Inclusion Scotland is a ‘Disabled People’s Organisation’ (DPO) – led by disabled people ourselves. Inclusion Scotland works to achieve positive changes to policy and practice, so that we disabled people are fully included throughout all Scottish society as equal citizens.
1. Introduction
Inclusion Scotland welcomes the recommendations of the Independent Review. We encourage MSP’s and political parties in Scotland to give their support to all 53 recommendations and in particular the creation of a new National Care Service (NCS) for Scotland. This is something disabled people have been demanding for a long time and Inclusion Scotland are calling for in our Manifesto for the 2021 – 2026 Scottish Parliament. [1]
We particularly welcome: the centrality of human rights, specifically incorporation of human rights conventions (Recommendations 1, 4), the structural changes that will result in shift of ultimate accountability away from local authorities to the SG and the creation of a new Minister for social care (Recommendation 15), a “relentless focus” on involving people who use services at every level (Recommendation 30), including on the Board of a NCS and voting rights on IJBs, abolition of care charges, the re-opening of the Independent Living Fund (Recommendation 51), strengthening Self Directed Support (Recommendation 27), inclusion of Personal Assistants in relation to improving workforce conditions (Recommendation 48), investment in Independent Advocacy and Brokerage services (Recommendation 8) and the “duty” to co-produce this system with the people it is designed to support (page 5).
2. The true test is what happens next. We cannot be let down again.
We wish to highlight, however, that we have been here many times before. There have been numerous positive reports over the years on social care support that have been warmly welcomed by disabled people’s organisations, going back at least to 2009, all saying much the same thing, including Independent Living – A Shared Vision (2009)[2], Vision for Independent Living (2013)[3],Our Shared Ambition for Social Care (2016)[4], National Health and Wellbeing outcomes framework[5] (2015), Review of targets and indicators for health and social care in Scotland (2017)[6], 2020 Vision for Health and Social care, and recently officials initiated discussion on another one for 2030. Similarly, the production of outcomes, indicators and standards has proliferated. There has been little if any cross-referral between them or vision statements. As recently as the 2018/19 Programme for Government in 2018/19[7] explored a top-up system but came to nothing. Why should disabled people and their organisations have any confidence that this time it will be different?
The People-led Policy Panel[8], made up of people with lived experience of needing Social Care Support, worked with the Scottish Government and other stakeholders on the reform of adult Social Care Support. At the point the Independent Review was announced, the PLPP had been working for well over a year on named work streams that came from the Programme Framework launched by Jeane Freeman, Cabinet Secretary for Health and Social Care, along with (another) Shared Vision,[9] in June 2019. The methods of developing this were highly innovative and proving to be highly successful, with the new PLPP model of co-production. This was in line with the commitment in ‘A Fairer Scotland for Disabled People.’[10] The report of the Independent Review of Adult Social Care must now accelerate positive progress on the good work already done, not represent another interruption to it. No one will tolerate are more good initiatives that fail to deliver. As we all know an excellent report is never enough. The true test is what happens next; how these positive recommendations will be implemented and financed. Scottish Government must not let us down again.
3. Ultimate accountability for social care support must move away from local authorities to the Scottish Government.
The evidence of local authorities’ long-term failures to deliver social care support that respects disabled people’s human rights is overwhelming. Since COVID-19 struck, it has been catastrophic for many people who rely on social care support even just to survive. Our surveys[11] , the surveys of other DPO’s[12] and the Scottish Human Rights Commission[13] revealed the shocking reality that disabled people had care packages stopped sometimes overnight. This left some people without support to get out of bed or get essential food and medication and violated many basic human rights.
To equate a NCS with top-down imposition, as COSLA is wont to do, is false. Moreover, to suggest, as COSLA appears to do, that an appropriate route to deliver a human rights based approach would be through local government is completely undermined by their long-term failure to deliver any such thing. A person’s rights should not be contingent on another person’s willingness and capacity to intervene effectively. Human rights should never be contingent on local priorities. If they are, then they are not rights of any kind.
There is also overwhelming evidence of the absence of any meaningful way to hold local authorities to account or seek redress, whether it concerns questions about the overall system, such as how they spent millions of pounds allocated by Scottish Government for social care, or for the cuts to the care packages of individuals. Local democratic accountability is a myth. It does not exist. And if it does, COSLA is invited to demonstrate how this works in practice and provide concrete examples. Local authorities have had years to demonstrate they can deliver on social care support. They have unequivocally failed. We support the recommended shift in accountability to the Scottish Government and the creation of a new Minister. However, we argue that this structural change needs to be coupled with the direct incorporation of the UNCRPD and linking with the recommendations of the Taskforce for Human Rights Leadership (as recommended on page 23).
