Meeting of the Parliament [Draft]

Meeting date: Tuesday, June 11, 2024

Official Report 922KB pdf

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Renfrewshire Health and Social Care Partnership

Our final item of business today is a members’ business debate on motion S6M-12891, in the name of Neil Bibby, on proposed cuts to Renfrewshire health and social care partnership services.

Motion debated,

That the Parliament notes reports that Renfrewshire Health and Social Care Partnership (HSCP) faces a £14.7 million budget blackhole as a result of Scottish Government underfunding and has proposed significant cuts to its local services, including in the West of Scotland region; recognises what it sees as the widespread concern amongst service users and families about the reported proposal to close Montrose Care Home, merge Mirin and Milldale Day Centres as well as withdraw funding for the Renfrewshire Head Injuries Service; believes that Montrose Care Home in Paisley is an excellent and vital public sector care home; further believes that the Mirin and Milldale day centres provide a lifeline service for hundreds of adults with learning disabilities and that the Quarries Renfrewshire Head Injuries Service provides invaluable support to over 80 users with complex and life-altering conditions; understands that serious concerns have been raised regarding the extent to which the consultations for these decisions have followed the proper processes and impact that they will have on hundreds of local families, including the workers, in Renfrewshire, and notes the belief that every effort should be made by the Scottish Government, Renfrewshire Council and NHS Greater Glasgow and Clyde to reverse these proposals.

17:07  

I welcome the opportunity to have this debate today. I would normally say that it is a pleasure, but I take no pleasure in having to talk about devastating cuts to health and social care in Renfrewshire. I thank my Scottish Labour MSP colleagues, and Russell Findlay, who supported the motion calling for a stop to the cuts, which, notably, did not receive any support from a single Scottish National Party MSP representing Renfrewshire or anywhere else in Scotland, despite the significant impact that the cuts and closures will have.

This week is carers week and, no doubt, the Scottish Government will say warm words about it, but the reality is that the cuts will add more pressure and will withdraw support from service users, their carers and their families. I thank those who have taken the time and made the effort to come through from Renfrewshire to the Parliament today.

Renfrewshire health and social care partnership has had to put forward a series of cuts to plug a near-£15 million financial black hole because of years of Scottish Government underfunding. Those cuts are not mere financial adjustments; they are life-altering blows to the most vulnerable members of our community. Like many people across Renfrewshire, I was relieved at the last-minute reversal on the decision to merge Mirin and Milldale day care centres for adults with learning disabilities. That U-turn is a direct result of the powerful and relentless campaigning by countless service users and their families, supported in particular by Councillor Iain McMillan, who is in the gallery today, along with Councillor Janis McDonald. Those campaigners are an inspiration, and I was proud to stand alongside them and stand up for them, but it should never have come to that point. The fact that the most vulnerable people in our community were forced to campaign outside Renfrewshire Council buildings in the freezing cold and torrential rain to save their lifeline services was disgraceful.

That is where the welcome news ends. Despite the best efforts of campaigners, Montrose care home in Paisley is set to close its doors, despite 3,000 people signing a petition against its closure. Montrose is an excellent public sector care home and it has been a highly valued sanctuary for the residents who have come to depend on it.

My constituent Jacqueline told me:

“Both my mother and aunt were residents in Montrose Care Home. Both had dementia, although different forms and with different symptoms. All of our family have nothing but respect for the service, and the friendly and well qualified staff. The members of the HSCP Board who voted to end this fantastic service have let Renfrewshire down badly. They should be ashamed.”

The 31 remaining residents and the staff who care for them now face an uncertain future and could face huge disruption. One resident moved to Montrose care home after facing the devastation of having all four of his limbs amputated as a result of sepsis. His home, where he lived with his wife and two daughters, became inaccessible to him, and he was unable to secure adequate support from the council to redevelop his garage into a living space, which would have allowed him to remain there. He had to turn to crowdfunding to raise the funds that he needed to carry out the necessary adaptations at his home. He has now been served with a legal notice to quit the care home despite the works at his family home not yet having begun. That will be an awful, unthinkable and truly stressful situation for my constituent to be in, but it is being compounded by the disgraceful decision to close the care home.

