Clydesdale Community Transport and Good Neighbours Project
The final item of business is a members’ business debate on motion S3M-7225, in the name of Karen Gillon, on the WRVS Clydesdale community transport and good neighbours project. The debate will be concluded without any question being put.
Motion debated,
That the Parliament commends the WRVS Clydesdale Community Transport and Good Neighbours Project for being, what it considers, a great example of how community volunteers and voluntary organisations can support older people and others; believes that there is value, in social and financial terms and in effectiveness, of preventative services, such as those operated by the volunteers and paid staff of WRVS and others in Clydesdale; further believes that these services help people to live independently, healthily and happily in their own communities and that they can prevent or delay the need to access costly acute health and social care services, thus preventing unnecessary costs accruing to the public purse; is of the view that, as Scotland faces what is considered to be unprecedented financial circumstances, these services, if properly resourced, can form an integral part of the health and care system in Scotland, and understands the importance of partnership working between the Scottish Government, NHSScotland, local authorities and the voluntary sector to achieve this.
17:32
I begin by thanking the 47 members from across the chamber who signed the motion. I pay tribute to the thousands of people who give their time and talents to support the invaluable work of organisations such as the WRVS in my constituency and constituencies across Scotland. I am sorry that the volunteers could not manage to get to the Parliament for today’s debate. Given the weather and the road conditions, they are probably better off staying in the safety and warmth of their own homes rather than making the journey through. I am sure that they will be listening in.
Indeed, the debate could hardly come at a more appropriate time. Many of the most vulnerable people in the communities that we represent find themselves increasingly isolated and dependent on neighbours, friends and those working in projects such as WRVS Clydesdale’s good neighbours project to enable them to access food, medicines and other essentials in this winter weather. We all should be grateful to people in such projects for the job that they are doing.
Clydesdale is a rural constituency. Although that brings many benefits, it also brings many challenges. More people are living for longer, so we need to face up to the challenges that that brings. By 2031, 1.31 million Scots will be at or above the state pension age—an increase of around 35 per cent. That is a sobering thought. Those people do not want to be stuck in their homes when the sun is shining outside, never mind when there is a foot of snow.
The project in Clydesdale helps older people in rural communities who do not have access to public transport or a private car and who therefore find it very difficult to engage in community life. The service enables people to retain their independence and live active lives within their communities. I saw that at first hand as I embarked on a journey with the project through my constituency. We visited various villages, picking up women from the local community as we went and ending up in the local leisure centre at Coalburn. It would be fair to say that the women were at the more mature end of the age spectrum, but they could certainly put me to shame. As a result of the project, they have a weekly fitness regime that sees them swimming and attending the gym. The project enabled them to access the centre and so they took up those opportunities. They keep fit, keep themselves well and, at the same time, keep in touch with friends and get out and about. On other days, the bus is used to take people to the ever popular Lanark market where they can buy fresh fruit and vegetables, helping their diet and maximising their income.
WRVS Clydesdale also provides a service to local nursing homes, sheltered housing residents and other community groups. The project takes referrals from organisations and health professionals and runs a pre-bookable, door-to-door, time-bound service. Volunteers drive their own cars, providing safe and comfortable transport.
The service has become ever more important over time, as the Scottish Ambulance Service has struggled to provide the level of patient transport services in rural constituencies such as mine that I would like to see. Many of the journeys that the Scottish Ambulance Service would have undertaken previously have been taken over by projects such as the community transport and good neighbours project. When we consider that a journey by public transport from Lesmahagow to an appointment at Monklands hospital takes two hours on a good day, we see how important the service is. From a village such as Douglas, the journey is even longer. Increasingly, the community transport and good neighbours project is filling the gap.
Given that the Minister for Public Health and Sport will respond to the debate, it is worth looking at how such projects can be better integrated into the delivery of patient transport services. It might be a better, more effective, best-value use of resources to support them, especially in rural communities where the Scottish Ambulance Service is finding it increasingly difficult to meet its obligations.
Volunteers are able to offer support from the door of the house to wherever people are going. That is increasingly important to people. People talk to me about the benefits that they gain from their chat with the volunteer drivers and about the drivers’ input into their lives. That is really important, as people may become increasingly isolated where a responsible community approach to ensuring that they get out and about is lacking.
