20 February 2024

“Some days, it feels like we literally hold people’s lives in our hands”

As part of our Rethink To 13 series, a support practitioner in Sense Scotland’s short breaks service tells us about the impact a pay increase to £13 would have on her, the workforce – and the people they support

“As a support practitioner in a respite unit for young people and adults with complex needs, I wear many hats, and perform so many roles in a day. I am carer, friend, cook, nurse, driver, emotional/physical outlet, entertainer, advocate, teacher, family, to name a few.

Some days, it feels like we literally hold people’s lives in our hands. I am paid the Living Wage for only one of these roles. Raising the wage to at least £13 an hour would not only allow us to feel more appreciated and valued within these roles, it would encourage experienced staff to stay within the care sector.

We do this job to the best of our ability and because we care. But in turn, we also need to feel that we are cared for. My role requires me to be registered with the SSSC, a professional body. However, we still are classed as unskilled workers. The roles we perform are anything but unskilled.

I have stayed with people in their hour of need, providing end of life care, ensuring they are not alone and feel safe and loved. Not because my role required this, but because this is what everyone deserves.

Raising the hourly rate of pay would lead to a happier, less stressed workforce, allowing us to focus on the care that the people receiving support deserve. This would enable them to have more confidence in the people caring for them and offer a happier, more positive experience of care.

It would also encourage others to look into a career in care, offering more diversity, skills and experience, which would enhance the level of service we can provide for the people we support.”

Find out more about Sense Scotland

Read more about our Rethink To 13 campaign

 

 

 

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4 December 2023

Comment: “Social care could be the gift that keeps on giving for Scotland. But only if the government rethinks its budget”

Marking the launch of our new Rethink To 13 campaign, Rachel Cackett argues that £12 p/h for staff is too low, is ethically wrong, and flies in the face of what Scotland need to enjoy equality, opportunity and community

On the 19th December, during the last week of 2023 for the Scottish Parliament, the government will publish its draft budget.

In unprecedented times, we are hoping for something a bit different from this budget.

For years now, there have been calls for the Scottish Government to be far more transparent in setting out how its draft budget is intended to match investment to its stated priorities. This is a primary task of government: To ensure that funds raised from the public are invested in the things the democratically elected government has told us are important.

And when things are tight, justifying the allocation of too few resources to those things that a government says matters most is more important than ever.

So, perhaps the government can do something different this year.

The first minister has stated that all funding decisions must deliver against three things:

  1. Equality, by tackling poverty and protecting people from harm during the cost-of-living crisis
  2. Opportunity through a fair, green and growing wellbeing economy that can support improved living standards, reduce poverty, and sustain high quality public services, and
  3. Community by prioritising public services – building sustainability and reducing inequality.

So, perhaps we can expect the budget to be structured to show clearly how decisions to invest – and disinvest – will deliver these.

Perhaps, for example, we will see a commitment to the funding of sustainable social care services that support families facing poverty or destitution in the current financial climate to stay afloat, to keep a home, to feed their families and keep children in school.

Or to services that support disabled people, or people with long term health conditions – who face a myriad of daily inequities – to maintain their right to independent living and stay well in their own homes.

Or to mental health services that help prevent adults and children reaching crisis – and stop yet more people waiting too long for NHS services that just aren’t there – so that they can live connected, engaged lives as participants in work, school, family and community.

Or to the availability of social care and support for everyone who needs it so that unpaid carers can maintain jobs that can keep their families afloat.

Or to those staff in our sector, overwhelmingly women, who provide care and support to some of the most vulnerable members of my family and yours – but are paid far less than those in the public sector to do equivalent jobs simply because the government doesn’t provide enough funds.

Staff who may often work – and spend their wages – in the communities they support. Staff who are often working part time to juggle their unpaid caring responsibilities.   Staff who desperately need equality, opportunity and community.

