Elderly Care - Scottish Parliament speech 28th. October 2009

I welcome the minister's contribution on this important issue.
I also pay tribute to my colleague Irene Oldfather, who has, along with the cross-party group on older people, age and ageing, driven a lot of the work on the issue. Unfortunately, because of to her own caring responsibilities, she is unable to contribute today.
In debating services for older people, we must recognise that many older people are active and positive contributors, even though—inevitably—the discussion then begins to focus on care issues.
When Malcolm Chisholm and Rhona Brankin, as ministers, drove our older people's strategy, they were keen to ensure that there was an emphasis on the former aspect as well as on care
I hope that colleagues will forgive me if I concentrate on care issues in my speech.
Journalists do not often find themselves being praised in the Parliament, but I begin by offering a vote of thanks to the BBC and The Herald for what was investigative journalism at its best.
They made an important contribution to opening up a more rigorous debate on the nature of care of older people in our communities by confronting us all with the reality of neglect and abuse of vulnerable older people.
The "Panorama" exposé on home care and the more recent Herald investigation have had a powerful impact, but I regret that there has been insufficient evidence of urgency on the part of the Scottish Government in its response to their findings.
The investigations revealed the misery and inadequate support of real men and women.
Those findings are in tune with the reports of some of my constituents and, I am sure, of constituents of members throughout the chamber.
Few of us will be untouched by the realities and frustrations of securing proper care for older people.
Too many people—and their carers—describe their search for consistency and continuity of care as a battle or a struggle that is shaped by fear for the future rather than by confidence.
When we think of carers' battles for their loved ones, how much more fearful should we be for those without family or those for whom family members, as The Herald identified, are the problem because they are the perpetrators of abuse?
In the face of that situation, the Scottish Government's approach as indicated by the concordat—although certainly not by the broader contribution from the minister today, which was welcome—focuses simply on respite places and funding issues around free personal care.
That approach is inadequate and it misses the point.
We know all too well of cases in which people are offered inappropriate respite and that, as a consequence, much-needed support is not taken up.
It is also evident that we need to go beyond simple repetition of a commitment to free personal care, to addressing the quality of care and, indeed, what we mean by care.
The journalistic investigations have highlighted the gap between the reality in communities and the debate that the Parliament has been having over time.
We face a massive challenge: if the voices describing physical abuse, sexual abuse, financial abuse, neglect and exploitation of vulnerable people and those who are unable to defend themselves are to be heard properly and understood, we should not—indeed, we cannot—be defensive.
Our response must be brutally honest and urgent.
This is no time to explain away or defend the situation, or to marshal statistics to prove that everything is better than it has ever been—or, if it is not, to claim that the blame lies elsewhere.
I agree with the minister that the huge challenges that face us go beyond our usual politicking: this is the time for members of this Parliament to ask what we can do to address the challenges, and to examine what we need to change in order to respond to this scandal at the heart of our communities.
The challenge for ministers, the Scottish Government and the Parliament is to acknowledge that everything that they do must be tested against whether it makes people safer or makes things worse.
One example is the Scottish National Party's commitment to a centrally imposed council tax freeze.
Although the move has given some older people £1 or so a week extra in their pockets, it has also resulted in cuts to their day care services at a time when the Scottish budget has increased by £600 million.
If we are to interrogate the options seriously, we cannot simply leave to one side the reality of the impact of the imposed council tax freeze, with only assertion to defend it.
In response to the "Panorama" programme, the minister has said that she will issue guidance on home care that will be "very robust indeed".
I would welcome more information on whether that work has been done, on the dialogue that she has had with local authorities on the matter and on concerns that have been expressed about contracts.
As I say, the nature and scale of the challenge demand creative thinking and the acknowledgement that, as far as our society's priorities are concerned, we are in very-big-question territory.
Although much of the debate about older people has focused on pensions and funding, and despite our recognition that for many people the fourth age is a time for learning new skills and facing new challenges, the fact is that surveys of older people have repeatedly identified as key concerns loneliness, isolation and safety issues.
How should the Scottish Government be protecting those often very low-level but nonetheless lifeline services that are provided by lunch clubs, projects that take people to the library or to church and community transport schemes that allow people to visit hospital—in other words, the services that provide the kind of experiences that sustain people in their own homes, as opposed to care regimes that contain them there?
