Meeting of the Parliament

Meeting date: Tuesday, December 6, 2016

Official Report 872KB pdf

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Social Care Charging

The final item of business is a members’ business debate on motion S5M-02130, in the name of Johann Lamont, on the care tax in Scotland. The debate will be concluded without any question being put. I call Johann Lamont to open the debate.

Motion debated,

That the Parliament considers that disabled people and people with long-term conditions such as dementia and motor neurone disease in Glasgow and throughout Scotland are increasingly paying more for social care services; understands that campaign groups, including Scotland Against the Care Tax, and Frank’s Law, are concerned about the effects of this charging; considers that social care is essential to enabling them to enjoy their human rights; further considers that the current local authority charging regimes may be discriminatory in applying different rules to people of different ages without sufficient objective justification, and notes the calls to explore ways of making social care charging fairer with a view to ending the practice altogether.

17:06  

I thank everyone who signed the motion and who is here for the debate. I particularly note that the Cabinet Secretary for Health and Sport will respond to the debate herself, acknowledging the significance of the issue for many people. I also acknowledge the work of the Scotland against the care tax and Frank’s law campaigns, the Coalition of Carers in Scotland and all the other tireless campaigners who have focused their attention on the significant issues that are faced by disabled people and those who need social care. I acknowledge the particular role of my former MSP colleague Siobhan McMahon, who, while she was here, pursued these issues with great passion and commitment. She insisted that I, for one, should ensure that they continue to be raised now that she is no longer in this place.

I do not pretend to be an expert on these important issues, so I am grateful to all the organisations that provided briefings for the debate. They highlight a wide range of concerns, including the lack of consistency across Scotland, the unmet needs of those with neurological conditions who are under 65, the danger of cost deterring the uptake of low-level preventative care measures and many more—too many for me to cover in the debate. At the heart of it, we must recognise that, behind every story that is told and every issue that is raised, there are human beings who are experiencing difficulties that have been caused not by them but by a system that does not properly acknowledge their needs.

I am pleased to say that many of those who understand and live with these issues are with us in the public gallery tonight and will be involved in a meeting following the debate in which we will continue the conversation. I hope that the cabinet secretary and other members will be able to attend that meeting with us.

In too many debates, there is a danger that we settle for identifying others to blame and sit back on what we are doing ourselves. In building a consensus, I think that there is a central role for the Scottish Government in refreshing its approach and in understanding and addressing the unintended consequences of some of its political choices. Local government must do that, too, in its actions in the area. What we cannot do is put the issue in a political “too hard” box and settle for telling people how much we care, without taking the action that matches that concern.

The motion highlights the fundamental injustice in the facts that disabled people and those with long-term conditions such as dementia and motor neurone disease are paying more for social care services; that, astoundingly, over the period 2009 to 2013, the amount of money that was collected from older and disabled people rose at approximately four times the rate of inflation; that the charges are, in effect, a tax that the rest of us do not have to pay; that disabled people contribute to mainstream services that they cannot access unless the social care that allows them to do so is funded; and that the cost of care—its availability and affordability—is seeing people priced out of using services, with a consequent cost to their wellbeing and with an impact on their unpaid carers, who pick up the slack.

We know that disabled people are more likely to be living in poverty and to be on the front line when it comes to facing the consequences of the austerity approach of the Tory Government, but we should not compound their problems by the choices that we make. We know that it makes no economic sense to ignore disability-related expenditure—the extra cost of heating, of transport and of simply living—and to deny disabled people who want to work the opportunity to fulfil their potential and to contribute through taxation. The fact that it costs them to work means that their loved ones have to live with greater stress and ill health. That approach increases costs, causes more crises and results in more emergency admissions to hospital. Instead of being in a position in which proper funding is provided for preventative spending, we are in one in which people can be supported only once they are in crisis.

As we look at our national health service, we know that the solution, in large part, is to invest in local government rather than targeting it disproportionately for cuts. That is a rational means of improving the health and wellbeing of all our citizens. Therefore, it is rational and a matter of logic and of justice to address the issue; critically, it is also a matter of human rights. The issue is not about our being able to display how much we care, how much we empathise or how we can be a little kinder to disabled people and those with long-term conditions; no, it is about how we live up to our oft-repeated commitment to human rights and equality. It is not a “maybe”; it should be a “must”.

To the people who say, “I get that—there is an issue here, but it’s just too expensive; we can’t afford to eradicate care charges,” I say this: educating our young people is expensive, but we do not suggest that we should educate only our boys because we cannot afford to educate all our young people, so why can it be acceptable to deny disabled people the right to live independently and the right to access work and economic opportunities? Why can it be acceptable for the needs of two people with the same degenerative condition to be supported differently on the grounds of age or because of where they live?