You see, social care and support – ever the Cinderella of public service investment – could be the FM’s answer this Christmas. It could be the gift that keeps on giving; the glue that binds his priorities to effective investment. But it’s only possible with a workforce to deliver it.

And there’s the issue.

Half the people who moved jobs in our sector last year left social care altogether. And the unethical approach to embedding pay inequity into public service delivery means staff continue to leave and social care isn’t always there when you, or I, or our loved ones need it.

The FM has already imposed a £12 p/h pay deal for social care and support staff in our sector next year and, sadly, we expect to see this confirmed in the draft Budget on 19 December. But this won’t help the government meet its own budget priorities; it will undermine them.

So, Scottish Government, rethink your budget.

Investing at the very least £13 p/h in 2024-25 for all social care staff in our sector is the absolute minimum that will cut it – and that only as a first step in a plan to reach parity in pay.

£12 is too low; it’s ethically wrong; and it flies in the face of what you’ve told us it matters to invest in and what many people in Scotland need to enjoy equality, opportunity and community.

Please. Rethink your budget.

#RethinkTo13

Find out more about the campaign here.

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24 October 2023

Statement: “With promised £12 per hour base pay no more than the Real Living Wage, social care staff need action now to show they are valued”

Our CEO Rachel Cackett responds to today’s announcement that the Real Living Wage will rise to £12 per hour

Responding to today’s announcement that the Real Living Wage will rise to £12 per hour, CCPS’s Chief Executive Rachel Cackett said:

“Back in September, the Scottish Government announced a £12 per hour base rate of pay for social care staff, starting in April 2024. Today, we know that this offer is no more than the new Real Living Wage amount, which will be introduced at the same time.

This means that many not-for-profit social care staff – who work with disabled people, older people, children, families and many others who need support in communities across Scotland – will now receive just the minimum the Living Wage Foundation calculates is needed to meet every day needs.

This is nothing like enough.

Before the new base rate and RLW kick in next spring, social care staff will have to navigate the winter months as an acute cost of living crisis continues, whilst many earn just the £10.90 per hour currently set by the Scottish Government.

The First Minister’s states his priorities are “Equality, Opportunity and Community”. These priorities are at the heart of social care. Yet a workforce that makes such a vital contribution to society, to supporting people to thrive and live independent lives, continues to face inequality and limited opportunities through poor government pay awards. The knock-on is a lack of available support for the most vulnerable people in our communities.

Investing in the value of social care is a political choice, and there is still time to make the right choice in the 2024-25 Budget. We know public finances are tight. We know we won’t get to parity of pay, terms and conditions for equal work with public sector colleagues overnight. We are very far from that now.

But we need to see a clear step to closing the pay gap in April next year and a plan to get to equality; a move towards showing staff that they are truly valued.

So, we are calling on the First Minister to up his offer to at least £13 per hour for all social care staff from April 2024 as part of a published timetable to achieve Fair Work.

Not as an end point, but to indicate in tough times that our government sees the value of our sector and is committed to ending deep inequities for social care staff in Scotland.”

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12 October 2023

4 Steps Comment: “The door is open. Now we need to push it a bit further”

Our CEO Rachel Cackett reflects on the disappointments and successes of our 4 Steps to Fair Work campaign – and what our emerging movement can do next in its fight for social justice

“You can survive, but you can’t really live.”

Those words from Derek, a frontline social care worker, have echoed around my head during our #4StepsToFairWork campaign. They describe what it feels like to live on the amount the Scottish Government makes available to our members to pay staff who provide support to some of the most vulnerable people in our communities.  People we all clapped through COVID. The people who might work to support my family or yours.

It’s the quietest national scandal that, behind doors in streets and villages across Scotland, are people who need support to live, to thrive, to be well, to stay independent, who can’t get it because there simply aren’t the staff.

It’s the quietest national scandal that social care and support staff working in our sector – the vast majority of them women – are paid 20% less to deliver public services, from our taxes, than people doing equivalent work in the NHS.

So, at the start of 2023 we decided it was time to stop being quiet and call for better, loudly.