Given the rise in the elderly population and the rise in dementia in Renfrewshire, the HSCP should be expanding the number of public sector care homes, not leaving the vulnerable elderly and their families to the vagaries of the private sector. The closure represents the dismantling of public sector care homes on the SNP’s watch.

The Renfrewshire head injury service as we know it is also facing closure. Local campaigners took their fight to the health and social care partnership, forcing it to revisit its budget and roll back on its decision to scrap the service completely. The existing service will still close, and it will be replaced by a yet-to-be-defined new service, backed by a much smaller funding pot. That closure took place last week but, despite the new funding offer, families have been left in the dark about when the new service will be up and running, whether it will be able to meet the complex needs of their loved ones and what they should do while there remains a gap in provision. In the meantime, highly qualified, skilled staff, who have provided consistency for service users, have been lost. The service has been a lifeline for individuals recovering from traumatic head injuries.

My constituent Jed, who is in the public gallery, told me earlier that, if it was not for that service, he would not be here. Replacing it with a drastically underfunded alternative is not just a cutback—it is a betrayal. It sends a clear message that the SNP sees the wellbeing of these individuals as expendable.

I have also spoken to another service user, David. The service offered David and his family a range of support, including opportunities to socialise and a comfortable environment where no one had to explain their moods or behaviours. It provided consistency for those who needed it. The head injury service is an excellent service, which has helped David and many others to develop, grow and build confidence. The prospect of losing it has led David to say that he feels “written off ”and “abandoned”. Many families are worried about how they will cope without such clubs and services.

Let us be clear: those are not abstract figures on a balance sheet. They are real people, with real needs, who are being pushed to the margins—and many of them are here today. The SNP claims that it wants to protect health and social care services, but the reality in Renfrewshire is cuts to vital services for our most vulnerable people. The SNP says that it is against privatisation of services, but the reality in Renfrewshire is that more and more people are having to go private as the council closes excellent public sector care homes and services.

Actions speak louder than words. The cuts are not inevitable. SNP councillors on the integration joint board, SNP MSPs who represent Renfrewshire and the SNP Government cannot shirk responsibility. I understand that there is a meeting of the leadership board of Renfrewshire Council next week, with the closures on the agenda. I hope, for the sake of those in the gallery and those watching at home today, that the decisions will be reversed, and that the Scottish Government will intervene to stop the cuts from happening, because that is what my constituents are calling for.

Enough is enough. Health and social care services are not luxuries; they are fundamental. The cuts are ill thought out and cruel. They may balance budgets in the short term, but they will cost us dearly—much more—in the long run. The health and wellbeing of our community is not negotiable, and it is time for the Minister for Social Care, Mental Wellbeing and Sport and Renfrewshire health and social care partnership to do something about it.

17:15  

I thank Neil Bibby for bringing this important debate to the chamber. At the outset, I stress that I agree with a lot of what he said about the importance of these services throughout Scotland.

I will focus my remarks on health and social care partnerships generally, as the issue that Mr Bibby highlighted is clearly very local. I apologise to him as, until I heard him speak, I was unaware of the detail and the background that led him to lodge the motion.

Will the member take an intervention?

No, thank you—I have just started.

Although, as I said, this matter reflects the particular issues facing Renfrewshire Council, I understand that local authorities throughout Scotland, and in England, are facing similar challenges in social care. That includes my own local authority, East Dunbartonshire Council.

This morning, I watched an excellent evidence session at the Health, Social Care and Sport Committee on HSCPs, and heard an informative discussion around self-directed support. David Aitken, who is head of adult services on East Dunbartonshire integration joint board, gave an excellent account of the initiatives and planning in his department that go into making the everyday decisions that affect the lives of so many vulnerable people who need support. All our local authorities do an outstanding job in that respect.

Having “a £14.7 million budget blackhole” is extremely difficult, to say the least, and hard choices have to be made. Many local authorities throughout the country, including my own, are having to make such choices. Nevertheless, I point out to Mr Bibby—I think that he is well aware of this point—that the Scottish Government budget has been cut in real terms by 1.2 per cent since 2022-23, and the UK Government has held back £13 billion that was due to come to us. In that regard, it is difficult to see how to avoid cuts, but that is, of course, very much down to individual decisions by local authorities.