How is the Scottish Government going to support the community initiatives—such as the reminiscence groups run by the Village Storytelling Centre in my area—that seek to intervene early in respect of the impact of dementia, or the services that support elderly carers who wish to keep their loved ones with them as long as possible?
The fear is that, despite this debate and discussion, those very services, which provide people with real quality of life, are seen as luxuries when funding decisions are made.
We must be concerned by Audit Scotland's finding that local authority spending on care is being retrenched towards high-level needs, so I would welcome the minister's saying what discussions she has had with local authorities on that shift.
We have to fear for localised services when the efficiencies that the Scottish Government is demanding might be resulting in the stripping out of the key bits of care that make a difference.
We must acknowledge that if such services, which are driven by a compassionate understanding of need, are proving to be vulnerable, and if contracts are being squeezed to the extent that care providers are experiencing high staff turnover, the result can be the unbearable image from the "Panorama" programme—which is, I am sure, seared on all our minds—of an elderly man being washed while his carer was talking on her mobile phone.
Such an image will drive everyone in the chamber to tackle these issues.
I am interested to find out what the Scottish Government is doing to address staff turnover and the lack of regular contact with the same person, which are particular concerns in relation to quality of care.
I cannot be the only member with constituents who still, with all the stress that it involves, go home at lunchtime to check whether the support for their elderly parents has been delivered in the right way.
I am glad that the minister has acknowledged the critical role that the voluntary sector can play in understanding and meeting needs.
However, what is the sector's real role in the Government's work streams?
I understand that we cannot start with a blank sheet of paper, but liberating those who best understand need to tell us what has to be done has informed policy in the past and can do so again.
For example, we know that older volunteers have played a key role in supporting people and that an active interest in volunteering can keep people healthy and involved for longer.
It is therefore a matter of regret that the retired and senior volunteer programme had to close through lack of funding.
I am sure that the minister will recognise the anxiety of many that the shift in the balance of care will lead to increased pressure on carers, including voluntary carers.
I seek from the minister assurances on sustained funding, particularly for carer centres, which advocate for carers and offer a proper understanding of their experience as well as a support and help group for them through very challenging times.
Such centres provide proper and meaningful support so that carers can do what they want to do as well as possible. Although I understand that spending alone does not solve problems, stopping spending often creates problems or compounds them.
That is my concern about what is seen as the bonus issue.
There is an important debate to be had about the limit of technology as a means of supporting people in their homes. Although technology can buttress support in practical ways, it cannot be a substitute for it.
Technology cannot hold a person's hand when they are sad.
I am interested in what work the minister has done to shape the current approach of the Minister for Housing and Communities, at a time when sheltered housing is reducing—the number of wardens is reducing—and when organisations such as Inclusion Scotland are highlighting the need for local authorities to do more to provide housing to meet disabled people's needs.
Another issue is the effectiveness of the Scottish Commission for the Regulation of Care in monitoring and in dealing with those who abuse the trust that we place in them to care for people.
We must ask how a dementia strategy can be supported and funded so that we transform the nature of care and provide proper processes in relation to personalised care and who is in control.
The future care of older people is a care issue, but it is also a justice issue.
We must hear from the minister about the discussions that she has had with justice officials and the care commission about prosecuting those who are guilty of stealing time from care packages or of abusing older people who are in their care.
That is not just in the interests of the identified victims; it will also deter those who might be tempted to prey on the elderly, which we will revisit tomorrow.
It is a scandal that the only action by the police as a consequence of the "Panorama" programme was to arrest the journalist who exposed the neglect rather than the perpetrators of it.
We should all condemn the treatment of the undercover journalist Arifa Farooq.
We must know that the justice system recognises its role in protecting the elderly.
If ever there was a need for a national conversation and a big debate, it is for one on future services to support older people.
People need consistency, continuity and confidence
The work of The Herald and the BBC opened up a set of circumstances.
It is a test for the Parliament to rise to the challenge. I assure the minister that, on the big questions, she will have the Opposition with her in ensuring that we have a proper strategy to protect our older people.