WRVS research shows that local authorities’ social care budgets must often be targeted at older people who are in most immediate need because they are at “critical” or “substantial” risk, despite the Scottish Government’s most recent national eligibility criteria, which advocate “a strong preventative approach”. Given that research shows that every pound spent on preventive social care services for older people brings about a saving to the national health service of £1.20, we need to look at the issue much more closely. The cost of providing social care in that way means that we will need an extra £1 billion by 2016 and an extra £3.5 billion by 2031, with some estimates predicting a rise of £27 billion over the next 15 years—a period in which Scotland will have £42 billion less to spend. With an ageing population, that is a challenge indeed.
I know that the project in Clydesdale works well. It helps the most vulnerable people in the community, who would otherwise not be served by transport services—people who are older, people who are socially isolated, those with specific health needs, carers and the disabled. We need to remember that some people do not have family and friends available to provide transport; projects such as the community transport and good neighbours project fill the gap.
The service takes people to hospital and general practitioner appointments and to visit relatives in hospital and care homes. That is a very important part of life as people get older. If, for good reason, one partner has to be in hospital or a care home, the other will want to access visiting opportunities. The community transport and good neighbours project matches clients to volunteers in order to cater best for their needs. The service provides not only transport that would not otherwise be available in our area but volunteers who know how to get clients to their destinations and provide support and care. In 2009, the service did 2,581 car journeys and 1,128 bus journeys, totalling 1,909 volunteering hours. That is quite an achievement.
All of us are aware of the invaluable role that such projects play across our constituencies. I will finish with the words of a service user, Joyce Scott, who uses the service to get out and about. She said:
“The WRVS service has become invaluable in my life since my sight has started to go. My husband has been taken into hospital and the service has allowed me to visit him several times a week. It has also allowed me to lead a normal and active life in the community. The service means a lot to me, there is always a welcoming voice at the end of the phone, the staff always try their best to help even at short notice.”
That is praise indeed, but that is the project that I know.
I am sure that all members know of similar projects in their constituencies, run by volunteers. I hope that we can move to a situation in which those projects continue to be supported—and better supported—in the years ahead. That will be increasingly challenging but, without them, the social fabric of our communities would be much the poorer.
17:40
I congratulate Karen Gillon on securing tonight’s debate. She raises the general issue of preventive care measures as well as the specific work of the WRVS, which is well worth the recognition that is given to it in the debate. I was pleased to add my name in support of the motion.
My friend Aileen Campbell was also happy to sign the motion, and she has asked me to pass on her apologies for being unable to take part in this evening’s debate. For those who do not already know, she gave birth to her baby boy earlier today, and mother and baby are both doing very well, albeit a day late—although those who know Aileen will know that one day late is actually quite early for her.
Aileen lives in Biggar, which is in the Clydesdale area of the South of Scotland region that she represents, and she has told me of the great respect that she has for the work of the WRVS in that area. I am more aware of its work in my own area—I will come to that shortly. I am sure that the same respect is extended by all members to the WRVS in their part of the country. It was founded more than 70 years ago, and the ethos and impact of the organisation remain as important now as they were back then.
About 10,000 volunteers help to deliver WRVS services across Scotland. Earlier this year, I was privileged to see some of its work in the Central Scotland region that I represent. I visited its cafe at Monklands hospital, where I met volunteers who have provided years of dedicated service, giving their own time to help others. Those volunteers, along with others at Udston, Wishaw and Hairmyres hospitals, thoroughly deserved to be the first-ever winners of the merit award from the lord lieutenant of Lanarkshire earlier this year.
The motion recognises both the social and the financial value of such volunteering, including at the volunteer-run cafes in our hospitals, which helps to preserve funding for front-line medical treatment and care. Many of the volunteers will have years of experience and can offer friendly, informal advice and support to those who make use of the hospital cafe, whether they are patients or their friends and family.
Other services that are provided by WRVS volunteers help to meet wider social aims. Karen Gillon’s motion refers to community transport and good neighbour schemes, which provide older people in particular with lifts to shops and other services or help with household tasks such as changing light bulbs or basic gardening. That work is to be commended.