Our demands weren’t huge.  Simply, we wanted all staff to get at least £12 per hour from April 2023 as the first step of a public plan to pay people fairly. A plan to give staff, and the people they support, hope.

And our #4StepsToFairWork campaign began to snowball.

Frontline staff and CEOs from our member organisations stood up and spoke up. And then others joined.  Carer Organisations, Scotland’s Faith Leaders, partner organisations, people with experience of care and support all spoke up through blogs, emails to MSPs, social media posts. I would like to personally thank every one of you who did so.  In a sector, based on the rights of people to exercise choice and control about their own care and support, our diversity and our voice are our strengths.

Then, early in our campaign, our new First Minister stood up to give his first speech to the Scottish Parliament.

We waited.

“Equality, Opportunity, Community” he said. Those are the government’s new priorities.  “That’s social care!”, we thought.

We waited…

A commitment to £12 an hour, he said.  “At last!”, we thought. The voices had been loud enough for him to hear.

But then he gave no date.

A crisis heard, but half a promise made. And a crashing disappointment for the thousands of committed staff in our sector, and to the leaders trying to keep their organisations open.

140 days later the date came in the Programme for Government – £12ph from April 2024. We hoped for a mistake in the speech, but no. A year late and by then, again too little.

And no plan.

Of course I am disappointed that the voices of so many have not resulted in our asks being met in full. That the national scandal of the Scottish Government baking in inequity to social care, and leaving people without the support they need, remains. But is it over? Absolutely not.

The door is open. We just need to push it a bit further.

Your voices were so loud, your arguments so clear, that our new FM knew he had to make a commitment to our sector in his first speech. We shouldn’t ignore this; we should build on it.

For the first time, the pay award has been extended to those working in children’s services: A first inequity addressed through our campaign.

The collective, public, voice of our sector and our allies is building to bring social justice to social care and support. Nurturing that emerging movement in the run-up to elections, as parties set their new priorities, is crucial.

And finally – and importantly – let’s remember that the £12 announcement might be made, but the Scottish Budget is not yet passed.  Every MSP has an opportunity to speak up to call for more, for better.  All of us can still call on politicians, whose core job is to allocate tax payers’ money to fund priorities for our nation, to make a better decision.

So, our #4StepsToFairWork campaign concludes today; but our campaign for better for our sector does not.

Watch this space….

Blogs, video contributions and resources from our 4 Steps campaign (June – October 2023) are available to read here

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11 October 2023

4 Steps Guest Blog: “Ending the difference in funding levels between services would be a step towards the fairness we need”

A hierarchy in adults and children’s services or between regulated v unregulated services simply means more inequalities, says Fiona Steel, Action for Children’s Acting National Director for Scotland

In the recent Programme for Government the First Minister announced a commitment to ‘provide the necessary funding in the next Budget to increase the pay of social care workers in a direct care role, to deliver funded early learning and childcare, to at least £12 per hour’. As ever, we await the fine print on how this commitment will operate in practice.

While this is a move in the right direction and may go some way to ‘dealing with pay inequality’ – the first step of the 4 Steps to Fair Work campaign – there is still unfortunately a long journey to go before social care and support workers are properly rewarded and recognised. We can’t forget that The Promise stated, ‘the purpose of the workforce must be to be caring above anything else. That starts with recruiting people with the right ethos and qualities rather than qualifications’.

But how do we get these people into social care?

Action for Children knows that there is a current struggle to attract and retain people into the social care workforce. We also know that social care staff are experts in the people they care for. To provide that vital care requires staff to use multiple skills ranging across the clinical, emotional and academic, while also collaborating closely with a myriad of other professionals.

People who choose to work in the care sector display astonishing levels of compassion, empathy, commitment, and kindness to ensure people they care for are made to feel they belong, are safe, loved and valued.

For too often the perception of social care work as being low skill prevailed. This needs to be challenged and changed.

