Official Report 1081KB pdf
The next item of business is a members’ business debate on motion S6M-02777, in the name of Alex Rowley, on the long-standing underpayment of social care staff. The debate will be concluded without any question being put.
Motion debated,
That the Parliament notes the belief that the longstanding underpayment of social care staff should end, and that action must be taken to address the inequalities across the health and social care sector in order to deliver greater dignity and respect within the profession; considers that the rate of pay for social care staff, including in the Mid Scotland and Fife region, does not come anywhere near to recognising the complexities and challenges of the work; further considers that the main underlying cause of recruitment and retention issues in the care sector is a result of poor pay and unequal terms and conditions; condemns what it considers the poor treatment faced by many care workers in the course of their employment, which, it believes, would not be acceptable in any other profession, and notes the calls for all workers being hired directly or indirectly to deliver key public services to be paid the proper rate for the work they undertake.
12:54
I thank those members who made today’s debate possible by signing my motion. In particular, I thank Willie Rennie and Murdo Fraser for signing the motion allowing the debate to take place.
I was surprised that the Greens refused to sign the motion, given the fact that the treatment of workers that it describes happens every day in every community across Scotland. The refusal of Scottish National Party members to sign what is a factual statement demonstrates the “stick your head in the sand and hope it fixes itself” approach to a growing crisis that is impacting on older people in Mid Scotland and Fife and across all of Scotland.
Let me be clear. I do not intend the debate to point blame at any political party—far from it. I am attempting to say that, unless we act now to address the unequal and unfair treatment of care workers, we will not fix the growing crisis in the provision of community care in Scotland.
It is a fact that care workers on the poorest terms and conditions and the lowest pay are walking away from being carers. Why would they stay when they are treated so poorly? When we look at the way that some care workers are treated, is it any wonder that firms cannot recruit new staff and are losing the staff that they have?
Some will say that there are labour shortages in many sectors and that Brexit has made those challenges even more difficult. That is true. Why, then, would someone choose to work in a sector with very demanding jobs when those jobs have some of the worst terms and conditions in Scotland’s labour market?
Last week, while giving evidence to members on the Public Audit Committee on his report into social care, Scotland’s Auditor General, Stephen Boyle, said that improvements must be made urgently and warned that some things
“cannot wait until the establishment of a national care service.”—[Official Report, Public Audit Committee, 3 March 2022; c 23.]
The committee heard that there are
“major problems with recruitment and retention”—[Official Report, Public Audit Committee, 3 March 2022; c 3.]
in the social care sector and that existing staff do not feel valued or properly paid.
I have talked to care workers who work an eight-hour shift but are paid for only five or six of those hours because they are not paid for the time that they use to travel between clients. They tell me that they often work 10 or 11 hours, because they are on a split shift with a two-hour break in the day, and, if their clients are miles away from where they live, they have to sit in their car during those hours. They are given a mileage allowance of 25p per mile for travel between clients, but they are not paid for their own time. They get 25p per mile when MSPs get 48p per mile, as is the case for the majority of public sector workers.
The difference between council staff working as carers and those in the private sector is astounding. It cannot be allowed to continue. Council staff will be paid for the hours that they work, not only for the hours that they spend in a person’s house. They will get the same travel allowance as all public sector workers. How can it be that we have two sets of workers, doing the very same job and being paid by the public purse to deliver the same public services, being treated so differently?
As the Auditor General told members last week:
“The predominantly female workforce does not feel adequately rewarded or valued. There are also major problems with recruitment and retention ... The Scottish Government now needs to take action to improve working conditions for this vitally important workforce, otherwise it will not be able to deliver its ambitions for social care.”—[Official Report, Public Audit Committee, 3 March 2022; c 3.]
On Tuesday, the Government launched a consultation on what is working well and what needs to change in social care. The health secretary, Humza Yousaf, said:
“I want Scotland to be the best place in the world to grow old, with older people living full and rewarding lives, contributing to society and actively involved in their health and social care.”
I am here today because older people are having their care packages cut. People in desperate need are not able to get a care package. The number of people who are trapped in hospital because they cannot get home as there is no care package to support them is increasing. What is the reason for that? The private companies that have been commissioned by the health and social care partnerships through a procurement process to deliver half-hour and hour blocks of care say that they can pay the staff only for what they are being paid for, which is the blocks of care that have been commissioned.