- We urge MSP’s to show their support for disabled people by also signing our joint statement calling for direct incorporation of the UNCRPD into Scots Law [14] and our Manifesto Pledge[15].
- We strongly urge all parties to actively demonstrate, in their Manifestos and future programmes for government, a clear commitment not just for the establishment of a National Care Service but for the implementation of all recommendations made by the Independent Review.
- We require clarity about implementation and next steps. This importantly includes how the Review sits within the wider Reform Programme, and the Scottish Parliament’s own Inquiry into Adult Social Care[16].
- We also would like to know more about practical mechanisms for ensuring deaf and disabled people and our unpaid carers will genuinely be equal partners in designing and delivering this new system, including a central role for the successful co-production model of the People-led Policy Panel[17] and strong roles for Disabled Peoples’ Organisations.
Given the impacts of the pandemic on an already broken social care system and the resulting devastating human impacts disproportionately faced by disabled people, the time for change is now. Just as the NHS was set up after the devastation of World War Two, we too see the establishment of a National Care Service as our post COVID-19 legacy. The creation of a National Care Service for Scotland can play a crucial role, not just in recovering socially and economically, but in how we recover our humanity after the COVID-19 crisis.
For more information contact:
Dr Kirsten Maclean, People-led Policy Officer
Inclusion Scotland E-mail:kirsten@inclusionscotland.org Tel: 07769 223152
Visit our website: www.inclusionscotland.org
Download this briefing in MS Word format: Inclusion Scotland MSP Briefing – Independent Review of Adult Social Care MS Word
Download this briefing in PDF format: Inclusion Scotland MSP Briefing – Independent Review of Adult Social Care PDF
References listed below:
[1] Inclusion Scotland (2021) Manifesto https://inclusionscotland.org/manifesto2021/
[2] Scottish Government, COSLA and ILiS (2009) Independent Living – A Shared Vision https://www2.gov.scot/resource/doc/935/0093260.pdf
[3] Scottish Government (2013) Our Shared Vision for Independent Living in Scotland https://www.webarchive.org.uk/wayback/archive/20170112131056/http://www.gov.scot/Publications/2013/04/8699
[4] Inclusion Scotland (2016) Our Shared Ambition for Social Care https://inclusionscotland.org/wp-content/uploads/2018/05/Shared-Ambition-for-social-care-final.pdf
[5] Scottish Government (2015) National Health and Wellbeing Outcomes Framework https://www.gov.scot/publications/national-health-wellbeing-outcomes-framework/
[6] Scottish Government (2017) Review of targets and indicators for health and social care in Scotland https://www.gov.scot/publications/review-targets-indicators-health-social-care-scotland/
[7] Scottish Government (2018) Delivering for Today, Investing for Tomorrow: the Government’s Programme for Scotland 2018/19 https://www.gov.scot/publications/delivering-today-investing-tomorrow-governments-programme-scotland-2018-19/pages/7/
[8] For further information on the PLPP see: https://inclusionscotland.org/what-we-do/policy/people-led-policy/
[9] Scottish Government (2019) Social Care Support Reform: Partnership Programme Framework https://www.gov.scot/publications/social-care-support-investment-scotlands-people-society-economy-programme-framework-partnership-programme-support-local-reform-adult-social-care/
Scottish Government (2019) Social Care Support Reform: Vision https://www.gov.scot/publications/social-care-support-investment-scotlands-people-society-economy-shared-vision-adult-social-care-support-including-support-carers-partnership-programme-support-local-reform-adult-social-care/
[10] Scottish Government (2016) A Fairer Scotland for Disabled People: Delivery Plan https://www.gov.scot/publications/fairer-scotland-disabled-people-delivery-plan-2021-united-nations-convention/
[11] Inclusion Scotland (2020) COVID-19 Experience Survey: https://inclusionscotland.org/covid-19-evidence-survey/
[12] Glasgow Disability Alliance (2020) Supercharged – A Human Catastrophe: https://gda.scot/what-we-do-at-gda/resources/publications/supercharged-a-human-catastrophe-inequalities-participation-and-human-rights-before-during-and-beyond-covid19
[13] Scottish Human Rights Commission (2020) Covid 19, Social Care and Human Rights: Impact Monitoring Report https://www.scottishhumanrights.com/media/2102/covid-19-social-care-monitoring-report-vfinal.pdf
[14] Sign the Joint Statement here: https://inclusionscotland.org/join-us-in-calling-for-stronger-human-rights-law-for-disabled-people/
[15] Sign Inclusion Scotland’s Manifesto Pledge here: https://inclusionscotland.typeform.com/to/WE9aqh4P
[16] Scottish Government Reform of Adult Social Care: https://www.gov.scot/policies/social-care/reforming-adult-social-care/
[17] For more about the People-le Policy Panel please see: https://inclusionscotland.org/what-we-do/policy/people-led-policy/