Many of us are familiar with the meals-on-wheels services that are provided by the WRVS, and I have had the opportunity to join teams taking meals to older, vulnerable residents in Croy and Cumbernauld on more than one occasion. Again, I pay tribute to the sterling work that volunteers have done as they have literally delivered that service, which makes a great difference to those who are on the receiving end. The specialist vehicles and the logistics behind meal preparation and delivery runs are equally impressive. Those involved at that end deserve credit, too.
Such services do not simply provide social and practical benefits to the individuals involved, although for many recipients the friendly face of the WRVS volunteer is valued as much as the meal that they enjoy, as was clear to me from my experience of travelling with the meals-on-wheels service. Such services help to maintain the independence of the individuals who use them, which, as Karen Gillon said, has a wider benefit for society as a whole. As she mentioned, for every £1 that is spent on preventive social care services for older people, savings of £1.20 can accrue to the national health service. They help to keep people fit and active through community transport schemes, they provide a healthy diet through meals on wheels, and they keep homes safe and secure through good neighbour projects. Those services all help to prevent circumstances in which older or vulnerable people might need to rely on public services for support—and they reduce the cost to the public purse.
Age Scotland has produced research that shows that a package of preventive support that is delivered in the community can cost almost two thirds less than a full-time place in a care home for an older person. That is important financially, but delivery in the community is important because it also respects and supports the dignity of the individuals themselves and allows them to live happier, more structured lives than might otherwise be the case.
I welcome the support and recognition that the Scottish Government has given, and will no doubt continue to give, to preventive services and to the many volunteers who help to deliver them. I am sure that the Minister for Public Health and Sport will explore some aspects of that in her winding-up speech.
I congratulate Karen Gillon once more on bringing the debate to Parliament.
17:44
I am delighted to participate in the debate. I congratulate Karen Gillon on securing the debate and highlighting the various issues that she covered in her speech. I thank the WRVS and Age Scotland for the information that they have provided for the debate. I have the great privilege of being Labour’s older persons champion, but I am conscious that organisations such as Age Scotland and the WRVS do that job far better than I can do it. It is critical that we listen to such organisations when they flag up issues to do with our elderly population.
Projects such as that which Karen Gillon highlights in her constituency exist throughout Scotland. I am grateful to all the people in my constituency who volunteer and give up their time to support people in the way that she described. There is a fabulous community transport project in my constituency. It is fabulous not just because it takes people from A to B, but because it understands a community in which people are less likely to have cars. It understands that the issue is not just getting elderly people to hospital appointments or visits, but enabling them to feel safe when they go to hospital, which is a situation in which we all feel trepidation. It is about being compassionate and supportive. I have had the privilege of meeting volunteers who go far beyond what might be expected to support people. We must find ways of recognising the critical role of such volunteers and bus transport projects.
As the cold weather continues, I am anxious. Earlier today members talked about the visible problems that the cold weather brings, but there are also invisible problems. What we are hearing might be the tip of the iceberg. We do not know about older, vulnerable people who are isolated in their own homes and are perhaps not getting the help that they should be getting from their local authorities. As the minister thinks about the issue, I urge her to talk to Age Scotland, the WRVS and other organisations that are highlighting the isolation and vulnerability that people feel. Perhaps we need a more co-ordinated approach to reaching out to people. In the short term, we do not know what problems and difficulties people are facing.
I agree that preventive spending has a critical role. That is why we argued for transparency in the budget process. How do we shift attitudes towards preventive spending and make the case that a project that keeps people together is cheaper in the long term? It is not just an issue for Government; I think that everyone understands that there is a challenge to do with how we make the transition from one attitude to another. It is important that we work our way through the issue, because decisions that are being made now might counter the ability to secure benefits in the longer term. In the short term, people will get rid of funding for projects that would have a long-term benefit if they continued to receive support.
We need a means whereby we can organise and support people who volunteer. The Community Service Volunteers project for older people who volunteer services has already gone. There are anxieties about funding for voluntary projects, although there are people who are waiting to volunteer. We have to tackle the issue. It is clear that we need a refreshed volunteering strategy, which addresses anxieties about funding and understands the needs of the voluntary sector. We need to understand how to support people who want to volunteer so that they can join an appropriate project, which will be sustained. That is about more than just funding.