We have a fundamental choice to make. We can increase the size of the resource cake to meet needs fairly, through taxation, or we can redistribute the existing resource cake fairly, but we cannot, in all conscience, shrug our shoulders at what is a manifest injustice and a denial of the human rights of all too many in our communities. I seek from the minister an acknowledgement of the problem and a commitment to act. It cannot be left till some distant point in the future when we will have solved the problem of spending more while taxing less. This is work that Parliament can do right now. We can support the Government in developing a proper strategy that focuses on the injustice of the problem of the imposition of a care tax on those who need support services in order to live their lives independently. We need a commitment to justice, and we must work with those who understand best what it is like to live with a disability without the means to achieve their potential.

This is an urgent matter. It is a matter of equality and of human rights, and I believe that it requires us all to show a little bit of courage. We must be willing to be bold and to say that the issue is a problem, that it is one on which we can act, that we will open up the debate about why taxation should benefit all in our communities and that a fair distribution of resources would mean that we could all achieve our potential. It is an area in which we can come together as a Parliament to confront issues that matter directly to far too many people across our communities.

I look forward to the debate, and I hope that it is just the start of a wider debate that will result in our making a difference and responding to the long-held campaigning convictions of those who deserve the right to equality and justice.

Speeches should be of around four minutes, please.

17:14  

I thank Johann Lamont for bringing the debate to the chamber and for the tone that she struck in opening it.

It is important to address the issue. We need to consider it accordingly, set politicking to one side and acknowledge that there may be a difference between what we might all ideally wish to be delivered now, and what might be deliverable in the short, medium and longer terms. A realistic and informed debate is required about how it might be possible to meet the aspirations that people who are affected by the issue rightly have, set against the financial pressures that the Scottish Government and local authorities face. It is a fact that there are tough choices to make about what we can and cannot fund.

From the case that has been advanced by the family of my late constituent Frank Kopel, who died of early-onset vascular dementia and did not qualify for the support that he would have had if he had been over 65, through the arguments that make a similarly strong case for those who have been diagnosed with all types of terminal illnesses or disabilities, to calls for blanket, outright abolition of the charges now: even the most heartless of individuals would surely struggle to disagree with the merits of those calls.

Ideally, we would all aspire to the abolition of charges for the under-65s, given the difficulties that the charges create for those people and their families. How do we say to any group or individual that, whatever the strength of their case, in the short to medium term it cannot be addressed? However, if we accept that, given the increasing demands that are being made on the health budget, funding outright abolition is unachievable in one giant leap, we can still, as Enable Scotland has suggested,

“explore some of the pragmatic steps that can make a significant difference on the journey to ending this practice”.

More than that, we should ensure that the Scottish Government delivers on its commitment to make progress on delivering a fairer system.

For that informed debate to be kicked off, we need accurate figures for the cost of abolishing social care charging for all under-65s. That is the elephant in the room. In responding, will the cabinet secretary offer some hard details on that, if only to bring some context to the financial challenge concerned?

Whatever the costs involved, we cannot ignore the case that is being made to pursue possibilities for progress. We should not put the issue in the too-difficult-to-do box, as Johann Lamont mentioned.

The briefings that have been provided for the debate from a variety of sources contain a number of criticisms of the Scottish Government’s provision of £6 million to local authorities to take 800 under-65s out of paying any charges and reduce the charges that have been borne by 13,000 others. I understand entirely that people and their families in such a situation would prefer that no one was paying anything, but that was a genuine first step along the road that the motion calls on us to travel.

It was concerning indeed to learn that some councils may have failed to ensure that the full benefit of the £6 million was felt by those whom it was intended to help. Shame on any councils of whatever political hue that did that. However, I caution about rushing to judgment on such allegations without substantiating them. I was horrified to read an assertion that Angus Council, which is my council, had failed to deploy the money for the purpose for which it was received, but that turned out not to be the case.

If we accept that we will have to move forward at a pace and in a way that will not necessarily meet the aspirations of all, what could we do? The programme for government revealed an intention to conduct a feasibility study into extending free personal and nursing care to those under the age of 65 with a diagnosis of dementia. Can we move forward on that sooner rather than later? What of the Marie Curie charity’s call to consider ensuring that anyone under 65 who has been given a terminal diagnosis is exempted? What about taking account of any disability-related expenditure before arriving at the point at which care charges kick in? What about the suggestion from Learning Disability Alliance Scotland that the threshold at which disabled people should have to start paying charges should be set at £11,000 rather than the current £6,500? It strikes me that, in the spirit of exploring a fairer way forward, those ideas are worthy of costing and consideration.

In conclusion, I repeat my welcome for this opportunity to debate the issue. I recognise entirely the challenges, but encourage the Scottish Government to make whatever progress that it realistically can towards arriving at a more equitable situation.

17:18  

I congratulate Johann Lamont on securing this members’ business debate.

The Scottish Parliament agreed the free personal care for the elderly policy in 2002, with all-party support. However, since the Community Care and Health (Scotland) Act 2002 was passed, it has become clear that, for many people in Scotland who live with a life-limiting condition, unfair age discrimination surrounding access to vital personal care has been an unintended consequence.

At present, anyone under the age of 65 who requires personal care because they have dementia, motor neurone disease, Parkinson’s disease, multiple sclerosis or Huntington’s disease has to fund the cost of that personal care themselves. Since the election, I have met a number of constituents and organisations that have legitimate and genuine concerns about the current social care charging system for people with those conditions. I recognise the strong feelings that exist and believe that we need to address the issue and respond to the unfairness that is often very clear to see.

