Chamber and committees

I am in my last minute, but I will take a very brief intervention.

Given the pressures that are faced by unpaid carers—one of the groups who have been most adversely affected by the pandemic—not least due to rising energy bills, as has been articulated in the chamber during First Minister’s question time, as well as their needs in the recovery phase, what does the Deputy First Minister intend to do to support them through the Covid recovery budget, not least in relation to testing, antivirals and personal protective equipment?

Our NHS dentistry services are experiencing unprecedented levels of pressure and, not for the first time in the health sector, the Scottish Government has taken its eye off the ball. Its mismanagement of NHS dentistry has left the sector fighting for its survival.

Since the onset of the pandemic, more than 6 million NHS dental appointments in Scotland have been lost. That includes essential annual check-ups, which are a cornerstone for maintaining good oral health, as any potential issues can be identified early and properly assessed, which boosts the likelihood of a positive outcome.

Since coming to power, not only has the SNP-Green Government presided over the privatisation of dentistry services in Scotland, it has accelerated the process of privatisation. In response to any criticism or scrutiny, as we have again seen today during the debate, the Scottish Government gives its excuses, one of which is to state that 95 per cent of Scots are registered with a dentist. However, being registered with a dentist is meaningless if you cannot access an appointment for several weeks or if you cannot afford the expense of going private, particularly in our most deprived communities where access to such appointments is crucial.

The impact of the widespread privatisation of dentistry services is a marked increase in health inequalities, most prominently among children. New research from the British Dental Association has found that the proportion of people who have visited their dentist in the past two years has fallen from 65 per cent in 2020 to only 50 per cent in 2022. Three in every four children have visited their dentist in the past two years compared with just more than one in two children in the most deprived communities.

When the SNP came to power, as we have already heard from my colleague Paul Sweeney, the difference in dental participation rates between children from the most affluent areas and those from the most deprived communities was only 3 per cent; it is now 20 per cent. That is a shameful statistic, which is indicative of the SNP’s shambolic management of NHS dentistry and its lack of targeted action over 15 years to reduce health inequalities.

We are faced with the reality of dental care being a privilege that can be accessed only by those who have enough disposable income to seek private treatment.

I would like to say that I was pleased to hear the minister confirm that the Scottish Government has extended the bridging payments, which update the NHS fees to help dental practices to deal with rising costs—that is what the minister said would happen—but I do not think that we have had any acknowledgement of the multiplier effects or the systemic issues with the current funding model, which is completely broken and is accelerating the shift away from NHS dentistry and into private practice.

I will come back to the minister’s point, but he has some gall to stand there when he has presided over a postcode lottery for 15 years.

The message is clear—pause the bill now and get back round the table. Our social care sector needs Government action to deal with the immediate problems. Care workers cannot wait another three or four years on the promise of a national care service that is not worth the paper that it is written on.

That is why Scottish Labour has called for an immediate uplift in the wage of social care workers to £12 per hour, rising to £15 per hour, and for the Government to deliver on the recommendations of the independent review into adult social care by scrapping non-residential care charges for those who are supported to live in their own home by social care workers. That was a manifesto pledge of this Government that it does not seem too keen on fulfilling any time soon.

It is time that the minister and the cabinet secretary removed their heads from the sand and addressed the significant and growing concerns of front-line workers, trade unions, professional bodies, local government, their own back benchers and—before the minister gets to his feet to intervene again—people with lived experience, who are speaking to me and sharing their concerns about this shambles of a bill.

The Government needs to get serious about addressing the crisis in social care, and it has to act now to give social care workers a meaningful pay rise and scrap those non-residential care charges. Addressing that crisis in social care will have a huge impact on the problems in our national health service, because it is clear that having meaningful and real action on dealing with delayed discharge can change the game in relation to what is happening in our NHS. This Government needs to get serious about it.

It is clear to me that we must put people at the heart of this national care service if it is going to work at all. Social care workers do not need warm words and platitudes from this Government, or ministers who were happy to stand and clap for them during the pandemic, but a real pay rise.

I move amendment S6M-07813.1, to insert at end:

“, and further calls on the Scottish Government to immediately uplift social care pay to £12 per hour with a plan to raise it to £15 per hour and, as recommended in the Feeley Review, remove non-residential care charges.”

The cost of living crisis is being felt most acutely by people with caring responsibilities and those who are in receipt of care.

The Scottish Government commissioned the independent review of adult social care, which included a recommendation to scrap non-residential care charges, but we know that action has not been forthcoming to deliver on that recommendation. The removal of non-residential social care charges would, overnight, improve the lives of more than 100,000 people in Scotland by relieving the financial pressure on their households. Why has the First Minister failed to listen to experts such as Derek Feeley, and to scrap non-residential care charges?

The minister’s answer would be funny if this were not such a serious issue. Pat Rafferty, the Scottish secretary of Unite, has described the National Care Service (Scotland) Bill as “not fit for purpose”. Unite’s intervention joins a growing chorus of voices raising significant concerns about the lack of clarity on what the bill will achieve in practice. All of that begs the question of why the bill was not co-designed from the beginning, before we had the proposed legislation in front of us.

Unite’s withdrawal is a significant development. The union represents thousands of social care workers who are on the front line of delivery. On countless occasions, the minister has talked about the importance of a co-design process in shaping the national care service. Can he explain why so many stakeholders, particularly those representing front-line care workers, have lost confidence in his national care service proposal?

The minister talks about listening to people, but he has his fingers in his ears. How many key stakeholders will have to withdraw from the co-design process before he starts treating the issue with the seriousness that it demands? The concerns that Unite has raised reinforce wide-ranging concerns that have already been aired by professional bodies, trade unions and front-line workers. Many trade unions have described the bill as not fit for purpose, and many have said that the minister needs to get back round the table, do the co-design process properly and think again. Indeed, the Parliament’s own Finance and Public Administration Committee—

Will the minister recognise that his proposals have lost the confidence of key stakeholders and commit to pausing the bill?

To ask the Scottish Government what its response is to the reported announcement that Unite the union has withdrawn from the co-design process of the national care service. (S6T-01149)

—which is chaired by a Scottish National Party colleague, voiced its concern on the cost of the bill. The minister needs to wake up and smell the coffee—