Warning of the Collapse of Care Charities: When your rights are broken, Who Actually cares?
Over the weekend, the Herald ran a story warning of an impending collapse of the care sector in Scotland. More than 200 charities that provide care voiced concerns that they are near collapse unless the Local Authorities who pay them to provide care increase said payments.
There are multiple overlapping failures compounding the issue. Demographics shifts are leading to an older population with more complex needs - increasing the cost of providing care - while Local Authority funding is being ever more tightly constrained.
Not mentioned in the article is also the significant inefficiency of providing care via outsourcing to charities and private companies. While certainly not the case universally, we have identified instances where even “not-for-profit” care providers extract significant amounts of money away from care provision via mechanisms such as extremely high salaries for executive staff or by extracting money from the “not-for-profit” sector into “for profit” companies by routes such by forcing charities to lease privately owned care homes from for-profit companies, some of which are based in tax havens.
The Scottish Government has championed a “rights-based approach” to many aspects of their policies, including care provision. The idea is that you have a right to be cared for and that someone should be responsible if that right is breached. The fundamental weakness of outsourcing “rights-based” functions to a charity is that the charity does not legally need to provide care or to exist at all.
But, in practice, the fragmented nature of care provision in Scotland means that this approach inevitably leads to a situation like the one being reported on this week. Local Authorities outsource their care to charities and can blame those charities if the care falls below the standard mandated by your right. The charity can turn around and blame the Local Authority for not adequately funding care. The Local Authority can blame the Scottish Government for constraining their finances, denying them tax-raising powers and ring-fencing funding towards other “essential” functions and the Scottish Government can blame the Local Authority for failing to fulfil its duties in a “local issue”.
All the while, your right to be cared for is still being breached.
The National Care Service was supposed to fix this. In our blueprint for an NCS - Caring For All - we advocated for care to be brought back into public ownership so that all of the problems above would be rectified. Executives would not be paid exorbitant salaries without being democratically accountable for them. Assets like care homes would be publicly owned rather than owned by foreign tax-haven companies. Local Authorities would deliver care as a statutory duty. And the Scottish Government and the relevant Ministers would be directly accountable to Parliament when your rights to be cared for are broken.
Unfortunately, the Scottish Government seemed to think that the purpose of the NCS was to continue the outsourcing and privatisation of care and to simply rebadge it under a new brand. It’s no wonder that the legislation failed.
We can only hope that this intervention by these care charities forces a rethink by the Scottish Government. It should be a priority for the Parliament after next year’s election to redevelop the legislation for a National Care Service and, this time, to ensure that we get one that provides care for all that is publicly owned, locally delivered, not-for-profit and free at the point of need.