As a result, the care workers end up being treated poorly. That is the main point. The workers might be paid by private companies, but the money comes from Government. The contracting and commissioning is done through the Government’s health and social care partnerships. Putting the work out to tender through the commissioning regime means that it is cheaper for the partnerships. Let me be clear that that practice, which results in appalling treatment of care workers, has been practised by all political parties when in power. It is not about trying to blame one political party; it is about recognising that care on the cheap does not and will not work.
I am well aware of the on-going debate about a national care service. I and my party will fully engage in that, but I stress that, unless we deal with the poor terms and conditions and low pay of care workers now, the problems will just get worse and worse, and older people will pay the price through their suffering. Let us deal with this issue and deal with it now.
13:01
I welcome the opportunity to speak in this debate and I recognise Alex Rowley for securing it. He has just outlined the complexity of the care system. My first job when I left school, before I started my nurse training, was in a care home. I know that that was a long time ago, but I remember the complexity of the work that we were trained for and asked to do.
I want to be clear from the outset that our social care workforce here in Scotland are absolutely valued. They do crucial work every day, often in very challenging circumstances. The Covid-19 pandemic has emphasised the need for our social care sector to be supported and valued.
Social care includes all types of personal and practical support for children, young people and adults who require it. It includes a wide range of roles, such as home carers, care home staff, activity and care co-ordinators, care managers, social work assistants, children and young persons support workers, day centre staff, cleaners in care settings, admin support staff and many others. It is important to keep that in mind when discussing the sector. It is more complex than just being about one job, one role or one pay scale.
Social care is an investment in Scotland’s people, society and economy. Many of us or our family members or friends will already use social care, and many of us will need to use it at some point in our lives.
The social care sector in Scotland employs approximately 200,000 people and has an estimated financial value to Scotland’s economy of £3.4 billion. The sector is hugely important, and a lot of work is going on to improve it and the experience of its workforce.
The Scottish Government is committed to supporting people to stay at home or in a homely setting with maximum independence for as long as possible.
It is crucial to attract and retain the right people to work in social care, support and social work. That has not been helped by the withdrawal from the European Union, as Alex Rowley said.
We need to raise the status of social care as a profession. We have discussed that in the Health, Social Care and Sport Committee, of which I am a member. To do that, the Scottish Government has embarked on the largest reform of adult social care in Scotland. Working with the Convention of Scottish Local Authorities, people with lived experience, unpaid carers and other stakeholders, the Scottish Government has developed priorities that are currently being implemented when it comes to social care. They include
“a shared agreement on the purpose of adult social care support, with a focus on human rights”
and
“social care support that is centred on a person, how they want to live their life, and what is important to them”.
What matters to them is important. Another priority is
“changing attitudes towards social care support, so that it is seen as an investment in Scotland’s people, society and economy”.
That is also valuable. A further priority is:
“strengthening the quality and consistency of co-production at local and national level”.
Derek Feeley’s independent review of adult social care was a crucial step towards the creation of the national care service for Scotland. It will enable us to improve the experiences of everybody who works in or uses social care. The review was comprehensive and found many aspects of our adult social care system that are worthy of celebration, such as the introduction of self-directed support. The Carers (Scotland) Act 2016 is also important, as is the introduction of free personal care.
Given the aims that the Government has in mind, which also include the principles of fair work, we need to welcome the fact that the Scottish Government is taking issues forward, and I look forward to working further with the Health, Social Care and Sport Committee to look at what we can do. I also look forward to hearing from the minister in his response.
13:05
I thank Alex Rowley for securing what is an important debate, for his considered contribution and for his long-standing commitment to social care.
I start my speech by thanking everyone in the social care system for all the work that they have done and that they will go on to do. I also thank those unpaid carers—some very young and some much older; often family members—who look after many in our communities. They are unsung heroes.
We are all accustomed to paying tribute to the valuable work that is done by our national health service staff, but our care and support workers do not always get the public recognition that they deserve. However, never has our front-line workforce demonstrated such extraordinary dedication, compassion and selfless commitment.
As Alex Rowley said, the Government urgently needs to address the social care crisis. Pay and conditions are part of the solution to that crisis. Heroic staff are overwhelmed, and care is still being provided on the cheap. Staff went above and beyond during the pandemic, but they have not been given the leadership or the appreciation that they deserve, and people who require care services are suffering as a result.
Audit Scotland’s report on social care, published in January, should act as a wake-up call. The report revealed a social care system in which
“Staff are not adequately valued, engaged, or rewarded for their vitally important role.”
Audit Scotland also reported that the average hourly rate across all care in Scotland is just £9.79. We must also bear in mind the fact that the new £10.50 rate will not apply to all who work in social care.
