Personal care costs escalate

A story in today's Herald newspaper highlights the latest Scottish Government statistics on free personal and nursing care for elderly people living at home in Scotland. Spending has increased by more than 160% since the policy was introduced, with the bill reaching almost £350m in 2012-13.

In 2012-13, 47,680 people benefited from the policy, receiving an average of 8.4 hours of care a week, compared to 32,870 people receiving an average of 6.9 hours of care a week in 2003-04. A further 30,000 people in Care Homes also benefit from the policy.

This large increase in people receiving services in their own homes reflects an increasing older population and a move away from long-term care in hospital and care homes, towards providing care in a person’s own home for as long as possible.

The Scottish Government gave councils the extra £40m, but the latest statistics shows the total bill for free personal care, including packages provided to care home residents, is now £465m. That is another £41m increase since 2009-10.

Cllr Peter Johnston COSLA's health and social work spokesperson said: "... it is evident from the Scottish Government's publication that the policy is becoming more expensive. Councils' social work budgets are under huge pressure, with some - from what we are hearing - nearly at breaking point. It is for this reason that a fundamental debate about the funding of care and support is required."

This view is reflected in UNISON Scotland's 'Time to Care' report. Front line staff describe how the financial shortfall is driving a race to the bottom in social care provision. In addition, the pressure on care homes is reflected in home closures and adverse inspections. This is driving bed blocking in hospitals. There are 837 patients assessed as ready to be discharged in Scottish hospitals - that's the equivalent of the total number of beds in the Southern General Hospital.

More elderly people being cared for in their own homes is of course a good thing. But the policy has to be properly funded. Devolving attendance allowance, as recommended by the Scottish Labour Devolution Commission is a positive medium term solution. It is often forgotten that Attendance Allowance is not paid to Scottish residents in care homes. This means that nursing and personal care support in England is £188 and in Scotland £241 - not quite as significant as it is often portrayed. Free care in Scotland is not quite what it seems given hotel costs and Scotland should not have ignored the Dilnott report.

These latest statistics should be a wake up call and the Scottish Parliament needs to review the funding of the policy now. Before care for Scotland's elderly, gets even worse.

 

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The treasure that is our local libraries

The author Stephen McGinty has written a great piece in Saturday's Scotsman on the joys of rediscovering his local library. In fact more than that - the library has rekindled his passion for reading.

He sets out the range of services available in a modern library that explains why library useage is on the increase, even if the number of books taken out is down. It's also great value, as he says:

"Economists in a report published this week have calculated the monetary value of various sporting and cultural activities and what came out on top was that regularly visiting the library is, in terms of satisfaction, the equivalent of a pay rise of £1,359. By comparison, playing a team sport has a value of £1,127. This is a remarkable return on investment, as our library service costs us each about £21.90 a year in taxes."

I particularly liked the "rotating carousel containing the racier titles". I recall my time as NALGO Branch organiser in the 1980's, when the County Librarian used to have a cupboard in his office for books that had been the subject of complaints from sensitive readers. Times have changed!

He concludes:

"The green and blue cardboard library tickets of my childhood have long since been replaced by a plastic card, but it is still a key to a kingdom of riches. Economists may value a library at £1,359, but to me they are priceless."

We could not have put it better ourselves!

Local Democracy

The Commission for local democracy has published its interim report. The key finding is that local democracy is under pressure as a result of a fifty year trend in centralising power and functions in Scotland. This also is as a result of and a continuation of a “centralist mind set”; where bodies at all levels hang on to powers and resources rather than empower individuals and communities.
The commission highlights the following as the key implications from evidence they have received:
· Definite loss of trust and confidence and participation in democracy: disadvantaged communities that need the most representation are least able to participate
· Link between representative and participatory democracy has become hard to bridge because of the gap between the scale of representative institutions and the community base for participation
· Big government and big local government have struggled to address inequalities because they occur at a “granular local community level” big systems also struggle to engage with the diversity of Scotland’s communities because they are so geared to uniformity and standardisation

The Commission believe to move forward:

· Scotland needs to change the way it thinks about democracy

· Strong democracy is both participatory and representative

· Services and decision making must fit communities

· Improving outcomes requires fiscal empowerment

The report makes interesting reading and the focus on democracy and delivering real change in communities rather than local government structures is welcome. It also gives a good overview of how local democracy operates elsewhere. What it also highlights is how uniform local government functions, responsibilities and electoral mechanisms are across Scotland when so many other countries operate very different solutions for example in villages towns and cities.

The focus on resources is also welcome. The report looks not at just funding for local government but at how to resource and empower communities.

There is a lot to think about in this interim report and very useful detail on how others operate local democracy. The hard work is yet to come though: designing and implementing solutions.

There will be a fuller briefing for branches next week.

Food inspection changes highlighted

The Guardian ran an excellent lead story last week on the impact EU changes to food inspection could have on food safety. This is an important issue in Scotland as the Food (Scotland) Bill is being considered by Parliament.

They report that our inspectors have issued a grim warning that more infected animals could enter the food chain because of a shakeup in the inspection process which, means some of the millions of animals they reject each year as unfit for human consumption could still reach Our food plates. Quite astonishing in light of the horsemeat scandal.

Figures collected from UK factories show that millions of carcasses carrying parasites such as tapeworm and animals infected with pneumonia, septicaemia, peritonitis and tumours were removed from the food chain by official inspectors between 2012 and 2014.