People who are involved in volunteering and the voluntary sector have a critical role, not just in meeting needs but in showing us what the needs are. We need to work closely with those people, who understand the anxiety that older people experience. With their help, for example by providing a library service or lifts to church or hospital, we will not just contain but sustain people in their homes. I am sure that we all agree on that.
17:48
I congratulate Karen Gillon on securing this worthwhile debate. It is a pleasure to support the motion in her name.
The WRVS is a great organisation. From its roots in long-established services such as meals on wheels, hospital trolleys and lunch clubs it has branched out into innovative schemes such as good neighbour and community transport schemes. It has listened and responded to the changing needs of elderly people. The WRVS slogan—positive about age, practical about life—sums up its approach well.
As we heard, the WRVS has an army of volunteers, who are worth their weight in gold. Many of them are retired—it is about time that we redefined the word “elderly”. In my region, many people offer their time to the organisation, to help thousands of elderly people remain in their own homes for longer than they would otherwise be able to do. The volunteers are held in high regard locally. Many have continued to help during the current tough weather conditions, and I commend them for that.
In north Aberdeenshire, the good neighbour and community transport scheme covers the villages of Ellon, Newburgh and Balmedie. Volunteers who give just two or three hours a week make an immense difference to people’s lives every week. The scheme provides a great service by keeping elderly people in touch, helping them to attend day centres, keep medical appointments, and go on social outings or do shopping. It also reduces isolation by helping people to visit relatives in hospital or care homes. Just as important is the companionship and friendship that are offered to the housebound. These days, families are often scattered and too far away to help with the little things, and WRVS good neighbours provide company and help with a range of tasks such as collecting pensions, going on outings, and even attending when workmen or officials visit so that people do not feel scared.
As council and health care budgets are squeezed, funding tends to be ever more focused on those at high risk, and investment in preventive care is neglected. That is a false economy, which leaves us with growing bills. As Karen Gillon said, it is estimated that 1.3 million Scots will be at or above the pension age by 2031 and if we keep providing social care in the same old way, we could be spending another £27 billion over the next 15 years. I have also heard it estimated that if we keep trying to provide care in the same way, by 2030 every school leaver will have to go and work in the health service. We will spend all those billions of pounds, but there will be no discernable improvement in people’s circumstances. We will just be dealing with those growing numbers.
If we tackle the situation from the other end and intervene early to help people to stay in their own homes and to remain as active as possible in their community, that is more cost effective and beneficial to people’s overall wellbeing. We should surely be striving to do that. More than 60 per cent of the Scottish Government’s spending on care for older people is on care in hospitals and care homes. Almost £1.4 billion a year is spent on emergency and non-elective admissions, while only 6 per cent is spent on providing care at home. As Johann Lamont said, we must find a way to shift the focus from institutionalised care towards more independent living. The WRVS and Age Scotland can help us to do that.
The National Endowment for Science, Technology and the Arts’s recent publication “Radical Scotland” demonstrates one way of doing that. It points to the introduction in Western Australia of local area co-ordinators who match the personal needs of the service users in a particular area to what local providers, existing social networks and community assets can offer. That means that people can stay independent for longer and communities are strengthened. Western Australia has seen a 35 per cent cost saving from its more traditional service-led approach. I believe that North Lanarkshire has been piloting the idea and I would be interested in learning how successful that pilot has been
Karen Gillon points out, rightly, that voluntary services such as those that are provided by the WRVS should form part of our health and social care system and I join her in calling for greater partnership between the NHS, local councils and Governments to achieve that. Changing demographics mean that we need to think again. Older people are an asset, not a liability, and a different approach would help them to stay in the heart of our community for longer.
17:52
I, too, congratulate Karen Gillon on securing the debate and thank Age Scotland and the WRVS for their helpful briefings.
The debate is timely when we consider the challenges that have been posed by the severe weather and the needs of older people who might be isolated and stuck at home. It is clear to me that the WRVS has a key role to play in reaching those older people and in prevention. Without doubt, preventive care is sensible, long-term planning. It is more efficient financially and better socially. Preventive spending improves the quality of life for sick and older people and it reduces the amount that has to be spent on providing care at the point at which people need more critical or substantial care. The allocation of funding to preventive care would fix the leak so that we do not have to spend tightening budgets on bailing out the water.
