If you need proof that the SNP’s modus operandi in government is to make it up on the hoof, consider the party’s plan for a National Care Service (NCS). Announced by former first minister Nicola Sturgeon, the NCS was to be a radical – even visionary – solution to growing pressure on both the National Health Service and the social care sector. By bringing sharp focus to the needs of a growing elderly population, the new care service would not only mean immediate improvements to the lives of those it was established to serve, it would also end the use of hospitals as unofficial care homes. The argument in favour of the creation of a dedicated care service are absolutely compelling. What a terrible shame, then, that the Scottish NCS is never going to become an actual thing.
The Scottish Trades Union Congress is the latest organisation to publicly withdraw its support for the proposed care network. In a letter to Scottish Health Secretary Neil Gray, the STUC has attacked the SNP government at Holyrood for its failure to address pressing problems in the sector. The letter reads:
Care workers are on their knees trying desperately to cover shifts and visits to those in need. There is a shortage of staff across Scotland, with local councils and employers all struggling to deliver the vital social care, yet the government is ploughing on with the National Care Service Bill which fails to address fundamental issues about how care is delivered and has lost the confidence of workers in the sector.
The chances of ministers talking the STUC round appear slender. The union body’s letter to Gray continues:
Profiteering, low pay and insecure conditions within social care are rampant throughout the sector. It would appear the Scottish Government, through the proposed NCS Bill, seems content for that to continue, something which we cannot allow in our name.
It is now apparent that Sturgeon’s vision went no further than a back-of-a-fag-packet outline of an idea.
Last month, the umbrella organisation for Scotland’s councils Cosla announced it would not support the SNP’s plan for an NCS. Like the STUC, Cosla expressed concerns about a failure to address problems in the here and now. This wasn’t always the view, however. When then-first minister Nicola Sturgeon announced her plan to establish a National Care Service in 2021, it looked like a rare case of an SNP leader thinking deeply about something other than the constitution. After all, in the aftermath of the pandemic, it was abundantly clear that Scotland’s NHS and its care sector were both in need of radical reform. Sturgeon’s decision to push ahead with the creation of a dedicated care network was the kind of bold action described in SNP speeches – but very rarely seen in reality.
But it is now apparent that Sturgeon’s vision went no further than a back-of-a-fag-packet outline of an idea. Over the past three years, almost £30 million has been spent on what the Scottish government describes as ‘work related to the NCS’, yet neither ministers nor civil servants are at all clear about how the service might work in practice. Indeed, neither are able even to describe exactly what the NCS might look like. All the while, bed-blocking in Scottish hospitals continues to rise, with there being an average of 2,000 ‘delayed bed days’ in NHS Scotland’s secondary care facilities as of August 2024. The lack of a feasible fix to the country’s crippled care sector only means that congestion in Scotland’s hospitals will continue to worsen, with less beds available for incoming patients as they remain occupied by those who require a sufficient community care package to leave. It’s a mess that no one snappy acronym can solve.
And yet despite the lack of a blueprint for the service and the fierce opposition of local authorities and trade unions, the SNP government maintains its determination to see through the creation of an NCS, no matter whether it is fit-for-purpose or not. Ministers have proposed a framework bill, which would allow MSPs to vote for the creation of this new care service without anyone having to worry about any of the more complicated details. Not that the Nats are especially adept at handling the fine print themselves: the SNP’s failure to provide funding and operational information on Sturgeon’s social care vision over the last three years makes one highly sceptical ministers might be trusted to fill in the gaps once, if ever, the NCS is established.
New First Minister John Swinney did not inherit much of a legacy when he succeeded Humza Yousaf earlier this year. But it appears that, for now at least, he prefers to go along with the idea that Scotland will indeed see this new – and widely criticised – kind of care sector introduced. He'd prefer keep up the pretence, it seems, than to admit that this is yet another SNP promise (see also the gender reform bill, the plan to give every child a state-appointed guardian, and the now-revoked ban on 'offensive behaviour at football matches') made without a single thought about the implications and, thus, doomed to be broken.
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