During Covid we did see the beginning of a shift in people’s attitudes towards the sector: our frontline workers were seen as key workers who added social value. Our staff were the people who society relied on in times of crisis but also in times of normality. It’s disappointing that this view change hasn’t been built upon.

We need renewed government support and help to attract and retain staff in the sector.

As an organisation we are focused on investing in our staff. We are dedicated to building a diverse, inclusive, and authentic workplace. We pay the real living wage; we embrace the Government’s Fair Work agenda. We offer excellent training and developments opportunities; we help staff gain professional qualifications and offer flexible working hours. We encourage young people into our workforce, highlighted by the fact we recently gained a Platinum Award from Investors in Young People (IIYP).

However we are still facing recruitment challenges, especially when it comes to the complexity of commissioning of services.

We as a sector need parity. We shouldn’t have a hierarchy between adult and children services or between regulated vs unregulated services. The difference in the levels of funding between each of these areas can create inequalities.

That’s why Action for Children fully supports CCPS’s campaign calls to ensure equal pay for equal work and value all staff who play their part by delivering funding packages that value the crucial role of the different staff who make up the social care workforce.

The third sector delivers many local authority services, but councils are competing with these providers for staff. They are offering more in wages to attract staff than they give in rates in the contracts for providers, ironically making it harder to staff these local services.

Something fundamental needs to change to make sure Scotland has a talent pool for social care that is deeper not shallower. Action for Children believes the 4 Steps to Fair Work campaign can be the catalyst for change needed. That is why we offer it our full support.

Find out more about Action for Children’s work

Read more about the 4 Steps to Fair Work campaign

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5 October 2023

4 Steps Guest Blog: “In all good conscience, we cannot allow the support of vulnerable children to be devalued”

We refuse to accept that our children’s services staff are any less important than their adult counterparts, writes Cosgrove Care’s Depute Chief Executive Pauline Boyce

Cosgrove Care is proud to work with children and adults with learning disabilities, mental health issues, autism and other support needs. We want to see them thrive and grow, realise their human rights and live life to the full. We simply cannot do that without our dedicated, committed and skilled team. That means the direct support workers and their managers, in both our children’s and adult services.

In recent years the uplift in pay for adult social care staff has been welcome.  However, the consistent failure to equally value the children’s social care workforce has placed a significant financial burden on organisations such as ours, who refuse to accept that our children’s services staff are any less valuable than their adult counterparts.

How do you explain to a skilled support worker that, in the eyes of the powers that be, the work they do on a Monday morning, caring for a vulnerable adult at our wellbeing group, is of more value than the care and they provide at 3pm the same day, to a vulnerable child after school?

The answer is you do not. You simply cannot in good conscience allow the support of vulnerable children to be devalued. As an organisation you absorb the cost of increasing wages for children’s service staff, carrying an unsustainable financial burden.

The First Minister’s recent statement announcing an uplift to £12 an hour – which does appear to include both adult and children’s services staff – is again welcome. But it does not recognise the burden organisations such as ours have carried in the last few years supporting children’s services staff.

Equally, the provision of funding to increase the rate of pay for social care workers in direct care roles does not recognise the burden that we carry in maintaining a differential for our first and second level managers. It fails to value our team leaders and managers.

Are they less deserving of a pay increase? Are their families less deserving of their support? How do you explain to your managers that the work they do supporting staff, managing and deploying ever more stretched resources, all whilst ensuring quality services, are delivered and improving outcomes is of less value than direct support work?

The answer is you do not. You simply cannot in good conscience allow the support of your staff to be devalued. As an organisation you absorb the cost of increasing wages for front line managers, carrying an unsustainable financial burden.

If we are genuine about valuing social care, in recognising it as a worthwhile service and career we need to ensure funding increases value all aspects of the social care work force, without placing further burdens directly onto organisations.