There are real concerns about the disparities and inconsistencies in social care charging across Scotland, as well as about the collection cost, which make it one of the most inefficient charges or taxes collected.

The motion refers to Frank’s law. Along with Ruth Davidson, I recently met Amanda Kopel to discuss her campaign. I welcome Amanda and other campaigners to the public gallery this evening and congratulate them on the incredible campaigns that they have been running across Scotland to try to get the Scottish Parliament and the Scottish Government to act to address this unfairness. I pay warm tribute to Amanda for the outstanding and high-profile campaigning work that she has undertaken to support a change in the law to allow under-65s with conditions such as dementia and MND to receive vital support for their social care. Amanda’s selfless efforts are to be commended, and I know that her determined campaigning will not cease until we see a better system in place in Scotland.

Official figures show that the number of people who are under 65 and being treated for dementia is increasing, and that trend is likely to continue. Dementia can devastate an individual and their family, but early-onset dementia can be even more devastating for family members. We need to look at how we can better support them to care for their loved ones.

As Graham Dey outlined, earlier this year the Scottish Government announced an extra £6 million for local authorities to raise the threshold at which people begin paying for care at home. That is a small improvement that will help only a limited number of people. It is vital that the Scottish Government sets out, in as much detail as possible, the accurate costings and projections that it has for extending free personal care to all those who need it, broken down by condition, so that we can have an informed debate about what extra resources are needed and how we can take forward a change in policy.

The Scottish Government’s feasibility study of expanding free personal and nursing care to people with dementia who are under 65 is welcome, but it is also important that we look at other long-term conditions, such MND, MS and Huntington’s disease.

I am pleased that we are having this debate, which is very timely. I know that charities and individuals will continue to campaign hard on this issue to press the Scottish Government to act. I welcome their continued input and efforts. I hope that, as Johann Lamont said, we can reach a consensus in this Parliament to provide a better and fairer system of social care support for people under 65 who are in need of personal care at what is clearly the most difficult time in anyone’s life.

It is vital that we make progress on the issue beyond a member’s debate and that this Parliament and this Government move it forward. I suggest to the cabinet secretary that we establish the first-ever Scottish Parliament all-party working group on this specific issue, to look at it and work to bring forward costed solutions. I hope that, in responding, the cabinet secretary will agree to that suggestion and that we can look to establish the group at the earliest opportunity.

No illness, long-term condition or disease waits for a person to reach the age of 65. For those who need support with social care, regardless of age, we must see that that need is recognised and support provided, when they need it and where they need it.

17:23  

I declare an interest, as I am a local councillor. Also, until just after my election to the Scottish Parliament in May, I was employed by Parkinson’s UK.

I thank my colleague Johann Lamont for the opportunity to debate the important subject of care charges and to start, I hope, a wider discussion on the issue of how we provide and fund social care in Scotland.

It is now 14 years since the last Labour-led Government introduced free personal and nursing care to everyone over the age of 65. Today in Scotland, around 77,000 older people benefit from that policy. However, to use the words on the Frank’s law campaign website,

“no disability, illness, condition or disease waits until a person reaches the age of 65, then strikes.”

Across Scotland, 90,000 people are living with dementia. Not all of them are over 65; in fact, more than 3,000 are under the age of 65. If any of those 3,000 people require personal care, they are financially assessed by their local authority to determine whether they should make a financial contribution towards that care. Where they live often determines how much they pay. It is the same for many other long-term conditions, including motor neurone disease, Parkinson’s, multiple sclerosis, cancer and many others.

In our election manifesto, Scottish Labour made a commitment to work towards the abolition of such care charges for those under 65. I reiterate that commitment today.

Given Labour’s commitment, can the member explain why Labour-controlled Dumfries and Galloway Council has lowered the threshold at which disabled people start paying care charges, and why it has introduced a disparity between over-65s and under-65s?

I will come to that point but, as Joan McAlpine knows, the policy was supported by the SNP councillors.

When she responds to the debate, I hope that the cabinet secretary will say whether the Government supports the commitment to the abolition of charges or, at the very least, set out a timetable for extending free personal and nursing care to those who have a diagnosis of dementia. Labour will support that work.

This issue goes beyond party politics in the same way as it did when Labour introduced free personal and nursing care. It is disappointing therefore that Joan McAlpine seeks to make it a party-political issue by attacking Dumfries and Galloway Council, which, as a direct result of funding cuts, brought charges in line with those in most of the rest of Scotland. Historically, the charging policy in the region was more generous than it was elsewhere and that was not without consequences. Overspends in social work under previous administrations were common and, in order to balance the books, a more generous charging policy meant cuts to other services. Faced with this year’s unprecedented 4.5 per cent cash cut in the Government grant, the council instigated a review of the policy as the options for making savings elsewhere became increasingly limited.