We must remember that 15 per cent of social care workers work unpaid overtime, 13 per cent of the workforce work more than 50 hours a week, and two in 10 are not on permanent contracts. The industry is undermined by long hours, low pay and low recognition, which means that care providers struggle to keep staff. It cannot be right that supermarkets and shops often pay more and appear to offer a greater sense of career progression. That is wrong and must change.
It angers staff when they are described as low skilled when, in fact, their roles are highly skilled and complex. They have to understand medical needs, deliver medication and possess soft skills such as empathy and tact.
It is clear that there are problems of recruitment difficulties, rising sickness absences and high vacancy levels. The SNP’s solution to that, in part, is to develop a national care service. However, far from being a positive step, that could be perceived as a direct assault on local government by removing accountability and, potentially, undermining patient care. Instead of reorganising the chairs on the deck, ministers must now urgently and meaningfully engage with carers, staff, those who work in the sector and those who need support.
Dr Donald Macaskill, the chief executive of Scottish Care, has warned that the industry is at risk of disintegration and collapse. We simply cannot wait for a national care service.
I accept that additional funding has been made available. In 2024-25, Scotland will benefit from an additional £1.1 billion as a result of the health and social care levy. However, if the Government is really committed to ensuring that every person receives the care that they need in order to be provided with the dignity that they deserve, it must take urgent action to address the needs of the workforce. That means better workforce planning. We need to show the people who show an exceptional level of personal commitment and accountability that they are valued when it comes to pay and conditions. It is time to respect and reward those who work in social care and to end providing care on the cheap, as Alex Rowley rightly said. Too often, staff are on the forgotten front line. We look to the Government to change that.
I call Paul O’Kane, who joins us remotely.
13:10
I thank my colleague Alex Rowley for securing this extremely important debate and for his powerful speech outlining the issues. I pay tribute to all our care workers across Scotland, who work, day in and day out, to look after and care for older people, people who have disabilities and people with long-term and life-limiting conditions. Their contribution is immense and their work brings dignity, respect and, indeed, happiness to the lives of so many and their families.
Caring is an essential service in our communities, but it is more than that. It is a vocation; a role that dedicated and compassionate people offer themselves to—and we know from the figures they are very often women.
Colleagues might not know this, but, when I was a student, I worked in a care home. I was an activities organiser, which means that, among other things, I can call a really mean—[Inaudible.]—bingo. The experience taught me a lot about older people and the challenges of living with an illness such as dementia. Although I played a small part in a wider team, it was nothing compared with the contribution of the care staff: they taught me the most.
I was always in awe of the dedication and patience of the care staff and the genuine care with which they supported the people living in the home. They took time to get to know them and their families, found ways to brighten their day with stories or songs, fiercely protected their dignity and independence, and shared with families all the news and important moments that they may have missed during the day or week.
In my job prior to being elected to the Parliament, I had the honour of helping to tell some of the most amazing stories about personal assistants at Enable Scotland and the work that they did during lockdown. That work included recreating at home the Friday nights spent at the favourite social club of the person whom they cared for, arranging for local pipers to play outside people’s homes and linking people up with their loved ones via digital methods. They went above and beyond because they cared.
Respect for their work and the rates of pay never matched what those staff gave, despite the efforts of some employers—particularly in the third sector—and they still do not today. That should shame us all. We must acknowledge the skilled and vocational nature of the work and pay people what they deserve, as the motion calls for.
I was struck by the recent Common Weal report highlighting the current failings in our care system and calling for ambitious reforms with the advent of a national care service to deliver the changes that we need. As I have said in the chamber many times, this has to be about values, not structures, and those values begin with our people—the people who deliver care across Scotland.
We do not have to wait—we can act now. Scottish Labour has joined our trade unions—particularly my union, the GMB—in calling for a £15-an-hour minimum wage for care workers. We advocated for that in the last two budget processes, but it has been rejected in favour of a 48p rise. If we are serious about honouring what was said in the pandemic about the value of carers, who were called “Covid heroes”, that must be matched by our action.
There is more to do. We need to provide better support for the wellbeing of care staff through breaks and the supply of food, rest areas and support services; more standardised qualifications that can be accredited and recognised across the care system; apprenticeships in care, which would show that it is a valued and important career choice for our younger people; and clearer progression routes for workers, so that they can get on.
It is clear that we owe all our carers across the country a huge debt of gratitude. We trust them with the most precious thing in our lives—our family members—in often difficult and challenging circumstances, so we should offer them a rate of pay and a set of conditions that meet that huge responsibility and reflect their talent and dedication.