This afternoon, during a debate in the chamber highlighting the First Minister’s priority of eradicating child poverty—which is responsible for so many health issues that dog people from childhood to adulthood—Paul O’Kane admitted that there was a UK context to the current situation. The First Minister spoke of his hope that an incoming Labour Government would help in our bid to eradicate poverty. Abolishing the two-child cap and the benefits cap would—and should—be a start, although much more could be done with the correct political will and priorities. Our Scottish child payment is transformational, lifting 100,000 children out of poverty. We introduced that benefit, which is not available anywhere else in the UK, in the context of having to mitigate Westminster cuts in the face of a shrinking budget.

To return to Neil Bibby’s motion, the cuts that are being proposed in Renfrewshire would have a terrible impact on those who rely on those services. Neil Bibby articulated that very well, and I can only agree with him. Care homes and day centres are the mainstay for so many vulnerable people, and they often provide a lifeline. I sincerely hope that some other way of saving them can be found, perhaps through the use of reserves, although I clearly have no background information on the council’s finances in that regard.

In conclusion, I genuinely hope—as, I am sure that, more than anyone, the people who are sitting in the public gallery hope—that a solution can be found, and I thank Neil Bibby for shining a light on the matter in the chamber today.

17:18  

This debate is about vital, and excellent, public services in Renfrewshire: Montrose care home, the Mirin and Milldale day centres and the Renfrewshire head injury service.

As Neil Bibby pointed out, Renfrewshire health and social care partnership has a £15 million “blackhole” to fill—that is the absolutely appropriate term that he used to describe the situation. Of course, as Rona Mackay said, the HSCP faces hard choices.

A few months back, when the matter was first brought to my attention, I was fortunate enough to meet a group of Milldale mums. Those ladies were determined that the service on which they and their loved ones rely would not close its doors, as it had been proposed that the service should be merged with a similar service nearby. Their action resulted in what they thought at the time was a victory. They worked with one of my council colleagues, David McGonigle, and they believed that they had won an undertaking from the partnership that the service would be saved. Unfortunately, as Neil Bibby’s motion suggests, the proposal is back in play and the services are at risk again. I know that those women will be absolutely devastated.

Today, I was fortunate enough to meet the dedicated staff of many of the services involved, including Montrose care home, and service users. Bare words in a motion, no matter how good the motion is, cannot possibly convey the human cost of those services closing or being downgraded or merged, nor the value that they bring to families and individuals. People rely on those services—we may think, “There but for the grace of God,” as none of us would wish the situation on anyone. Without that provision, those people would be living very different lives.

When I met the staff today I was struck by the pride that they take in transforming lives. The services change lives for the better, and the staff—who work behind closed doors, so the public rarely see that work—take great pride in that.

The entire process has caused a massive amount of anxiety and uncertainty for service users and their families. A theme that seems to be common in such situations is the consultation process. I hear from people all the time that consultation feels like little more than a bit of a sham; it is quite a cynical exercise. I have heard that repeated again today.

Ultimately, if the closures go ahead, it will be a false economy. It will take money out of the economy, as families who currently rely on those services must become full-time carers as they will be unable to work. In addition, it will diminish hugely the quality of life for people across society who otherwise thrive in such environments.

I have no doubt that the minister will talk a lot about financial constraints—Rona Mackay has already mentioned that aspect—but it is important to get on the record some hard facts about the financial reality. The Scottish Government is in receipt of the largest block grant on record—it is £43 billion for 2024-25. The Fraser of Allander Institute, which is a respected organisation, describes it as the highest in real terms since 2009-10.

This is not, therefore, an issue that the SNP can blame its usual Westminster bogeyman for, as it does for everything; service users will not be interested in those excuses. It is about choices that the Scottish Government has made. What this Government, or Renfrewshire health and social care partnership, is proposing is not inevitable.

I close by telling members what one of the service users said to me this afternoon. I asked him, “What would you say to the Government?” His message to the minister was, “Put yourself in our shoes.” I urge the minister to do so and to make every effort to save these critical lifeline services.

17:23  

I thank my colleague Neil Bibby for lodging the motion and securing the debate, and for his eloquent opening speech, in which he laid out in detail the challenges that exist and warmly paid tribute to all who have been involved in the campaigns to protect the services.