That review began before the Government announced the social care fund, but we also know that the Government’s financial assumptions in relation to that fund were flawed. For example, the Government initially indicated that the application of the living wage to care staff from 1 October would cost around £37 million across Scotland—approximately £1.1 million in Dumfries and Galloway. However, the actual cost to Dumfries and Galloway Council of the living wage was more than £3.4 million. The Government cannot therefore claim that funding is available to ease charges when the package of measures required under the social care fund was in excess of that funding.

Faced with £21 million of cuts, councillors reluctantly agreed to bring its social care charging policy more in line with those in the rest of Scotland. As I said, the policy was backed by all councillors and all parties, including the SNP. In fact, the SNP group’s budget in which it proposed the change showed that the additional income raised avoided the necessity of making a further £500,000 of cuts. That is the equivalent of up to 15 social worker posts or more than 30 carers. If politicians in Parliament want to attack local councillors for making decisions that they do not like, at very least they should have the guts to say where they would make the cuts. I will not hold my breath.

In the time that we have to debate this issue, it is possible only to scratch the surface of the challenges that we face in delivering and properly funding social care. Addressing individual issues such as social care charges in isolation will not solve the problem. I hope that today’s debate is the start of a wider discussion of the future of social care in Scotland.

17:27  

I thank Johann Lamont for bringing the debate to Parliament. The issue is important and I am pleased to be able to use the time to raise the interests of my constituents in the south of Scotland.

However, I will start by addressing the point that Colin Smyth just made about choices and the cuts that are—let us not forget—being imposed on us by Westminster. I have suggestions about an area in which his council could save money. His council is raising about £450,000 this financial year on the back of charges to disabled people, and it is spending a similar figure on a new group of officers whose job is to shadow councillors. They are called ward managers and they are on between £42,000 and £46,000 a year. They are not front-line social workers, teachers or learning support assistants; they are bureaucrats whose annual wage bill costs about the same as what is being raised by charging disabled people. Colin Smyth asked me to make a suggestion, and that is my suggestion.

The member will be aware that the option that she has talked about was a saving, because it meant a cut in the overall number of staff, and all the posts were filled by existing members of staff. I presume that that is why SNP councillors agreed to the proposal—it did not need any additional funding, so there would not be a saving.

Those are weasel words. The posts are new and are not front-line posts. The difference between me and Colin Smyth is that I am willing to stand up and say that I oppose the charges. I do not care who has supported them—I know that Colin Smyth supported them—but I am willing to stand up and say that I oppose them.

What Dumfries and Galloway Council has done has had a really detrimental effect on some of the most profoundly disabled people in the country. One constituent who wrote to me cares for his profoundly disabled son. The son’s care charges have risen from zero to £31.30 a week in the past two years. That is more than £1,600 annually, which comes out of the son’s employment and support allowance and disability payments. The charge has risen by more than 500 per cent.

A lady who wrote to me is a pensioner with three disabled adult children. She is now paying an extra £60-odd a week to cover two of them.

Dumfries and Galloway Council has defended its decision to hike up charges by claiming that the £177 per week threshold that it used until this year was overgenerous. That is deeply insulting and insensitive. It is easy to dehumanise people by calling them service users—some councillors have said in the press that the council was overgenerous to service users. However, if someone said that they were overgenerous to severely disabled people, that would bring home exactly what the consequences were of what they were doing.

The guidelines that the Convention of Scottish Local Authorities published earlier this year were intended to protect people on the lowest incomes from charges by using the £6 million from the Government that has been mentioned. However, critically, the amount was not reduced for councils that were, as Colin Smyth might put it, overgenerous in their payments. Those councils still got the same allocation. Dumfries and Galloway Council got £182,000 extra as its share of the £6 million but, instead of using that to reduce the charges, it pocketed the money and raised charges for the people involved.

Will the member give way?

The member is just about out of time, Ms Lamont.

I realise that the decision is not easy but, as I have said, councillors have choices as well. This is an example. We are constantly being told that we should not centralise and that we should not dictate from the centre; this is a local decision by a local council and it is very damaging for disabled people in Dumfries and Galloway. [Applause.]

I ask people in the public gallery to please hold fire on any clapping of hands. If you wish to show your appreciation for any member once the debate is over, you are welcome to do so, but not during it. Thank you.

17:32  

I declare an interest as a serving councillor on Argyll and Bute Council. I join colleagues in congratulating Johann Lamont on securing today’s members’ business debate on this important issue. I also commend her for the passion that she brings to the subject; she gave an excellent speech.

As a former chair of Argyll and Bute health and social care integration joint board, I understand the difficulties in deciding whether someone should be charged for services and how much they should be charged. It is important to keep the debate on a level that does not get down into petty politics; I was slightly ashamed of what happened in the previous speaker’s comments.

It is never easy to make such decisions and, for obvious reasons, they create strong and understandable feelings. A lot of people see many aspects of the current system as being unfair, such as people receiving different levels of support because of when their birthday is or where they live.

That is why the Scottish Government announcement earlier this year that an extra £6 million would be given to local authorities to raise the threshold at which people pay for care at home was a welcome step. However, it is a small one that will help only a limited number of people. I hope that the Scottish Government will go further in offering that vital help in the future.

