report by Abigail Robertson Stirling UNISON Branch
The National Care Service (Scotland) Bill, is the Scottish Government’s response to the recommendations within the Feeley Report. This report was commissioned by the Scottish Government to provide an independent review of Adult Social Care Services and to explore the principles of creating a National Care Service. The purpose of the Bill (NCS- Bill) is to provide a framework for the development of a National Care Service, but the result is a Bill that provides a broad-brush framework with a worrying lack of detail and many more questions than answers. This has been described by some as a “pile of blank paper”. Scottish Government aims to add detail to the Bill through the implementation of secondary legislation, and in the absence of detail, we must ask, exactly what are we being signed up to?
UNISON is not against the concept of a National Care Service. There were many elements of the Feeley report which we supported. However the Feeley report not only stopped short on the need for a ‘not for profit’ agenda in care services, it was actively promoting the private sector as part of the overall framework. This Bill falls far short of the positive recommendations within the Report and does nothing to redress the concerns UNISON expressed about Feeley’s Report.
UNISON has consulted widely on the NCS Bill, with our members, internal groups such as SWIG, Social Care Committee, IJB Reps group, the 3rd Sector, Professional Organisations, etc, and is seeking the withdrawal of this Bill. We want further engagement to develop a model of National Care from the grassroots up. We will explore the reasons for this in more depth below.
There are some big concerns within the Bill that cannot be ignored.
Lack of commitment to Not for Profit: We are all aware that the current care system relies heavily on the procurement of care services from the private sector. Many of these companies make substantial profits via the public purse but, their priorities are banking the money and paying shareholders not improving the quality of care they provide or improving pay and conditions for their staff. UNISON firmly believes that public money spent on care should remain within the public domain and be invested for the benefit of those who access care and staff who work within the care system.
Impact on Local Government/ Local Democracy: The current Bill is a threat to our Local Authorities. The removal of 75,000 Social Care and associated staff from our local authorities in Scotland will not only reduce the size of our Councils, it will significantly reduce the funding, and maybe only the beginning. To illustrate this, currently, Social Care makes up 33% of overall council budgets and Education makes up 47%, once Social Care is removed from the Councils into a NCS, Education funding will make up 80% of Council Budgets. This appears to be the beginning of an agenda to dismantle local government.
Local democracy will be affected because there will be no local political oversight or local democratic accountability for decisions made affecting local communities and individuals. The reduction in the size of Local Authorities means they are disempowered when it comes to representing local communities, and the NCS will be a vastly centralised system under one Scottish Government Minister.
Impact on Local Services: Currently our Social Care Services work closely with Council Colleagues in other LA services, particularly Housing and Legal Services. However, with the removal of Social Care services close liaison and valuable working partnerships with these services will be impacted.
Additionally, local issues for communities and individuals will be easier to overlook and less easy to challenge, in a ‘one size fits all’ National Care framework, consisting of a rigid system of Care market codes and procurement for ‘qualifying organisations’.
Spending costs of the proposals: Estimates from the Scottish Government are that they have set aside funding for the set-up costs for the NCS of £250m, and £500m each year. This may be a serious underestimation of the costs, as remember, this is an untested model, based on incomplete legislation. We don’t even know how many IJB’s there will be or how they will function as this is to be a matter for the Scottish Government Minister in charge to establish. Effectively, this means that much of the work and substantial cost is already undertaken to set up IJB’s, establish integrated services, etc may be money and time down the drain.
There has been a lot of chatter around the Bill improving conditions for the workforce and only purchasing care from reputable companies but let’s be clear, none of this has been written into the Bill at this stage. There has been a failure to embody the principles of the Fair Work Convention or the Ethical Care Charter, despite the Scottish Government’s previous endorsement of these campaigns.
Impact on staff/ TUPE/Professional Ethics: Not everyone currently working in Social Care will be working within the NCS going forward. The Bill specifically allows for staff outsourcing to anywhere within the services they procure. This is a significant risk, particularly for frontline care staff who may very well find themselves TUPE’d over to the 3rd Sector or Private sector employers.
Interestingly, it appears that the NCS will be able to ‘poach’ services from the NHS, such as Addiction services, Geriatrics, and MH services into the NCS, but the reverse won’t be true for Social Work or Social Care staff in terms of migration to the NHS. However, NHS staff are currently legally protected from being moved out of the NHS so this is a clear contradiction and illustrates how much work still needs to be done to make the Bill fit for practice.
Impact on UNISON LG Branches: We must also be aware of the huge impact on our current UNISON Branch and National structures of members from our biggest workforce being removed from Local Government Branches. This is certainly not a reason to reject good reform in itself, after all, UNISON would have to adapt our own structures to accommodate this change and as already mentioned UNISON is not against the concept of a National Care Service. However, it should be a real concern to Branches that a significant portion of our Branch members may be forced to change employers in such precarious circumstances.
It is also worth noting that TU representation on the new care Boards has not been specifically guaranteed, and we don’t know what this will look like. The Government Minister at the top of the structure will decide how many care Boards there will be going forward, they will also have the power to decide who sits on the boards as well as remove any representatives they choose from the Boards.
It is essential that we are all aware of the NCS Bill, and its broad impact of the Bill, be ready to share our concerns with the broader membership and be willing to show solidarity with the Social Care workforce in whatever is ahead.
What our Social Care members are saying:
Social Care Members are expressing concerns on a number of levels. They are of course concerned about their own jobs, terms and conditions, pensions, and who their employer will actually be. However, broader than that many Social Workers are concerned about the potential impact on their professional role and function because of the lack of detail about the role of Social Workers within the Bill. This indicates that the Scottish Government has failed to understand the SW role, training, or their concerns as a workforce. This is not an unusual situation, as legislation relating to SW practice has failed to utilise the skills and training of Social Workers, has constrained the role of the profession for the last 30 years, and allowed the most rewarding elements of practice to be carved up and taken on by other professionals. This has led to a demoralised, exhausted, and diminishing workforce. There has been little attempt to consult frontline Social Workers and there is little in the Bill to alleviate the concerns of this professional group. It is a huge missed opportunity.
Social Care staff are similarly concerned about their terms and conditions, who they will be employed by, and what will happen to their LG pensions. Given that these staff work closely within local communities, there are concerns that this may be negatively affected.
There is a national shortage of Social Care staff and Social Workers. Given the demographic of this workforce (predominantly women, many of whom are part time workers, and over the age of 45) there is a very real risk that the NCS will struggle to retain valuable experienced staff, who may choose other work options going forward.
UNISON has been working with SWIG, Social Care Committee, IJB Reps group, and other relevant internal groups to gather the concerns and perspective of our members, and a variety of responses to the NCS Bill have been prepared. UNISON has also held online seminars and has been developing videos to get the message across to our members and the public. UNISON has also been working closely with the 3rd Sector, Social Work Scotland, Commonweal, and many others to campaign against the NCS Bill in its current format. It is fair to say that not all stakeholders share exactly the same concerns, but they do all have concerns about this Bill lacking the detail required to make such a massive structural change.
I am asking our Branch reps and members, to familiarise yourselves with the NCS Bill, and the concerns we have, share those concerns widely, and show solidarity with Social Care Staff because this is a Bill that will affect us all.