I say to Rona Mackay—I would have said this earlier, had she accepted my intervention—that, although she made a valiant attempt to defend the Government’s position, it is disappointing that there is no local knowledge of the matter from members on the Government benches. The local SNP members for Paisley, Renfrewshire North and West and Renfrewshire South are not in the chamber this evening to contribute or to hear the debate, and that is very regrettable indeed.

I declare an interest, as I was an employee of Enable Scotland until I was elected to Parliament in 2021. I mention that not only because it is right to do so but because, in preparing for the debate, I have been thinking about many of the experiences that I had when I was working there and supporting people who have learning disabilities and their families. All too often, it is the most vulnerable people in society who have borne the brunt of decisions such as the one that we are debating today.

In the case of the campaign to save Milldale and Mirin day centres, like my colleagues Neil Bibby and Russell Findlay, I had the opportunity to spend time with many of the parents and carers and, indeed, with service users. The meeting that I attended, in Renfrewshire carers centre, was on a Monday morning. I am sure that everyone will know that a Monday morning meeting can often take a while to get going, but that was absolutely not the case in this situation. They are a fiercely passionate, dedicated and inspiring group of people, who are making the case for their children to have choice and control over the lives that they lead.

The group wanted to speak to me about that because, as we have heard reflected already, they felt that although we often talk in council chambers or in Parliament about choice and control and people having the freedom to choose how they live their lives, the reality is often very different and is driven by financial decisions—and by the cuts agenda, which is under way across Renfrewshire. They spoke to me with righteous anger about their feeling that there had been a lack of consultation with people who have learning disabilities and their families during the process. Many of them felt that their views had been disregarded. I think that it was Russell Findlay who said that they felt that lip service had been paid to their views.

What is clear tonight is the tenacity of campaigners across Renfrewshire who have a stake in the services or who either attend them or have a family member who does. It is their tenacity that is making decision makers sit up, think again and take stock. Everybody who has spoken tonight and has signed the motion is standing beside them—not least my colleague Neil Bibby, as can be seen by all the work that he has done in the campaign.

All of that is about a wider issue as well. Too many people with learning disabilities or physical disabilities and their carers say that everything in their life is a battle and has to be fought for, and that nothing is ever straightforward. The motion rightly points to the other experiences of those at Montrose care home and at the Quarriers Renfrewshire head injury service. Many of the people in the gallery would have similar experiences of everything being a battle. We have to acknowledge that.

We must also acknowledge that the decisions that we make and that are made in HSCPs are directly impacting on people’s lives. We know from what we have heard already and from the motion that it is not always in the hands of local decision makers to be free to make the choices that they want to make, because of the cuts that are passed down to them by the Scottish Government and the £14.7 million black hole that has been created by underfunding in Renfrewshire.

We must stand with the families and listen to what they have to say. We must also listen to the people who use the services. I call on the Government, in its response to the debate, to tell us how it will support and stand with those families in Renfrewshire to ensure that those vital services can be protected for the future. [Applause.]

I am sorry, but I ask people in the gallery not to clap, please. You are very welcome to attend our proceedings, but we are involved in a debate.

17:28  

I thank members for their contributions, and I am grateful to have the opportunity to close the debate. I thank the individuals involved in the delivery of health and care services in Renfrewshire, the services mentioned by name in today’s debate and the many more that have not been mentioned. I am acutely aware of, and want to acknowledge, just how much hard work and expertise are involved in providing excellent services locally.

The Scottish Government continues to provide record funding for the health and social care portfolio, with more than £19.5 billion allocated for 2024-25. That figure includes more than £2 billion for social care and integration, delivering on our programme for government commitment to increase social care spending by 25 per cent over this session of Parliament, two years ahead of our original target.

Far from underfunding the sector, as Neil Bibby’s motion implies, that uplift exceeds the front-line Barnett consequentials that were passed on from the United Kingdom Government. I also note that the Scottish Government has increased the resources that are available to local government by £574.6 million in 2024-25, which is a real-terms increase of 2.5 per cent.

Let me be clear: it is for local partners to agree a budget that will enable them to meet the needs of local people. These decisions are, therefore, matters for the Renfrewshire integration joint board. Alternatively, in some cases, they are joint decisions to be made between the IJB and Renfrewshire Council.