UNISON's Heather Wakefield, said: "The UK government's agenda will result in food that repulses us being dished up on our plates. Most people do not know that there are a small group of meat inspectors and vets that keep them safe from harmful and repulsive additions to our sausages, Sunday roasts and beef pies. They work in some of the most awful conditions in blood and animal discharges every day. They are always the first to come under attack, not only from the food business operators, but also from our government."

Labour has supported our campaign. Shadow food minister, Huw Irranca-Davies, said: "The government need to explain why they are seeking to weaken consumer protection and the wholesomeness of produce, barely a year after the horsemeat scandal. British consumers will be appalled at any risk of tapeworm, parasitic lungworms and diseased parts of animals ending up on their dinner plates at home, or in hospitals and schools."

The Scottish Parliament's Health Committee has issued a call for evidence on the Bill. UNISON Scotland will be highlighting these concerns to the committee.

 

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Why regulation matters

Good regulation rarely gets a mention in the 'red tape' headlines, but it's an essential safeguard for us all. Regulations don’t just protect the public from unscrupulous and dangerous practices they protect other businesses as well. Companies who don’t follow the rules can offer a cheaper and/or faster service. This makes it difficult for those who do the right thing to compete. Fly tippers can charge a lot less than those who pay to have their waste disposed of or recycled. This drives down profit margins and increases costs for taxpayers who have to pay to have streets cleaned.

Today, we held a meeting of our members who deliver a wide range of regulatory functions. Planners, environmental health, trading standards and meat inspectors ensure that Scotland is a better, safer place to live and work.

Both the UK and Scottish Governments have bought, to varying degrees, the 'red tape' myth. As the OECD has reported, the UK actually has one of the lowest administrative burdens in the developed world. Even business surveys show low levels of concern and very few actual examples of unnecessary regulation. None the less, in Scotland we now have the Regulatory Reform Act, a largely unnecessary and cosmetic piece of legislation, and today we were considering the consultation on a Scottish regulators code of practice.

The code is a high level strategic document which is the right approach as front line staff cannot be expected to juggle with conflicting requirements. However, there is still a concern that the concept of 'regulators as enablers' conflicts with the primary role of ensuring compliance. In some areas, like food safety, compliance should be absolute, whereas in others an enabling approach is possible. More effort is focussed on high risk areas but we should not abandon others. I did like the SEPA enforcement model in the consultation – ‘chancers’ indeed!

The Act introduced the concept of regulators contributing to ‘sustainable economic growth’. While this is an admirable, if vague, ideal, the actions of regulators have a minimal impact on economic growth. Creating an industry around this issue is likely to add to the recording and other burdens staff are already struggling with.

The biggest concern is cuts in staff and resources. As our FoI and survey evidence shows, many areas of regulatory activity are being abandoned as well as training and other forms of support to businesses. In areas like meat inspection, the industry is successfully lobbying for light touch regulation. I for one don’t want to eat food with abscesses, but that’s precisely what I am going to get when meat inspectors are limited to visual inspection of animals. This is something MSPs will need to address when the Food (Scotland) Bill is considered by the Health Committee.

Sensible regulation is something we all take for granted. We assume that someone is checking that the food we eat and the goods we buy are safe. Increasingly, that is simply not the case and as usual it will be a tragedy that causes governments to rethink the merits of light touch regulation.

Childcare: Time to Deliver

Another report on childcare shows that the high costs and complexities of the current system need to be tackled urgently if we are to give our children the best start in life. The Family and Childcare Trust 2014 Scottish Childcare report found that less than a quarter of local authorities in Scotland have enough childcare for working parents (the equivalent figure for England is 54%). Costs for that care continue to rise: 4.8% last year. The cost for part-time care for two children is now 22% higher than the average mortgage bill. Charges vary considerably across Scotland: in some areas the difference is as much as £3000.

The Family and Childcare Trust highlight how complex the delivery and funding of childcare is for parents and for providers. There are direct funding streams for what is officially early years education: your free hours for three and four year-olds, the childcare elements of Working Tax Credit, voucher based schemes through employers and then various small schemes through Job Centre Plus or other funding streams through anti-poverty initiatives which fund nurseries and crèches and breakfast clubs for example. Local authorities also provided free or subsidised accommodation to social enterprises offering childcare and while not officially childcare there are a range of sports and social clubs in schools which are in effect after school care.

The shortage of spaces for children is pushing up costs. Costs that mean many women just can’t afford to keep or find jobs: and yes it is still women who largely look after children both paid and unpaid. Getting childcare right offers a real opportunity to reduce gender inequality by reducing the financial penalties for motherhood. Ensuring that childcare workers are properly paid and have a career path will also reduce the gender pay gap.

Local authorities are best placed to address the challenges of childcare. Delivery by local authorities will help simplify and reduce the artificial barriers round the many agencies and complex funding streams currently in place. The artificial eradication/childcare split needs to go. Local authority provision is also the most cost effective route as currently nursery provision in the public sector is 11% cheaper than the private and not-for-profit sectors despite the higher wages and more qualified workforce. They need the funding to expand to meet the needs of the communities they serve.

The debate needs to move on from “hours” to organising the delivery of a proper service to support the development of our children and ensure that work pays for all those involved.