Summary of SPF Social Care
Dear Fellow Member,
Please find enclosed a summary of the responses received by the Scottish Policy Forum on Social Care.
I am very grateful for all the detailed responses which members provided and the many interesting and innovative ideas which will help to shape the party’s future policies in the area of Health and Social Care.
I will also be pursuing several policy discussions on the back of the points raised and will take forward further discussions on various policy options with external groups and health organisations.
Thank you again for taking the time to contribute to the Policy Forum.
Dr Nanette Milne MSP
1.Closer integration of health and social care
There was, unsurprisingly, an overwhelming support for a closer integration of health and social care. Objections have been raised, however,on grounds of such an integration being in danger of state monopolisation. In other words, a closer working relationship between the two sectors was universally desirable, but some respondents recognised the potential difficulties with implementation.
2.Shape and form of suchintegration
The above-mentioned concerns translated to a wide variety of responses to this question, although not all respondents chose to tackle it.A few common themes emerged. Severalsubmissions pointed out the discrepancy between social care provision on local authority level and health care provision on a national level, but differed in their conclusions. Whilst some argued for full integration nationally, and the creation of a new national health and social care service, others stressed the need for local discretion. Several responses argued that removing bureaucratic barriers and improving communication should be satisfactory and a few stressed the importance of GPs and comprehensive assessment in the whole process.
3. Self-directed support
Only a very small minority of respondents disagreed with the concept of self-directed support. Most people pointed out the need for a degree of flexibility in the system as well as for crucial checks and balances. It was argued that there should be a level of scrutiny preventing the abuse of direct payments (using the funds inappropriately) as well as protection for the most vulnerable.
4.Direct payments as the default option
It was consistently pointed out that the very idea of a ‘default option’ goes against the basic principle underpinning self-directed support – the freedom of choice. Consequently, only a very small number of respondents argued for direct payments to be specified as the default option in legislation.
5.Supporting unpaid carers
The contribution carers make to society has been universally acknowledged. Most submissions also stressed the importance of emotional as opposed to monetary support for carers. Many respondents focused on the identification of carers across different levels (GPs, local authorities, schools). The educational system was mentioned not only as crucial in identifying young carers, but also in relation to it needing to adopt a more flexible approach when it comes to dealing with young carers. A few submissions pointed out the potential for technology, especially new media, to provide information and support to carers.
6.Shifting focus from additional respite care
A vast majority of responses stressed the need for respite care and agreed for this to remain our focus. It has also, however, been argued that it is just as important to help by working ‘alongside’ as opposed to ‘instead of’ carers.
7. Carers’ Champions across local authorities
The responses to this question were rather interesting in their diversity. A narrow majority of submissions was in favour of such a policy and argued that a Carers’ Champion could be proactive and provide leadership, direction and consistency in policy-making as well as implementation. On the other hand, a significant number of respondents expressed reservations about, what one called, a new ‘layer of public bureaucracy’ and argued that individual advocacy might be more important. A mistrust of local government is also apparent in some submissions, which argue that carer support would be better directed centrally.
8.Free personal and nursing care andmeans testing
This question was one of the most controversial ones in the paper and this was evident in the opinions expressed. Several submissions made a clear distinction between personal and nursing care. While most respondents did not support means testing for nursing care, some were open to the idea (to a certain degree) in relation to personal care. Overall, however, means testing was seen as politically unpopular and also punitive to savers. A few respondents pointed out proposals from the Conservative 2010 General Election manifesto (a one-off insurance premium) for consideration.
9.National Concessionary Travel
Only a small minority defended the scheme in its current form, but an even smaller number of people argued for a complete scrapping of it. The vast majority of people saw the importance of some sort of travel support for the elderly quoting ‘remaining active’ and ‘staying in touch with friends’ most of all. Virtually all of the respondents, however, did not find it appropriate that free bus travel was used for commuting to work and, consequently, a majority supported a link with the State Pension Age. Quite a few respondents were in favour of minimal token charges, with 10p and 20p being the most common suggestions. Others argued for the introduction of distance limits or a form of zoning within cities.
10.Independent and council-run care home costs
One of the emerging themes across the answers to the question was the need to assess the quality of council-run and independent care homes. Many argued that if there is not a discrepancy in quality, whilst retaining the same level of care, steps should be taken to bring down the costs of council-run care homes. Respondents argued for a greater involvement of the private and voluntary sector and the need to outsource more services - even within council-run care homes. On the other hand, a few argued for a simple increase in the level of funding for independent care home places, albeit recognising the financial pressures of today.
11.Mental health policies
The response rate to this question was significantly lower compared to the above, which is understandable. The submissions generally supported our focus on staff training as well as over-medication and emphasised the need for alternative and more holistic approaches.
12.Any other policies
Whilst a few interesting ideas were floated, the only common theme across the submissions was the need to go beyond simple accounting. In other words, Social Care is not only about cost effective policies, but also about immaterial values like respect and dignity – this has to be considered throughout policy making. Several respondents highlighted the importance of families and the link to the ‘bigger societal picture’. The specific ideas that we received ranged from increasing our focus on telecare (and innovative thinking overall) through the design of care homes to more funding for home improvement/modification for those in need of care.
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