I will give an example that members will know about. The pilot partnerships for older people projects were a United Kingdom scheme that built a community infrastructure by collaborating in public service delivery. The scheme had a budget of £60 million. When it was evaluated recently, the savings to social care services were shown to be £1.20 for every pound spent. That is a saving of £72 million. The scheme helped something like 246,000 people, the average age of whom was 75—those of us who are in the chamber still have a long way to go—and the achievements are fascinating. Overnight hospital stays were reduced by as much as 47 per cent. Attendance at accident and emergency departments was reduced by 29 per cent. Out-patient appointments were reduced by 11 per cent, phone calls to GPs were down by 28 per cent, visits to practice nurses decreased by 25 per cent, and GP appointments were reduced by 10 per cent. What was not captured, other than in anecdotes, was that people were much happier and had a better quality of life. Those are all substantial results from which we should learn.
The work that is done by the WRVS is an essential starting point, with its 4,000 volunteers across Scotland working directly with older people to support their independent living and provide its services of home support, good neighbours scheme, meals on wheels, books on wheels, lunch clubs and community transport. All of that is critical and essential to our older people feeling connected with their community.
The WRVS goes about its work by meeting the needs that older people identify themselves, which I think is important. Older people appreciate that. A recent survey suggested that, as a result of the intervention of the WRVS, 62 per cent of service users left the house and 57 per cent were able to get to medical appointments when they would not otherwise have done so. Providing such personalised care at a local level is what the WRVS does so well.
We know that severe weather conditions increase the risk of ill health to older people. This is a time when they are in need of more support. When snow leaves the country gridlocked and councils find the conditions challenging—although they are doing a valiant job—it is local organisations such as the WRVS that step into the breach.
A number of members have talked about the challenging demographics, such as the increase of 35 per cent by 2031 in the number of pensioners. In a shorter period of time—I am sure that the minister will tell me the exact date—75 per cent more 75-year-olds are expected. All of that will cost us more in the long run. Estimates are of a £27 billion rise in the costs of providing care over the next 15 years while spending falls by £42 billion. There will be a huge gap. We need to recognise the role of voluntary organisations such as the WRVS and the army of unpaid carers who we know contribute so much.
The key question is how we go about working better. We need a deliberate shift to more care delivered in local settings, and we need a fully integrated health and social care service. The voluntary sector has a key and important role to play if the focus is to be on local delivery. Let me finish with a quotation from 2005 that is just as relevant today:
“A shift towards care in local settings is not just a shift in where care is delivered, it is a shift in how care is delivered.”
The WRVS has an essential role to play in that shift.
17:57
I join others in welcoming Karen Gillon’s motion and the opportunity to debate the wider positive impact of the third sector more generally. The challenges of the weather mean that the debate is timely because, as Karen Gillon and others have said, organisations such as the WRVS provide comfort and a vital service to people in their homes who could otherwise feel very isolated.
There are challenging financial times ahead, but that sometimes makes us look at the opportunities—which perhaps have not been looked at in the past when budgets have not been under such pressure—to make real changes to the way in which services are delivered in Scotland. We have to seize the opportunity.
There have been great improvements in health care and life expectancy. That is fantastic, but those improvements bring with them challenges, for example in ensuring the health and wellbeing of vulnerable groups who are living longer. As Jackie Baillie has outlined, we all know that there will be less money available to invest in the future. That means that we must do things differently and better, working in partnership to ensure that we are delivering every bit of value that we can get from the resources that we have.
Added value can be seen in many preventive services operated by volunteers in communities and by third sector organisations that focus on providing early intervention and anticipatory and preventive support in the community. Services such as the Clydesdale community transport and good neighbours project can and do deliver better outcomes for our older people. If better outcomes for older people can be achieved at a lower cost, that is a powerful incentive to invest in local preventive services. Failing to do so will simply shift the burden of care back from communities to acute services, and we cannot allow that situation to develop or, indeed, continue as it is.
