A future for social care in a Scottish ‘investment state’?

By Neil Crowther*

I’m really excited to be travelling up to Edinburgh this weekend to support an event hosted by the Independent Living in Scotland project on Monday.  The event is part of ILiS’s ongoing dialogue on the future of social care in Scotland, bringing together diverse social care stakeholders to develop a ‘statement of ambition’, which I am helping to draft.

The reading I have done in preparation is depressing and terrifying in equal measure.  Scotland has already endured massive spending cuts, but with respect to everyday services such as social care the biggest cuts are yet to come.   The Commission on the Future of Public Services in Scotland estimated that the Scottish public sector would face a £39 Billion shortfall between 2010/11 and 2024/5 – the year public spending is forecast to return to 2010 levels. To put that figure into perspective, it is equivalent to funding adult social care in Scotland for 13 years.

In the immediate term there seems little that the Scottish Government is able or prepared to do about Westminster-imposed austerity.  Scotland’s Finance Minister John Swinney recently ruled out using powers to set higher income tax rates in Scotland and froze council tax for a further year.  The grant to Scotland from the UK government will continue to go down in real terms for the next decade as George Osborne pursues a budget surplus.  Since Scotland introduce free personal care for older people in 2003, local council charging for social care has risen sharply, albeit unevenly with councils charging between £18 per hour and zero for home care depending on where people live.  As with the rest of the UK, eligibility for social care focuses on those with ‘critical or substantial’ needs and people who are eligible are receiving less generous packages of support or having their packages cut.

But amidst the gloom, some potential light.  Scotland may have decided to remain part of the UK at its recent independence referendum, but be in no doubt that the political economy of Scotland is developing along very different lines to that in England.

Of particular interest to readers of this blog will be central role that the UN Convention on the Rights of Persons with Disabilities, and human rights more generally, is playing in shaping policy and programmes.  The Scottish Government is presently consulting on its draft delivery plan on the UNCRPD, while the Convention of Scottish Local Authorities (Cosla) is ahead of the game having already published its own CRPD implementation plan.       In December, First Minister Nicola Sturgeon indicated the Scottish Government’s preparedness to consider incorporating the Convention and other international human rights treaties to which the UK is party into Scots law.

Arguably the biggest influence on social care reform in Scotland right now is integration of health and social care.  Following the Public Bodies (Joint Working Act) 2014 National Health and Wellbeing Outcomes have been established for health and social care and there is a requirement for NHS Boards and local councils to integrate health and social care budgets.  Each area will have an integration board by April of this year.   While there are many reasons to celebrate these developments, there is also concern that social care may become narrowly focused on ‘healthcare in the community’, undermining its broader role in supporting disabled people’s social and economic participation.  This is a particular risk if the only new funding to go into social care comes from the NHS.

To those ends, another big change on the horizon is contained in the Scotland Bill: devolution of social security powers related to disabled people.  This will see DLA/PIP, Carers Allowance, ESA and other benefits devolved to Scotland.  On the positive side, this presents an opportunity for Scotland to cultivate an entirely different approach to that which has evolved in England, and in particular to carve out a social security system that genuinely supports independent living.  Yet there is a grave risk that this money could end up plugging gaps in underfunded social services, and indeed Cosla has already proposed that such benefits should be administered by local councils.

More broadly, what I find exciting is the potential for Scotland in time to emulate a Scandinavian model, shifting from a ‘social welfare’ approach to a ‘social investment’ one. Nicola Sturgeon seemed to exemplify such thinking in her articulation of a future SNP government’s policy on childcare when she said this week:

‘Our most transformational infrastructure investment in the next Parliament will be in early years and childcare.  We will provide parents with 30 hours a week of government funded childcare enabling them to return to work, to pursue their careers and to know that their children are being well cared for, well educated and given the best start in life’ 

Social care has not benefited from such framing to date, nor has it enjoyed a research agenda to underpin a narrative that positions it persuasively not as a growing cost, but as crucial part of the national infrastructure ripe for investment.  As I have argued elsewhere, I believe that for independent living to have a future, it also has to be situated within the frame of social investment, not social welfare.

The public spending environment in Scotland is bleak.  Yet choices will continue to be made about how to spend the many billions of pounds that will still be invested in public services over the coming decade. Spending that can be shown to save money down the line, to strengthen communities and which can contribute to economic growth and prosperity is most likely to win out.  Without a narrative and underpinning evidence to sustain the case that social care (and independent living more widely) meet these investment tests, it will I believe continue its journey to the margins.

 

*Neil is writing in an independent capacity

 

 

 

 

 

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