Find out more about Cosgrove Care

Find out more about our 4 Steps to Fair Work campaign and take part

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26 September 2023

4 Steps Guest Blog: “Funding packages that value all staff will play a crucial part in developing a motivated workforce”

Alex Cumming, SAMH’s Executive Director of Operations, on why social care and support managers need our backing to ensure not just that they don’t leave the sector, but that they can thrive in it

At SAMH (the Scottish Association for Mental Health) we believe everyone is entitled to hope and choice, and to achieve personal fulfilment. We know from 100 years of working in mental health that the key to delivering on these values – and the success of services – is a sustainable, happy and valued workforce.

Critical to our frontline workforce is the support given by managers across the country. Within moments they move from crisis management, to hands-on delivery, meeting ever-more demanding compliance requirements and regulations. They do all this while embedding organisational changes, leading service improvements and delivering contractual obligations. Our ask of them is vast.

The role they play in creating and embedding a culture of compassion and providing the environment for staff to develop cannot be exaggerated. They provide support for improving practice and negotiate delicate performance conversations. They do all this at the same time as bringing the team together to work on the collective goal of improving outcomes for people we work with.

This means that the ability to sustain and develop management and leadership pathways is essential, and just as urgent as the frontline challenge all providers are facing. One way to address both these issues is delivering funding packages that value all staff, which will play a crucial part in developing a motivated health and social care workforce that functions effectively, safety and consistently.

All of us are planning for the future, and considering what’s needed for management and leadership roles is key to that. However, we need a longer term view as well as support from government that delivers greater parity, enables us to harness the passion and skills to develop our managers, and reduces the fatigue our staff are feeling.

So where are the positives? Having spent time with more than 50 of our managers in the last week, I’m reminded of the drive and determination of our workforce and their unyielding commitment to those we support. Their resilience motivates others, but they need our backing and support to make sure not just that they don’t leave the sector, but that they can thrive in it.

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18 August 2023

4 Steps Guest Blog: “The staff who work for my son will tell you it’s not only good fun, but they have grown so much from supporting him”

As part of 4 Steps To Fair Work, we’re sharing views from beyond our membership. Here the Coalition of Carers in Scotland’s Jaynie Mitchell discusses how a new approach to recruitment could reap rewards

There is no doubt it is difficult to recruit support staff roles currently. There are many reasons for this, poor wages being one of the main ones, but I also believe that the pandemic and how care is now perceived by wider society is also having a huge impact.

Throughout the pandemic care was primarily reduced to a shrinking number of care workers providing short visits to multiple people at a time. Mainly providing personal care to those who were elderly, unwell, or requiring end of life care. While this type of support is incredibly important it is only part of the social care picture. Many of us have loved ones who are children, teenagers, and young adults, or grown-up children, brothers and sisters who have support needs because of disability.

I would argue that this group of people is often overlooked by the mainstream press whenever there is a news piece on social care. There may be many reasons for this, amongst them how complicated it would be to describe their support needs briefly in an article.

While personal care is an essential element of social care, in reality it’s a very small part of what people need to live the life they want. We need to also focus on how social care should help people to live a rich and full life and not just an existence of being clean, fed and often lonely and bored.

Using the passions and interests of our loved ones to find support is one solution to the workforce crisis. It is also a great model for more personalised care.

Our son is an adventurer who loves to explore new places, going for a run in the car for a hot chocolate. He loves fish and chips followed by an ice-cream. He’s a collector of rare books, so likes to visit charity shops to add to his collection. He is an artist and photographer. He is a whizz when it comes to technology has a wicked sense of humour, and the most infectious laugh. He loves to eat out and enjoys home cooked food too.

When we have advertised for staff in the past and listed his diagnosis, and that sometimes he requires 2:1 support, lovely people apply, but they share none of his interests, they are usually older, very experienced, and come with a notion of what support should look like for someone with complex needs, and that notion doesn’t align with ours.

When we advertise for people that love to drive, are artists and up for a laugh, have a passion for books, are into technology, and enjoying eating out and cooking, we get a completely different kind of applicant. Once we think they are a good fit we then teach them the technical stuff about how to support him.