The availability of options and early support to help older people to make the right choices is a key part of maintaining their independence and wellbeing, so we must ensure that a range of services is available to support older people to maintain their independent living. We recognise the pressures in a challenging fiscal climate, which is why we took the decision to allocate a £70 million change fund from April 2011 to help statutory and voluntary partners to focus on redesigning and improving older people’s services and to bring about a real shift in the balance of care. We must address the increasing pressure on our resources by redesigning the way in which we provide services. If we do not, the only way of controlling budgets will be to reduce the quality and quantity of care, and none of us wants that to happen.
It is unavoidable that we must plan and deliver services in a far more integrated way; if we do not, the combined pressures of financial constraint and demographic change will result not only in fragmented, poor-quality services, but in failure to provide effective stewardship of the public pound. We must deliver services in an effectively integrated way between GPs, hospitals, community-based health, social care and housing teams and, crucially, the independent sector. If we do not, we will be looking at a potential crisis in service provision.
We must find creative and cost-effective approaches to keeping people healthier and more independent in their own homes and out of the formal care system for as long as possible. I believe that that is in everyone’s best interests. The third sector and voluntary services are already helping people to live independently in their own communities using persuasive, convincing and well-evidenced approaches. They are generating services from within communities using local experience, knowledge and insight. Those are effective because they reconnect local people with their communities in ways as simple as befriending, arranging trips to local shops and having a chat over a cup of tea. Those things can make a big impact on someone’s quality of life and can help to combat loneliness and isolation, particularly in the communities to which Karen Gillon referred. Our reshaping care for older people programme recognises that in its inclusion of community capacity building as a core theme.
We are committed to working together with the third sector to reshape care for older people—quite simply, it cannot happen without the third sector. The motion calls for greater integration of voluntary services within health and social care and for them to be resourced accordingly. From frequent discussions with stakeholders and folk within the third sector, I know that there is already a shared drive to make things work via the change fund, which has been created following discussions with the Convention of Scottish Local Authorities and NHS chairs. The change fund—guidance for which we are finalising with partners at the moment, including third and independent sector interests—will present an excellent opportunity for partnerships to show what they can achieve with resources, focusing on people’s needs, not on structures.
The minister says that there is a role for the voluntary sector. Can she respond to the point about the need to support the people who support volunteering? We currently have people who want to volunteer, but the projects that organise volunteers are struggling financially. Voluntary sector organisations are slightly different from organisations that support volunteering. Can she see a way forward for those organisations?
I recognise the point that Johann Lamont makes. We have done a lot of work around the volunteering effort within the health service, for example, ensuring that the volunteers and the structures around their support are consistent in helping the health service to achieve its aims. The challenge is to make sure that the volunteers who come through those structures—I recognise that there are other structures—are looking at more community-focused support, rather than support being within hospitals. Those opportunities exist and a lot of people want to volunteer. I am keen for us to make sure that they are received well and supported in a consistent way.
We need to ensure that the voluntary and third sectors are included. I made it clear that, when the local partners gather to come up with the plans that will have a direct impact on where the money from the change fund goes, in Karen Gillon’s area or other members’ areas, the voluntary and third sectors must be around that table at the start, not as an afterthought once the plans have been drafted. They must be involved in deciding where those resources can go and where they will have the biggest impact. We want to avoid people turning up at the front doors of our hospitals. We want to keep people safe in their own homes. We must think about what services can be developed or how we can build on the successful services that are already there—as Jackie Baillie pointed out, there is some really good evidence about some of the projects that work well.
This is a timely debate. It is clear that we must further cement the successful relationships between local government, the Scottish Government, the national health service and the third sector, based on a shared understanding of the challenges that have been outlined tonight. Everybody understands the issues and knows where we need to go. The issue is how we can make that happen. I believe that the change fund will give impetus to ensuring that we can deliver in communities across Scotland the things that we know will work.
I raised the issue of the Ambulance Service and patient transport services. Is that something that you could undertake to consider?
I am happy to do that. I know that the Scottish Ambulance Service has already examined how, for example, volunteer drivers are supported. However, I am not sure whether it has considered some of the voluntary projects that are already providing community transport and how to get a better link-up in that regard. I will take that issue away and consider it further.
Today’s debate has given us an opportunity to acknowledge the role of the third sector as a full partner in taking forward a huge change in how we deliver services to not only older people, but a range of communities who need that support. It has been a pleasure to speak in the debate, and I will get back to members with the information that they have requested.
Meeting closed at 18:07.