As Mr Bibby is well aware, it is not appropriate for the Scottish Government to intervene in those local decisions. It is, however, vitally important that those local decisions are made in consultation with the people who use the services, and in full awareness of the impact on those people.

The minister is quite right to say that service users should be involved in the process. Service users and their families are in the public gallery today. They do not know what they are going to do without these services, and they are asking the Scottish Government and the minister specifically to intervene to save them. Can the minister outline what the Government will do to help to protect these services?

I encourage all partners in Renfrewshire to work together to find solutions that will not only address their financial pressures but put the needs of local people at the centre.

With regard to these specific services, I absolutely understand the distress that any planned closure will bring to families and loved ones. This is a really difficult time for them. I understand that the proposal to merge Mirin and Milldale day centres was rejected by the IJB at the end of April, but that Montrose care home is due to close, and that the contract with Renfrewshire head injury service ended on 7 June.

Again, while I reiterate that those are decisions for the IJB, I have received assurances that staff of the Renfrewshire health and social care partnership have acted in accordance with due process. I am told that they have communicated and consulted with the people who use those services, the residents of care homes and their families and loved ones, and that they have engaged with people who work in the services.

Although the HSCP has a duty to set a balanced budget, no one wants to see the closure of good-quality care services. My officials are actively seeking assurances that alternative arrangements are put in place to support the people of Renfrewshire and that the residents of Montrose house are fully supported during this period.

I am asked regularly to intervene on issues of social care. I remind members in the chamber that we are bringing forward a proposal for a national care service. It was clear in the “Independent Review of Adult Social Care in Scotland” report, and in the consultation on the National Care Service (Scotland) Bill, that people in Scotland want ministers to be held accountable for, and to be able to intervene in, these local decisions. I appeal to my colleagues on all sides of the chamber to consider supporting the National Care Service (Scotland) Bill, which will give ministers the power that members are looking for.

On funding, I hate politicising over vulnerable people, but there are real challenges with finances as we go forward, and the Labour Party has not committed to progressive taxation. The SNP has committed to progressive taxation and has raised an extra £1.5 billion of additional revenue in the current budget through that. In Scotland, we are committed to spend more per head on health and social care, and we are committed to tax accordingly. The Labour Party is, to be frank, not being clear about its plans for funding public services. In fact, the Institute for Fiscal Studies has said that there is a “conspiracy of silence” between the Labour Party and the Tories over their plans for £18 billion of cuts. I believe that voters have a right to know how the Labour Party is planning to fund public services in the future.

I find it very disappointing that the minister has chosen to politicise the issue in the context of the general election in the way that she has done. She mentioned the national care service. Will the national care service as proposed bring a single penny of extra money into front-line health and social care? Does she recognise that there is a serious challenge in supporting and recruiting staff to care jobs, and that her constant refusal to commit to £15 an hour for care workers—a rate which is outlined and supported by the trade unions, including the GMB, and by the Labour Party—is having a real detrimental impact that is adding to the current pressures?

I agree with the member that there are currently very serious pressures. I believe in investing in social care, so that it is regarded as an investment rather than a drain on society. That approach will mean that we are able to shift the narrative and put more money into social care.

The Labour Party has plans for £18 billion of cuts across the UK—that is the equivalent of 700,000 social care workers. Labour needs to be honest with the electorate about its plans for cutting public services.

Before I conclude, I reflect that today’s debate makes it absolutely clear, and illustrates precisely, why we need a national care service. The national care service will improve quality, fairness and consistency of provision in a way that meets the needs of individuals across Scotland. It will provide a critical opportunity to increase our focus on prevention and early intervention, and to ensure that social care support is human rights based and outcomes focused.

In closing, I thank members again for their contributions to the debate. The landscape is undoubtedly challenging—on that we can all agree. That is why the Government has chosen consistently to invest significant sums to support our health and social care system. I reiterate the vital role that is played by the many individuals who are involved in delivering quality health and care services, and I urge all the partners in Renfrewshire to continue to work together to find solutions that put the needs of local people, in particular those who are most vulnerable, front and centre.

That concludes the debate.

Meeting closed at 17:37.