I can give examples of people with whom I have been involved—particularly a young gentleman aged about 63 years old who lives in Edinburgh. I was his guardian after he had a severe stroke. He received the most brilliant rehabilitative care to get him back home from the Astley Ainslie hospital here in Edinburgh. However, because he was of the young age of 62 or 63, there were when he got home severe financial problems with providing the full care package that he required, which the NHS put in place. Consequently, some corners had to be cut, which did him no benefit. I understand from practical experience how the problem manifests itself when somebody is under 65.

I know of a gentleman in Argyll who, as a baby at the age of 10 months, had a brain operation because he suffered from severe epilepsy. He is now 19 and lives in Oban under care from his parents, who give him total overnight care and care during the weekend. They share the care with council services and the NHS. That is stretching the family beyond belief, because he falls into the under-65 category. There is an awful long way to go to rectify that.

All too often, I hear about cases of people who are under 60. I know of a 53-year-old and a 54-year-old who have severe dementia and who are struggling to finance their care because of their age.

I am a member of the Public Petitions Committee alongside Johann Lamont, and we are considering the long-standing petition by Mrs Kopel on this subject. It is a sign of Mrs Kopel’s dedication and work that the petition has the support of well over 1,000 individuals. I know that Ruth Davidson has met Amanda Kopel on several occasions in relation to Frank’s law. As our manifesto in May stated, the Scottish Conservatives have supported and continue to support most strongly the Frank’s law campaign.

I have given examples of people with dementia and Alzheimer’s who are under 65. As the number of such people goes up, the question of how we provide support for them is becoming an even more pressing matter than it currently is. Our manifesto also stated that we will continue to put pressure on the Scottish Government to increase support for dementia sufferers who are under 65. We will continue to do that until we see some movement in the right direction.

That is why I am glad that the Scottish Government has a feasibility study to look into the expansion of free personal and nursing care to people with dementia who are under 65. I support that but, as Miles Briggs pointed out, it is also a good opportunity to discover the cost of covering other conditions, such as motor neurone disease and Parkinson’s. Finding out how much it would cost to provide free personal care to all those who need care, whatever their condition and individual circumstances are, is vital to ensuring that the on-going debate on this important subject is well informed and based on fact, so that we politicians can make the correct decisions for our constituents.

The debate is important and I am sure that it will continue after today. It will inspire passions and I know that charities and individuals will continue to work hard to ensure that everyone can access the social care that they need. I hope that, in the coming months, we in the Parliament can work together to create a system that is better able to provide for people who are under 65 and in need of care.

17:38  

I join colleagues from across the chamber in congratulating Johann Lamont on securing this important debate. The motion makes a lot of good points.

The Scottish Government has a proven track record on free personal care. The Scottish National Party campaigned on a promise to protect free personal care for the elderly and it will keep that promise. Of course, as others have pointed out, much more can be done. In that vein, I welcome ministers’ plans to investigate ways of extending free personal care to other groups that would benefit from that great service, such as those with dementia who are aged under 65, as has been mentioned. That was outlined in the SNP manifesto and the programme for government. The cabinet secretary’s commitment to work closely with COSLA to get the best outcome for those who are in need is to be welcomed, and I hope that leaders of councils throughout Scotland will engage fully in that process.

It is fair to say that the Scottish Government is doing what it can to protect those in society in the face of eye-watering cuts. I do not think that many members would disagree with that. We often talk—rightly—about the vicious cuts that the Conservative Party is making and which are affecting our constituents throughout Scotland, and we talk about how that is a choice rather than a necessity. I know that I am not alone in dealing with large numbers of constituents who have been hit by those cuts. That is why I was absolutely heartened to hear the contributions and tone of Conservative members on the issue tonight.

I was also glad to hear Johann Lamont note that this is about not just the Scottish Government or the Westminster Government but the local authority taking responsibility. Two of my colleagues have already had a bit of a debate on that.

In my area, North Lanarkshire Council imposed a £5 per week charge on community alarms earlier this year. That is a massive £260 a year for some of the most vulnerable people in my constituency. The majority of people who have community alarms installed have them not for the sake of having one but as a means to remain in their own home, because they know that, if something happens, help will not be far away. A couple of weeks ago, a constituent approached me in Coatbridge Main Street and told me that she had decided to get rid of the alarm and was worried about the consequences.

I hear what Fulton MacGregor says. People are making such choices and not getting the preventative care that they might have got earlier, but does he accept that the Scottish Government has also made a choice? The cuts to local government are larger than those to the Government’s budget. That is a choice that the Government has made and it has a consequence—as local government cannot raise the money itself and its budgets have been cut, it has to make impossible choices. Does Fulton MacGregor agree that we should increase the size of the cake by using our powers to increase taxation on everybody in order to fund our services properly?

The point has been made by all members who have spoken that we all need to work together on the issue. I accept what Johann Lamont says in that regard, but my focus was on the responsibility of local authorities. I do not do my job for my constituents if I come to the Parliament and do not say what is getting to them and what they are coming to my surgeries—

Will Fulton MacGregor take an intervention?

