Mark McDonald, MSP for Aberdeen Donside, addresses the Scottish Parliament on 09 December. Watch the video below and click "read more" to view the text of the speech.
- From the outset I have been very supportive of the integration agenda. Having served on the social care, wellbeing and safety committee of Aberdeen City Council prior to becoming a member of the Parliament, I saw for myself some of the challenges that were faced in the delivery of social care.
While I was a member of Aberdeen City Council, we managed to get the delayed discharge figure down to zero. Unfortunately, since we left the administration, that figure has slowly crept back up to a higher level. One of the reasons why that has occurred is the difficulty of ensuring that appropriate care packages are put in place for individuals coming out of an acute setting. I have seen that in a number of constituency cases, with individuals often being taken from an acute setting and placed into a care home setting, rather than being allowed to return home, as the care package that would allow them to return home cannot be put in place. That has persisted even with the decision by Aberdeen City Council—a decision that I did not agree with—to outsource its social care to an arm’s-length organisation, Bon Accord Care, rather than having it delivered on an in-house basis.
The reason why I supported health and social care integration was to do with tackling and removing the silo mentality from health and from social care, as well as the gaps that can arise and into which individuals find themselves falling. I felt that we should pursue the opportunity to create a more joined-up approach. I still think that integration will benefit all our constituents when the work of the integration joint boards takes effect.
There are other areas that we need to consider tackling, beyond the silos that exist in health and in social care. I refer to the silos in areas such as primary and acute services, within the health service. Those still need to be addressed. Those services need to be brought much closer together in terms of the way in which they work. That would help with some of the issues that were raised earlier about individuals finding themselves in an acute setting, which is obviously more expensive compared with being dealt with through the primary care sector.
We must ensure that, even within the primary sector, all the different professions work together in a much more rounded and holistic manner. As we will be discussing in the debate on primary care redesign that has been scheduled for next week, we must ensure that, when an individual presents in a primary care setting, they do so to the most appropriate profession at that time. That would relieve workload pressures and would create a system that allows people to be seen and dealt with in the most appropriate setting.
I have a huge amount of respect for, and place great value in, the work that is done by carers, not least as my mother worked as a carer. She was employed as a carer and, latterly, she was also an unpaid carer. I entirely recognise and understand--
- Jenny Marra: Will the member take an intervention?
- Mark McDonald: I want to develop this point first. I entirely recognise the strain that is often placed on individuals in that environment.
With regard to the call for care workers to be paid the living wage, the cabinet secretary pointed out that those who are paid through the public sector already receive the living wage. However, beyond that, the ability to effect a living wage for those who are employed outwith the public sector environment would have been immeasurably increased had the opportunity been given through the Scotland Bill—as the Scottish Trades Union Congress called for—for powers over employment legislation and employment rights to come to this Parliament.
The other thing that would help—and something that we should perhaps be encouraging the integration joint boards to look at more closely—is a move away from unit cost purchasing when it comes to social care services. Instead, they should look more widely at an outcomes-based approach rather than at a simple unit cost-based approach. That might allow for greater flexibility around the pay and conditions that are afforded to care workers.
I realise that I said to Jenny Marra that I would take an intervention from her. She is indicating that she no longer wishes to come in.
It is clear that the care sector is facing difficulties in certain areas. In my area of Aberdeen, there is a real difficulty around recruitment and retention. That difficulty was highlighted to me when I held a care sector jobs fair in my constituency that was aimed at promoting opportunities within the care sector.
I know from feedback that I have had from organisations that individuals were able to secure positions as a result of that jobs fair. However, compared with a previous jobs fair that I hosted, which was much more wide ranging, there was a noticeable drop in footfall because individuals do not necessarily see the care sector as an area that they wish to work in. Part of that will undoubtedly be because of the pay element, but part of it is also down to a perception of what the role entails.
To help tackle some of those issues, we need to ensure that we present a much more positive image of the work that is done in the care sector and have more people speaking up for the valuable role that is performed by those who work in the care sector. That would be helpful in attracting more people into that role.
One thing that seems quite clear this afternoon is that a conflicting message is coming from opposition parties on where the health consequentials should be allocated. I have no understanding or knowledge of where the health consequentials will go—that is above my pay grade. What I do know is that the cabinet secretary and the Deputy First Minister will be entirely focused on making sure that the health consequentials are spent in a way that benefits the people of Scotland. For me, that is the most important element in all this.
- - See more at: http://www.scottish.parliament.uk/parliamentarybusiness/report.aspx?r=10261#sthash.SKQlrN9N.dpuf