Labour members will continue to urge the Government to act, while offering our own vision of what care should be in Scotland.
I call Gillian Mackay, who joins us remotely.
On a point of order, Presiding Officer. It was quite difficult to hear Mr O’Kane. I picked up the bulk of what he said, but it was not easy. If we are to hear from Ms Mackay online, could we try to do something to boost the sound a little bit, please?
Thank you for your point of order, minister. I noted that the sound was patchy. I am sure that the broadcasting unit has heard your plea, and I hope that it acts on it. Let us see how we go with Gillian Mackay, who is there and ready.
13:15
Thank you, Presiding Officer. I will try to use my outside voice, just in case the sound is still quiet.
Care workers perform an extremely challenging, complex and skilled role. They look after our loved ones, often when they are unwell, vulnerable or coming to the end of their lives. I offer my heartfelt thanks to care workers for all that they do.
For too long, the enormous contribution of care workers to our society has gone unrecognised. They were classed as low skilled by the United Kingdom Government, and we all know that that is simply not true.
It was international women’s day on Tuesday, and the theme was “break the bias”. In light of that, it is worth noting, as many other members have done, that with women making up approximately 85 per cent of the workforce, the failure to properly appreciate social care workers is linked to how we value caring roles, which are traditionally performed by women. I was struck by the words of Fiona Collie from Carers UK, who said in evidence to the Health, Social Care and Sport Committee:
“We often talked about the important role that the national health service plays, but we talked less about the significant role that social care plays in maintaining people’s independence and enabling them to live good and positive lives ... The role of social care has been very hidden.”—[Official Report, Health, Social Care and Sport Committee, 22 February 2022; c 2.]
It is right that social care has now become a national focus—that is long overdue. The pandemic may have highlighted the undervaluation of care workers, but that has been a problem since long before any of us had heard of Covid 19. Care staff were often working in difficult conditions before the pandemic, contending with low pay, long hours and insecure work, but for the past two years, they have also had to deal with a dangerous virus that has devastated care homes.
The interim findings of a workforce survey conducted by Scottish Care were published in September. One finding was that the number of hours that staff were working was markedly high, with increasing pressure on them to maintain the same quality of care while working longer hours. Almost 50 per cent of organisations relayed that their staff were working more than 35 hours a week. I am extremely concerned about the physical and mental wellbeing of care workers who have been under such sustained pressure. As we seek to help social care recover from the pandemic, we must prioritise workplace wellbeing. Some care workers may have been traumatised by their experiences and they must be able to access mental health support when they need it.
As we enter the recovery period, we are also creating a new national care service, the cornerstone of which will be improved terms and conditions for staff, with the Greens and the Scottish Government committing to deliver ethical commissioning that promotes fair work. That is vital. The report “Independent Review of Adult Social Care in Scotland” highlighted that
“The current approach to commissioning and procurement is characterised by mistrust, conflict and market forces.”
At the moment, commissioning and procurement processes are largely focused on cost, which can squeeze pay and conditions. Ethical commissioning would shift the emphasis from cost and cover a range of factors, including workforce terms and conditions, investment by providers in training and support for staff, and the quality of care. We must ensure that staff can access the training that they need, as well as opportunities for career development and progression. That will be key to improving both recruitment and retention. That is why we have also committed to a system of national collective bargaining, through which we will deliver improved pay, terms and conditions.
The increase in the minimum wage for adult social care staff to £10.50 is an initial step in improving pay for care workers, but we recognise that the work is far from over, and we will continue towards delivering pay that recognises the incredible work that care staff do.
Once again, I extend my thanks to everyone working in the social care sector. We recognise that care workers’ pay, terms and conditions must continue to improve. We will continue to work towards that, and we will create a national care service in which staff are properly valued and respected.
13:19
I thank Mr Rowley for his considered contribution today, and for the tone and tenor of what he outlined. If we took that approach more often in the Parliament, we would do a lot better, so I thank Mr Rowley for that.
I thank the social care workforce for their remarkable work in providing critical and invaluable support to people across our country. Although a lot of attention has been paid in the debate to the social care workers who deliver care, like Emma Harper, I also acknowledge the domestic, cleaning, maintenance and administration teams whose vital work keeps these critical services running. Therefore, I thank every member of the social care workforce, including two of my nieces who are social care workers—although one of them is currently having a wee bit of time off on maternity leave.
