very negative stereotyping. Because of her work with MECOPP, Suzanne Munday should be able to provide some background, but I wonder whether the other witnesses can tell us what, if anything, their organisations are doing to raise awareness among Gypsy Travellers of what they do and among their staff of how to deal with Gypsy Travellers.
I have to hold my hands up and say that we do not do anything specific for the Gypsy Traveller community. Much of our work is reactive, for example we respond to referrals, which come predominantly from local authorities. We focus on that activity because budgets are finite and given the way tendering works, we have to follow that purse. However, that does not mean that we do not provide support, for instance to people who are resident in a community home. The problem is that they would not necessarily be identified to us as being part of the Gypsy Traveller community. We provide training on BME carers and issues in BME communities but not specifically on the Gypsy Traveller community.
The same is very much true of Aberlour Child Care Trust. The issue falls under the organisation’s promotion of equality and diversity policy and there are a number of interfaces where we might well come into contact with the Gypsy Traveller community. Our business is about building family and parental capacity and supporting families and small children who, whatever their background, face adversity. The case that I mentioned earlier was resolved successfully because of the strength of family ties around the small boy in question. We would treat that family much the same as we would treat any family but with an understanding of the particular factors that affect that community.
As I said at the start, the trust and the network of carers centres exist for carers of all ages and all communities. However, I will take away from this discussion two things with regard to the particular group that we are discussing. First, in our annual statistical survey of the centres, we ask about the number of carers and the communities that they come from; however, we do not ask specifically about Gypsy and Traveller carers and I think that we will add that to the survey.
It is the same for Alzheimer Scotland. We do not have a specific remit for carers from Gypsy Traveller families, but having heard the evidence today, I will take the issue back from the meeting.
I would like to return to the removal of ring fencing, which has had an impact on marginalised communities in Scotland. Although I agree, in principle, with devolving budgets to the local level, that works only for those who have a seat at the local table. A lot of communities are perhaps invisible, less articulate or hidden and their voices are not heard, so resources are not channelled towards those groups. Carers in the Gypsy Traveller communities are a prime example of that.
It is unfortunate that ring fencing has been mentioned because I see it as a complete red herring. Previously, when there was a ring-fencing regime, someone either had a seat at a table or they did not. If they did but no longer do since ring fencing stopped, that should have been subject to challenge by the people from all parties who have the task of scrutinising the local authority. It is about assessed needs and priorities, and we would all probably have different priorities even within our groups. You are right to say that local authorities see some easy hits, but I do not think that the link with the removal of ring fencing—which is about empowering local authorities—is a good one.
Suzanne, do you want to come back in on that?
Gosh, no thank you.
I would like to return to our discussion about the missing millions in order to answer Stuart McMillan’s earlier point. I sit on the coalition for Scotland’s disabled children and we did quite a body of work to track down the progress of that money from Westminster, through the Scottish Government and into the local authority block grant. We contacted local authorities and asked them whether they were aware of it, but in many cases they said that they were not or that there was no extrapolation of how much they should receive based on the number of disabled children in their populations. Many excuses and reasons were given as to why the Barnett consequentials from the English spending did not lead to commensurate funding of a strategy for disabled children in Scotland, their families and the carers who support them, but the matter was never satisfactorily explained. That is often held up as an example of a casualty of ring fencing, showing that it can be problematic.
An old boss of mine always said, “Never have just two points when you can have three.” I will take away a third point from the meeting. As part of the carers strategy, we are involved in a working group with NHS Education for Scotland and the Scottish Social Services Council, which is looking at staff training on carer awareness. I will certainly take the issue of Gypsy and Traveller communities back to the group’s discussions, because although we are talking about equalities, access and other issues, the specific issue that has been mentioned can be considered.
This is a question for Suzanne Munday—it is a positive comment. It seems to me that one of the most constructive initiatives has been MECOPP’s programme of awareness training for service providers, which has vastly improved providers’ understanding of the particular and individual characteristics of Gypsy Traveller communities and seems to have gone a long way towards reassuring Gypsy Travellers that not everyone is hostile towards them and giving them the confidence to understand that there is a significant body of opinion that wants to help. Given the programme’s success to date, do you hope to continue making that positive contribution to breaking down barriers and facilitating better mutual understanding?
Yes. The next three-year work plan says that we will look to roll out the programme and target even more local authorities in Scotland.
I support that. In training sessions we can hear from training professionals, but the effect is strengthened when we hear the voice of an individual carer who is talking about their circumstances, whether they are an older carer or a parent carer of a child with a long-term disability. I agree that the voices of Gypsy and Traveller carers would add a great deal of weight.