I will not be able to take another one.

North Lanarkshire Council also reviewed the garden assistance scheme earlier in the year. On the council’s behalf, the scheme charges through-the-roof prices for many elderly and disabled citizens to have their gardens done. I mention those charges because, when a charge is placed on a product or service that is absolutely required, it is a tax. Some of the people who are affected by such charges are the ones we have been speaking about. They are the most affected.

I agree with the overall tone of the debate. We all have a role to play in working together as parties and at different layers of government—Westminster, the Scottish Government and local authorities—to get the right deal. I do not think that anybody will disagree with that.

I still have two members who wish to contribute to the debate. I will not be able to call them unless the debate is extended, so I am happy to accept a motion without notice that the debate be extended by up to 30 minutes. Ms Lamont is sitting with great anticipation. Would someone care to move the motion?

There is a first time for everything.

I move,

That, under Rule 8.14.3, the debate be extended by up to 30 minutes.

Motion agreed to.

I cannot believe that that is the first time that you have ever had to do that, Ms Lamont. My goodness.

17:43  

I, too, congratulate Johann Lamont on bringing the debate to the Parliament and all the campaigners who have diligently pursued the campaign. My colleague Jenny Marra and I visited Amanda and Frank Kopel’s house a few years back. I remain, and will continue to be, profoundly moved by that experience. However, I wonder how many other Franks there are who do not have an articulate voice and an articulate family campaigning for them. How many other Franks are there who do not have access to pressure groups, do not know the system and do not get their voices heard? They are foremost in my mind.

The social care system in Scotland is in a perilous situation. We see social care providers with severe staff shortages, care staff being underpaid and feeling demoralised and undervalued, council budgets being slashed, integration joint boards starting life making cuts, and health boards such as NHS Lothian in a desperate financial situation. Although Government ministers and civil servants claim that there are no cuts, only efficiency savings, every front-line staff representative who I meet in the social care field is astonished at that claim. In these desperate circumstances, it is inevitable that councils will use all their powers to try and recoup money from anywhere in an attempt to keep services afloat.

Let me be clear from the outset that I am not here to attack councils. I am not going to play Joan McAlpine’s game of voting to cut council budgets, shackling councils over council tax then turning around and pointing the finger at the same councils for making cuts and imposing charges.

Last week, Audit Scotland noted that the cuts to council budgets were the same as the cuts to the Scottish budget overall. I ask Neil Findlay to reflect on the fact that the point that I made about Dumfries and Galloway Council was relevant because all the councils that were in the same position as Dumfries and Galloway Council—those that had higher thresholds—kept their higher thresholds but only Dumfries and Galloway Council chose to immediately impose a cut on disabled people across the board. That is the difference. I totally appreciate that local authorities face challenges.

That is good. I look forward to Ms McAlpine voting the right way when the budget comes before this Parliament.

Two years ago, I published a report by the Labour Party commission on social care in Scotland. The commission recommended that we sweep away much but not all of the charging system. It recommended that support with personal hygiene, continence management, meal preparation, mobility, counselling, the administration of medication, and alarms and telecare should be provided without charge, but that local authorities should be able to charge for other support arrangements such as housework, shopping, lunch clubs and meals on wheels.

The commission also recommended that all adults, irrespective of age, who were assessed as needing social care should receive it for free. I think that that is a sensible, fair and compassionate approach. I do not understand why someone who is aged 45 with MND or MS and who is immobile and reliant on care staff for dressing, feeding and washing is denied free personal care, yet someone with the same needs who is over 65 gets it. That is not an argument for denying the over-65s the help that they need; it is an argument that says that others need it, too, and that we should care for our people according to their needs, not according to an arbitrary date on a calendar.

However, in sweeping away the charging system, this Parliament has to face up to some harsh realities. We cannot have a system that is financed by fresh air or is left to the vagaries of the latest punishment that the Government doles out to Scotland’s councils. I would like social care to be paid for in the same way as the NHS is, with all of us paying when we can and taking out when we are in need.

We could do that using a number of different options, which were identified in the commission’s report. We could take a different approach to policy decisions in relation to Government spend. We could increase national insurance contributions across the UK. We could use the Scottish rate of income tax. We could implement wealth or property taxes. My preferred option would be to have a UK-wide tax on estates that would be paid on death by everyone, whether they had used the social care system or not.

Could you come to a close, please?

Under that arrangement, services throughout a person’s life would be free at the point of access and paid for after the end of life. Whatever we choose, doing nothing is not an option.

This about the fundamentals of how we see ourselves as a society.

Mr Findlay, you must close.

Are we a civilised society that cares collectively for people throughout their lives or are we not?

17:49  

I congratulate Johann Lamont on bringing the issue to the Parliament’s attention. In the previous session of Parliament, as Johann Lamont noted, Siobhan McMahon raised the issue of unfairness in the current care charging system by proposing a member’s bill, and I welcome the opportunity to return to that issue in the current session.