I thank Mr Rowley for bringing this important debate to the chamber, and I thank members for their contributions. However, I object to the idea that the Scottish Government does not value the social care workforce, because we do, and we are fully committed to improving pay and conditions for the predominantly female workforce. The social care system as it stands is complex, with more than 1,200 employers and huge variation across Scotland, as Derek Feeley acknowledged in his report “Independent Review of Adult Social Care in Scotland”. Despite that, we are taking action, with partners in local government, to make improvements now.
Since 2016, the Scottish Government has provided funding to ensure that adult social care workers who are delivering direct care are paid at least the real living wage. We have led the way across the UK in ensuring that those workers have that minimum rate of pay, and the Welsh Government is following our lead by adopting that policy from April this year.
However, we are now going beyond that. In the past few months, we have committed to deliver two significant increases in pay. A mid-year uplift was delivered in December, which meant that adult social care workers’ pay increased to at least £10.02 per hour—an increase of more than 5 per cent. In April, the minimum hourly rate for those providing adult social care will rise to £10.50 per hour—a further increase of 4.8 per cent. For a full-time adult social care worker on the minimum rate, the increase to £10.50 per hour represents an uplift of more than £1,600 over the next financial year.
The £10.50 hourly rate in Scotland is 60p higher than the real living wage rate of £9.90 per hour that will apply to workers in Wales from April. In addition, Scotland’s minimum rate is significantly higher than the national living wage rate that is paid to many social care workers in England and Northern Ireland, as workers there receive £1 an hour less than workers in Scotland.
Of course, those are minimum rates of pay; Mr Rowley is right to point out that some folk are paid more, and that there sometimes seems to be an unfairness in that regard. We have heard from the Labour Party and others about proposals to increase pay to £15 per hour. However, that would cost £1.75 billion. We need to have a discussion on how we can do better while being realistic about what is achievable, because we cannot spend money twice, which is what some of the suggestions would mean. I am more than willing to speak to Mr Rowley and others on those points, and we need to go further, but we all have to grasp the reality that we will have to work through some of this and find the money, because we cannot spend that money twice. My door is open to Mr Rowley and others to bring forward any credible ideas that they may have.
I thank the minister for his commitment to fair pay for the sector. When the Government is changing pay rates in social care, can he tell us what assessment it makes of the issue of differentials, where there is an impact on other care home workers? The Government may not reimburse private sector providers, in particular, for those increases, which will then feed through the system.
There is a huge complexity to all of this. The two recent pay rises do not come without difficulties. What we have to do, in partnership with others, is ensure that the money that the Government has provided actually gets into the pockets and purses of the workers. Given that there are 1,200 different employers, that is not as easy as it sounds. The discussions that we have had with COSLA, local government, health and social care partnerships and others, including third sector and private sector employers, have thrown up other anomalies that we have to work through. In the very near future, I will be having meetings to discuss what has happened and the impacts on other sectors. We are looking at the issue that the member raised, too, but, as it stands, at this moment in time, it is immensely complex.
Mr Rowley was right to highlight the different forms of procurement, some of which certainly did not happen when he and I were in local government. There has been too much emphasis on getting value for money instead of ensuring quality services for people, including by paying staff well and having a workforce with the freedom and autonomy to do what is right for the clients they visit and care for on a daily basis.
That is why the ethical procurement that Gillian Mackay mentioned is so important. We have to get this absolutely right. Ethical procurement includes fair work, but I would point out that it is not just about that. Caring is a profession, and, in order to attract new—and young—people into it, we must ensure that they see an opportunity to advance in their careers. That is why it is so important that we have the right apprenticeships in place and that we enable people to continuously improve, get qualifications and swap careers between social care, social work and the NHS if and when it is right to do so. I am committed to doing all of that.
We must build a social care system for the future that has human rights at its very heart and that takes a person-centred approach, and we must include in all of that fair pay and fair work for the people who work in it. We will continue to engage with our national care service proposals to get that right. However, we cannot wait for the national care service itself to make some of those improvements. In that respect, I will continue to talk to COSLA, which has been very positive with the Government as we have looked at what more we can do.
The Government is absolutely committed to improving the experience of the workforce through fair work practices. We deeply value and respect the vital role played by social care workers in our communities. Let us be honest: without them, life over the past two years would have been very different for many people. My plaudits go to them, and my door is open to others to see how we can work together to improve things further on this front.
That concludes the debate. I suspend the meeting until 2.15 pm.
13:28 Meeting suspended.Air ais
First Minister’s Question Time