If your child wants to go to ballet lessons, ask some of the teenagers who attend if they want a part-time job. If they want to go to Beavers, try a Venture Scout. If your husband always enjoyed bowls, ask at their club who could support them. If they want to go to the gym, ask for a gym buddy. If they want to learn to cook, find someone who also wants to learn to support them. If they enjoy live music find someone who likes the same type of gigs. Not only will it be a better experience for your loved one, but a relationship may also grow from it which is and bonus for everyone involved.

We have been conditioned by the system and society that only a particular type of person can support disabled people. It is simply not true. Instead of paying staff a fair wage, staff are called ‘brave’ or ‘kind-hearted’, leading those that don’t see themselves as altruistic to think they need not apply.

Alongside improving the pay and conditions for the health and social care workforce, we also need to change the narrative. The staff who work for my son will tell you that it’s not only rewarding and good fun – but they have learned and grown so much themselves from supporting him.

Jaynie Mitchell is Rural and Island Engagement Worker for the Coalition of Carers in Scotland

Find out more about our 4 Steps to Fair Work campaign

 

 

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15 August 2023

4 Steps Guest Blog: “Which part of the elephant do we start with?”

For things to improve for supported people and carers, they first need to improve for the workforce, says Claire Cairns, Director of the Coalition of Carers in Scotland

As Desmond Tutu once wisely said “there is only one way to eat an elephant: a bite at a time.”

I have recently been reminded of this when considering the seemingly enormous task of how to reform and improve social care. It’s certainly stumped a lot of governments, which is why when I talk to my colleagues in other parts of the UK and Europe, they seem equally overwhelmed by the task.

And the social care system is undeniably complicated. There are so many competing demands, so many inter-connected issues, not to mention deeply embedded cultures, processes and structures that we know don’t work, but we can’t work out how to dismantle them. Where do you start? The legs, the trunk?

The Feeley report has given us a great map, or perhaps more of a hopeful brochure of our final destination, if we can ever get the plane off the runway.

So what is the word from unpaid carers on all this? And specifically what is their view on Fair Work?

When it comes to Feeley and the subsequent National Care Service Bill, the development carers are most invested in is the right to breaks from caring. This is something carers have been campaigning about for well over a decade. At the moment, as well as being unpaid, carers don’t have the right to time off from their caring role.

Let that sink in for a minute. Having to care for someone, 24 hours a day, often with a lack of sleep – yet no guarantee that you will be able to get a regular break. Even those carers who do have a decent support package are just coming out of the last two plus years of the pandemic with their batteries, all but depleted and many of the services they used to rely on, seemingly dismantled.

So you might think that the spotlight on Fair Work and improving the terms and conditions of the paid workforce would have carers saying ‘Hang on a minute’. But I think you would be wrong.

Carers know that very little can be achieved to improve social care without first addressing the existing workforce crisis. The right to breaks from caring is completely unworkable unless there are social care staff and services to meet the increased demand. Not to mention to ensure there is a broad range of services available to ensure the very diverse needs of the carer population can be met.

But more than that, carers see the unfairness of how the social care workforce is treated – overworked, underpaid and often unappreciated. Support workers and personal assistants come into peoples’ homes and are trusted with their loved ones. They build relationships with people and at times become like family members. Sometimes and especially over the last few years, they are the only people the family regularly sees, providing a bit of comfort and chat, as well as support.

Carers are often devastated when support staff move on, particularly when it’s because they need to earn more money elsewhere, but they don’t want to move on to a job they will find less rewarding. Then for the family there is the hard task of recruiting, or securing, alternative support from their local authority – yet another stressful thing to add to the list.

The truth is both unpaid carers and social care support staff are the frontline, often working together, both under-appreciated. Both at times hailed as ‘heroes’, when they would rather be recognised and properly recompensed for their essential and highly skilled labour.

