- Build a National Care Service which is fully publicly owned and publicly funded, and which delivers care on the basis of need free at the point of use – just like our NHS.
- Deliver a new deal for care workers to end the care recruitment crisis – secure jobs, higher pay, better working conditions.
Demand a National Care Service
The Scottish Socialist Party has pioneered the campaign for a National Care Service in Scotland.
Scotland’s care needs are only going to keep growing. We need a resilient, well-funded, needs-based, publicly owned National Care Service to make sure we have a suitable system of care.
There are now many plans for care from other parties that talk about a “National Care Service”. But only the SSP is clear that we need a National Care Service which is publicly owned, publicly funded, and free at the point of need. That means removing the private ownership, provision, and profiteering from care, and bringing care into democratic public ownership.
The Common Weal think-tank called COVID-19 deaths in Scottish care homes “the single greatest failure in devolved government since the creation of the Scottish Parliament“. There has been a Coronavirus catastrophe in Scotland’s care homes – caused by poverty pay conditions, austerity in care provision, and putting private profiteering before the needs of care workers and residents.
A Panelbase poll revealed that 69% of the population strongly support a National Care Service which, like the NHS, is “free at the point of need, paid for out of general taxation, publicly owned and run with facilities regularly inspected to ensure they are fit for the 21st century”. The proportion of women over 55 supporting the proposal reached 78%.
No one should have to worry about money when looking for care – but that is what private profiteering does to vital public services. Private care creates an unequal system where care and care quality is distributed on the basis of wealth, not on need. Those with greater needs but fewer savings face living with unsuitable levels of care.
Care homes spend, on average, just £6 per day on food per resident. The average weekly care home fees in Scotland are over £600 for residential care and more than £800 for nursing care. Many service users are required to sell their home, plunder their assets, or rely on family “top-ups” to fund care – and the system offers no flexibility to reflect people’s changing needs.
One in seven service users in Britain pays more than £100,000 per year in care costs. Almost 80% of that adult social care provision is provided by ‘for-profit’ companies who take a significant proportion of money out of the public purse and distribute it to shareholders around the world, rather than to care workers and service quality.
We wouldn’t accept this kind of system in our NHS, and we can’t accept it in care.
The public already pays the bill for private care through care fees, public grants, social security spending, personal debt, and corporate tax loopholes. Scotland’s big private care firms move money taken from the NHS, local councils, and residents to secret tax havens. £1.5bn “leaks” out of the care system through tax haven scams and into private hands every year.
According to the Competition and Markets Authority, the care home industry was worth £16bn in 2018 with 5,500 different providers operating 11,300 homes and 456,000 beds for older people. Yet, as Professor Allyson Pollock has pointed out, “it is virtually impossible to track where that public money is going”.
Large private care providers hide profit, and therefore pay less tax, by paying rent to subsidiary companies in the same corporate network, but which are based in tax havens. Care homes are underfunded and undermaintained, and self-funding service users are being made to pay more and more to support the system while billions are being sent to tax havens.
We can afford a National Care Service – but we cannot afford tax havens and private profiteering.
The Scottish Socialist Party knows that private profiteering in care fatally compromises care quality and working conditions. There are 1,100 care home providers whose fiduciary responsibility to shareholders outweighs the wider public interest. Retaining private ownership and provision of care is fundamentally incompatible with Scotland’s urgent and growing care needs.
The Scottish and UK Government proposals for reforming social care simply do not go anywhere near far enough. The “National Care Service” proposed by the Scottish Government is nothing of the sort. “Bureaucratic window dressing” will not alleviate the staffing crisis in care, deliver a single minute of care, or bring down care costs for service users.
The SSP supports a National Care Service delivered through local authorities, with a national body responsible for ensuring adequate resources, monitoring standards, and sectoral collective bargaining.
New Deal for Care Workers
Care workers have faced the Coronavirus crisis while dealing with the crisis of poverty pay and unsafe work.
209,690 workers – mostly women – are facing unacceptable and unsustainable pressure in unfair conditions. Audit Scotland has revealed that almost a quarter of care workers leave within three months over low pay, poor conditions, and overwork.
Three out of every four care workers report having to carry out unpaid training on their own time.
A fifth of care workers do not have permanent contracts; one in ten are on zero-hour contracts. Carers are paid as little as £10.50 an hour – and most low-paid care workers are women or migrants.
One-third of care home staff resign within a year over poor conditions – a loss of experience that undermines care quality. 52% of Scotland’s care homes report daily job vacancies.
This causes worker burnout, a mental health crisis, a high staff turnover, chronic understaffing, and dangerous levels of overwork which puts workers and service users at risk. 75% of care workers report not having enough time to delver an adequate standard of care.
The National Care Home Contract between COSLA and Care Scotland sets a lower rate of pay for care home nurses than their NHS counterparts and offers inferior workplace benefits. As a result of poor working conditions, 91% of care homes have difficulty filling nurse vacancies.
Despite this crisis in care, in May 2020, the SNP and the Tories worked together to shut down collective bargaining for private care workers – siding with each other, and with private profiteering, over workers yet again.
The SSP supports Trade Union demands for a £15 per hour minimum wage for care workers, including paid travel time and paid overnight shifts, with guaranteed minimum and maximum workings hours. We must ensure full average wages for sick/self-isolating workers to protect carers and service users, and to prevent another care home COVID catastrophe.
Carers are highly skilled, essential workers who do invaluable work that must be valued properly. Carers need career-long training programmes and real opportunities for continuous professional progression to reduce high staff turnover in care.