I welcome the motion’s call to

“explore ways of making social care charging fairer with a view to ending the practice altogether.”

I believe, as other members do, that it is essential that we do that. As the ALLIANCE—Health and Social Care Alliance Scotland—points out in its briefing:

“Independent living is a human right that does not rely on an individual being able to pay to achieve it.”

It is also right to point out that:

“Charges for non-residential care amount to an additional tax on disabled people for accessing vital support in order to live independently”

and that

“Free personal care ... should be extended to cover all people who require”

it

“in order to lead independent lives.”

Enable Scotland tells us that its members are concerned about the sustained affordability of social care charging; that they cannot afford to do the things that they would like to do; and that they are often going without. Jim Elder-Woodward of the Scottish independent living coalition is right to say that we now understand that childcare should be viewed as a social infrastructure investment and that that approach should be extended to social care support.

I thank all those who have provided us with such excellent briefings today—the number of briefings that we have received is testament to the number of lives the issue touches. The briefings are very well researched and come from those who have direct experience of the impact of the charge. I cannot mention them all, as I would use my whole four minutes, but they are very powerful and make us aware of the many inconsistencies in the current regime for care charges.

While the cost of procuring care differs in different areas—for example, care in rural areas is more expensive to provide—the current differences in care charges between local authorities cannot be explained only by the differing costs of care. According to Inclusion Scotland, home care services vary from being free in Fife to costing £23.70 an hour in Angus. The taper that local authorities apply to determine care charges also varies hugely, from 15 to 100 per cent of disposable income.

The rules that govern the calculation of charges can vary hugely. Charging for care by councils is self-regulated; COSLA develops guidance for the calculation of charges and local authorities are supposed to take that into account when they set charging policies. However, although COSLA recommends a list of sources of income to disregard for the purposes of calculating care charges, those are only recommendations. That could mean that, in some areas of Scotland, the very welcome increase in carers allowance that the Scottish Government is pledging to introduce could immediately be swallowed up by care charges, whereas in other areas it may be disregarded.

It is difficult to see any justification for that level of inconsistency. The benefits system operates on criteria that apply to everyone regardless of where they live. As free or reduced-cost care is a benefit in kind, the determination of eligibility for it should not be subject to such different approaches in different parts of the country. It is clear that we need urgently to bring some consistency to care charging as a first step towards phasing out charges for care. That can be done under existing legislation, as the Scottish Government has the power to regulate care charges under the Community Care and Health (Scotland) Act 2002. A decision was made at that time that those powers would be held in reserve until the implementation of the guidance that COSLA issued in 2002 could be evaluated. That evaluation has never been carried out, and—14 years later—it can reasonably be described as overdue. I would welcome the cabinet secretary’s comments on that.

The abolition of disability living allowance and the reduction in the number of claimants who are able to access the new personal independence payments will have an impact, too. Reductions in the income of people who use services may well take more individuals below charging thresholds and place additional demands on stretched resources. The 2014-15 COSLA charging guidance states:

“consideration is currently being given by the Scottish Government to mitigating the impact the changes will have”.

I would appreciate an update from the cabinet secretary on progress in that regard.

I am very pleased that we are debating the abolition of care charges but, as other members have suggested, that needs to come in the broader context of the new powers that are being devolved to this Parliament. There are opportunities for progressive taxation that could cover those costs. If we believe in healthcare that is free at the point of delivery, we must consider that seriously now. If we want to live in a truly inclusive Scotland, this unfair tax must be abolished—let us start now.

I do not think that I have ever heard four-minute speeches stretch quite so far as in this members’ business debate. I call Shona Robison to wind up the debate—you have around seven minutes, cabinet secretary.

17:54  

The debate has highlighted a number of issues around social care—in particular, around fairness of charges for social care, but also around wider issues. I thank Johann Lamont for bringing the debate to Parliament and for the very constructive tone that she struck. I add my welcome for the role of campaigners—particularly Amanda Kopel, whom I have met a number of times—in focusing our minds on fairer charging.

Johann Lamont’s motion calls for the Parliament to

“explore ways of making charging fairer”

I will outline progress that we have made on the journey towards make charging fairer. The additional £250 million that we provided this year for social care has achieved a number of things. It is worth noting that it helps to deliver the living wage for 40,000 care workers, which is important in making sure that there are staff there to deliver the services that people receive. Included in that £250 million is the £6 million that a number of members referred to, and which was provided to allow local authorities to raise charging thresholds in order to take about 900 people out of charging altogether and—which is important—to reduce charges for 13,000 more. That £6 million, as I said when I announced it, was the first step towards fairer charging. It was deliberately aimed at prioritising people on the lowest incomes to reduce their charges or to take them out of charging completely. I hope that members agree that that priority is important.

We have listened to campaigns, including Gordon Aikman’s campaign, for an end to charges for people who are in the last stage of terminal illnesses, so since 1 April 2015 we have ensured that no one who is in the last 6 months of a terminal progressive illness is charged for the care that they receive at home.