Feeley and the National Care Service is rightly focussed on improving outcomes for people who use services and their carers. But for things to improve for supported people and carers, they first need to improve for the workforce.

I suggest that’s the bit of the elephant we need to start with.

The Coalition of Carers in Scotland exists to advance the voice of carers by facilitating carer engagement and bringing carers and local carer organisations together with decision makers at a national and local level.

Since its inception in 1998 the Coalition has played a fundamental role in advancing carer recognition and support and in establishing a Carers Rights agenda in Scotland.

Find out more here. 

Find out more about the 4 Steps to Fair Work campaign here.

 

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25 July 2023

4 Steps Guest Blog: “What is the ethical defence of unequal pay?”

Old concepts of moral principle, politics and logic help explain the absence of fair work in social care, says Ron Culley

Ethos, demos and logos were concepts used by the ancient Greeks to make sense of the world around them: ethos referred to the development of a moral principle or argument, rooted in human values; demos referred to the body politic, to the rules of self-government; and logos referred to reason and rationality, the logical flow of an argument.

Two-and-a-half-thousand years later, and it seems to me these concepts are still useful in making sense of the world around us. The principle of fair work in social care, and the limited political progress that we have made towards it, can be helpfully understood by applying these concepts.

Ethos

The ethical argument for fair work in social care is plainly put. If social care workers across different sectors are delivering similar taxpayer-funded public services, why should the level of pay be different? Given that care workers are providing work of equal value, is the Scottish Government justified in mandating that a Healthcare Assistant in the NHS be paid £14 per hour, a homecare worker in a council £16 per hour, a support worker in a not-for-profit social care provider £10.90 per hour, and a care worker in a private sector care home £10.90 per hour? All of these jobs are comparable in terms of skill and responsibility.

So is it fair that the Scottish Government and Local Authorities have decided in favour of unequal pay? And let’s consider the fact that most people working in the care sector are women and that, on average, women continue to receive lower pay than men. Is it right that the Scottish Government and Local Authorities have not gone further to correct this injustice? Were there to be a reprioritisation of political choices, tens of thousands of women could be taken out of a low wage job. In short, the ethical defence of unequal pay is very difficult to present.

Demos

To explain why this situation nonetheless persists, we need to understand Scottish politics. The reality – however much we might want to pretend otherwise – is that the NHS is politically more important to the Scottish Government than the social care sector. It’s why many arguments about investing more in social care are actually framed around alleviating pressure on the NHS, and not about supporting people to realise their rights as citizens or to give expression to their personal agency. By this argument, social care is only important because to get it wrong damages the NHS, and a struggling NHS is a vote loser.

The other way democratic politics plays into this is in the stewardship of the public finances. There simply isn’t a strong enough tax intake to fund the health and social care system that many people would like, so we have developed a system that supports the cheap outsourcing of public services to the third and independent sector (euphemistically referred to as ‘best value’). That would be fine if it were a level playing field and all providers (including monopolistic providers like NHS Boards and Councils) had to compete for business on the same terms. But that would risk violating one of the golden rules of Scottish politics, that public sector delivery is best (despite evidence that the third sector consistently delivers higher quality care and support).

Logos

The problem with all of this is that it contains flawed logic and makes for poor strategy. What happens if we pay public sector care workers significantly more than third or independent sector workers? The answer is there is a migration of talent and experience from one to the other. As a result, the third and independent sector is weakened, especially given that the labour market has been structurally imbalanced by Brexit and Covid.

How will providers in the third and independent sector respond? I doubt there will be a dramatic implosion – there’s too much market diversity for that to happen. Rather, what we’ll see is a gradual reduction in service delivery across the sector – less care delivered by less people. That in turn will generate more unmet need. And where will those people go? I would imagine social work, GPs and Emergency Departments. Only this time, there’ll be no-one else to turn to.

Ron Culley is CEO of Quarriers, a member of CCPS’s Board and Chair of our Committee on the National Care Service

Find out more about our 4 Steps to Fair Work campaign

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