Are there examples of a more positive outlook on the part of non-Gypsy Traveller communities in an area where there is a site, as opposed to an area where there is no site?
I would have to take that question back to my colleague Michelle Lloyd. However, on a related issue, when Gypsy Travellers are in housing we have a lot of evidence of their disguising their identity for fear of discrimination and reprisals by neighbours. Gypsy Travellers are having to hide their identity.
What awareness-raising activity would you like to take place, particularly in areas where there is no site, to try to combat the impression that people have and the reality that some people have to face?
There would be tremendous value in delivering the training to every local authority and health board in Scotland. Whether that should be done through continuing professional development or through the skills and knowledge framework can be debated.
Do members have any further questions? Dennis?
Just the one. I think we were in slight danger of moving a little off the topic earlier, but do you see the move towards health and social care integration as a positive step towards taking away some of the barriers for Gypsy Traveller people and as a stepping-stone towards greater awareness within the profession?
I hope that you are not looking at me.
I can look right around the room if you wish, Suzanne.
I have just barely got my head around the health and social care integration agenda—
It is early days.
It is very early days. I can see where value could be added through joint training, which is always very useful. Having one point of contact, rather than having to deal separately with the health sector and the social work sector, providing a more seamless package of care, could be a great benefit. As I have said, it is very early days for my knowledge and understanding. I am being honest.
It is a thorny subject, but it comes back to the fact that it does not matter what structures are in place if people have not been identified or identified themselves as carers. We can have the best system and process, but people will not be able to engage with them or to access the support if that has not happened. We need to get the identification right first, then we can look at the structures that support it. That goes for carers across the board.
Would you accept, though, that the integration is there because of health being allied to social care? It might enable people to access the service more seamlessly.
I think that in theory the structure should be there and it should be far more seamless, but we still need to see the practical nuts and bolts of what that would look like. My colleague gave evidence to the integration group and we must consider what it looks like for an individual as they travel through the process and the structure.
It would be difficult to say that it would definitely make a difference to the travelling communities, but for communities as a whole, in the current situation, with separate health boards and social work departments, the breakdown comes on hospital discharge. One of the things that has disappointed me most is that in the 14 and a half years in which I have been involved in the sector, I have not seen any real improvement in what happens to people. Someone is discharged from hospital and the services go in for the first two or three days, and then there is a gap and people are left on their own. It would be good to get a closer link that helps people. The outcomes for individuals are what counts and I can only guess that a single unified system would help the Traveller community. People want one body to relate to; they do not want the NHS interested in them on a Tuesday and the social work department by the end of the week. There is a gap in such situations, a change of files and so on. All those things lead to confusion and a potential breakdown in service, so integration must be a good thing.
To answer Dennis Robertson’s point, removing barriers goes beyond the integration of health and social care and into such things as community planning, the drafting of single outcome agreements and the setting of targets and priorities at a local level. It is not just about the health and social care needs of a person or carer, whether they are in the Gypsy Traveller community or the wider community, but about educating local authority planners about what they can do at a local authority level to deliver real and demonstrable change.
On a point of clarification, Jack, you were talking about your organisation’s awareness of Gypsy Travellers and about how you do not give out specific information to employees at present. You said that you had a BME strategy, and a few others have said that. Are Gypsy Travellers included in that, given that they are an ethnic minority?
Yes, they are. The policy is there and we do the training, but on the question of having a direct strategy because we have said, “There is a community whose needs we are not meeting,” I will be honest with you: we do not have that as a specific agenda. We do have such an agenda for the BME communities in certain parts of the larger cities. They are identifiable and, again, we depend considerably on what is referred to us. We actively prepare our staff to meet the needs of those communities—in fact, we recruit staff so that we can meet those needs—but we do not identify the Gypsy Traveller community and gear ourselves up to work in it.
You commented on your BME strategy. Do you go out and target other specific groups?
Yes.
You do. So you have a strategy for other groups but just do not have one for Gypsy Travellers at this point in time.
That is right.
Committee members have no more questions, so I invite the witnesses to make closing comments on anything on which we have not touched or anything that they will take away from the meeting. I am more than happy to bring them in, but they should not feel obliged to say anything.
One of the things that would help Crossroads Caring Scotland would be to map the journey of individuals within the communities—perhaps we could talk to Suzanne Munday about that. At the moment, we tend to talk about them almost as a homogeneous group, which they clearly are not.
On the committee’s behalf, I thank the witnesses for attending. We have had a useful and informative evidence-taking session, and it will certainly help us in our work with Gypsy Travellers.