Looking forward, we have committed to ensuring that from next April guaranteed income payments and war pensions for armed forces veterans are excluded from consideration as income for the purposes of social care assessments. Some progress has been made, but there is further progress to be made.

In response to the concerns that have been raised by campaigns, including the Frank’s law campaign, today I confirm again that we have committed to conducting a feasibility study over the course of the next year into the possibility of extending free personal care to people under the age of 65 who are diagnosed with dementia. It is a complex matter: members have pointed to the fact that other conditions in people under the age of 65 must also be considered. I will be very happy to keep members informed of progress in that work as we take it forward. I think that Miles Briggs called for cross-party discussions: I am happy to use the feasibility study as the focal point for those discussions.

I am sure that many people will welcome a feasibility study for dementia sufferers who are under 65 and will welcome the point that the cabinet secretary made about veterans.

My interest is particularly in learning disabilities—I am vice-convener of the cross-party group on learning disability. Some groups are more effective, have more lobbyists and have a higher profile than others. I would be concerned if we were to pick out particular areas. Lots of people have experience of dementia, for example, and veterans organisations have a big profile, but perhaps people with learning disabilities do not have as many people to speak for them. There should be more equity.

I have general sympathy with Joan McAlpine’s point. It would be difficult to select one group of people with a particular diagnosis, because that would create other unfairness. The feasibility study, although it will be focused on people under 65 with dementia, will have to take a wider look at the general issue of charging for personal care for people under 65. I will be happy to keep members informed as we take that forward.

Will the cabinet secretary take an intervention?

I will make a little bit of progress.

One of the biggest concerns that has been highlighted repeatedly in tonight’s debate is the variation in local authorities’ charges for social care, which makes it difficult for people with disabilities to move between local authority areas, and can cause frustration when people see that there is a lower charge for the same service in a neighbouring authority. As a result, the Convention of Scottish Local Authorities has implemented a new standard financial assessment that should bring closer alignment in how local authorities assess charges for care. We are determined to make further progress in improving fairness. We have made it clear that, if the situation does not improve, we can use legislative powers to ensure that it happens, as was outlined by Alison Johnstone.

The feasibility study that the cabinet secretary has spoken about will focus only on dementia. Is there an opportunity to widen it to include life-limiting conditions? If so, we could get the information that we are all looking for, and take the debate forward.

As I said earlier, it would be hard to look just at dementia, because there would be a danger of creating other unfairness. We would have to take a wider look at the issue of charging under-65s for personal care. The focus and the catalyst was the unfairness around dementia, but we would have to look at the wider issue as part of the feasibility study.

We are putting additional money into social care. Health and social care partnerships now manage more than £8 billion of resources that NHS boards and councils previously managed separately. The bringing together of those budgets is important. Over the course of this parliamentary session, £1.3 billion of resources will go into social care, which is an important investment.

Local authorities provide more than 676,000 hours of care each week to people in their own homes, and the average number of hours of home care that are received has more than doubled since 2000. That reflects the fact that people who have more complex needs are now remaining in their homes, which is important.

With the implementation of the Social Care (Self-directed Support) (Scotland) Act 2013, the number of people choosing a direct payment to purchase the services that they require continues to increase. More than 7,500 clients chose to do that and an estimated £94.5 million was spent on it during the past financial year. Both those figures were up about 10 per cent on the previous year. People are able to remain in their own homes because of that increased independence.

Added to that is the support to carers that we have provided, as well as funds such as the independent living fund, which is helping people with disabilities to live independent lives. That fund has not been continued in England, but it is being continued here in Scotland and it will be opened for new applications. I appreciate what members have said about the need for work to be done in that area. I accept that, but I also hope that members will accept that we have made progress, especially in relation to the fairer charging elements that have already been introduced. In no way do we think that the job is done, which is why we will make further progress over the next financial year and why we are doing the feasibility study to look at what more we can do. We are determined to do what we can to help people on the lowest incomes, in particular.

I want to go back to the point about having the courage to think about more than just simply managing the resources that we have. If the feasibility study leads to the identification of gross injustice and unfairness, are there circumstances under which the Scottish Government would look at how it could increase resources through its tax powers, or at how it could redistribute resources that it already has, in order to meet that need? I want to know what the boundaries are for the conclusions that the Scottish Government might draw from the feasibility study.

It is worth putting on the record that we are looking at raising income. For example, we are not passing on the tax cut for better-off people that the UK Government is making and we are making changes with higher council tax bands in order to raise income. It would not be fair to say that there are no adjustments being made to raise income for public services. We need to look at what the options are in the context of the feasibility study.

I took the decision because I thought it important to focus the initial raising of the threshold on people who have the lowest incomes. People on very low incomes were paying social care charges, so raising the threshold was a step in the right direction. Further steps could be taken around the threshold, or we could make other policy decisions. However, I want the feasibility study to examine the options, which will involve costings and looking at the choices that we can make with the resources that we have.

I hope that members appreciate the tone of how I have responded to the issues that have been raised. It is work in progress and I am happy to continue the dialogue with interested members from across the chamber.

Meeting closed at 18:05.