Politicians must act to recognise the vital work of Scotland's carers

In Scotland, we want to build a country now, and then with the full powers of independence, that is a living embodiment of our values. Our vision should be bigger than just trying to do “a little better” than the UK Government. It should be a complete transformation, based on first principles. That’s the origin of the National Care Service.

Transformation always carries an element of risk, but Scotland has never shied away from transformation in the past. Take the integration of health and social care as an example, or the introduction and then expansion of free personal care. Under different political parties, Scotland has risen to the privilege of caring well. But that determination is required anew.

Increasing carers’ wages to £15 per hour would have cost well over £1 billion. It would have been worth every penny, but within a fixed budget, even with tax rises, it would only have been affordable if it went hand-in-hand with fundamental public service reform, particularly in the National Health Service.

To make it happen, we needed to work much harder to shift funding from the deep recesses of the NHS to the frontline, where doctors, nurses and carers are providing excellent care that is free at the point of need. Difficult though that would be, plagued no doubt with political point-scoring, we need to grasp the nettle. Failure to do so risks undermining our values and our vision for Scotland.

We believe, surely, that human worth is not found in social status, wealth or ability. Instead, we must uphold the inherent dignity of every human being. That means we build our society on the foundational principle that every human being – including those who are bed-bound, terminally ill or disabled – has precious worth that isn’t earned, it is intrinsic. That is surely the moral framework by which governments and decision-makers should be held accountable by the people.

The care sector safeguards and exemplifies this principle. We entrust our loved ones, our fellow citizens and, one day, ourselves (at the point of greatest vulnerability) to adult social care workers. That trust is laden with worry, hope and striving for the best care possible. The most dignifying care.

As a local MSP, I find myself helping families navigate the care system on behalf of loved ones. I hear them vocalise their worst fears, and then breathe a huge sigh of relief when a care package is assembled. Talking of a “care package” depersonalises it – what we really mean is a team of adult social care workers devoting their time, energy and care to another human being.

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To bring those values to life, let me introduce you to a lady in the Highlands who turns 92 today. As the matriarch of her family and the local town, she once led a physically active life as a nurse. Now, her days of working full-time, raising a family and travelling across Scotland are memories. She watches the world pass her window, bed-bound.

All the tasks she once did unthinkingly for herself are now done by care workers. Her life depends on their careful, gracious, sensitive care. They feed her, slowly, so she doesn’t choke. They offer her sips of tea, ensuring it isn’t too hot. They bathe and dress her, ensuring she has suitable clothing. These care workers are remarkable, and I hope they know how much this lady’s family values them. Because, in a word, they dignify her.

Yet, the Feeley Review into the care sector in Scotland drew the conclusion that social care workers feel undervalued and under-recognised. Despite being engaged in one of the most important occupations in Scotland, they earn less than somebody stacking shelves or arranging clothes in retail.

That’s not to denigrate the important job of retail assistants – but it provides a relevant contrast. Feeley also identified that one of the results is that recruitment is challenging and standards of care vary across the country.

Carers’ pay hasn’t kept pace with other sectors. A report by STUC published in April 2023 shows that in the past decade, pay for care workers has fallen relative to other low-paid sectors. In 2012, adult social care workers earned 16 pence more an hour than sales and retail assistants. In 2021, they earned 21 pence less.

Why is that? One suggestion is that the care sector is female-dominated, and we know that there have been disgraceful examples of unequal pay in the public sector. Eighty-three per cent of workers in the care home sector are female. I wonder whether the sector would battle low pay to the same extent if 83% of the workers were male?

Pay might be the root cause of carers feeling undervalued, but it isn’t the only issue. The care sector is characterised by job precarity and insecurity. A remarkable 11% of care workers in Scotland are on zero-hours contracts. There is also a serious issue with high levels of stress – 13% of staff work more than 50 hours a week, with many doing multiple jobs.

Analysis of the responses to the consultation on the proposed National Care Service showed that more than three quarters identified improved pay and better terms and conditions as absolutely critical. That includes improved sick pay, annual leave, parental pay, pensions and investment in learning and development.

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At the recent Scottish Parliament elections, Unite called for a minimum expectation of terms and conditions for all social care workers including two 30-minute paid rest breaks, enhanced sick pay and pensions. Those calls remind us that it is remarkable such terms and conditions are not universal.

Of course, beyond the importance of enshrining the principle of human dignity, we also really need an excellent care sector. It is well documented that our population is ageing – meaning more and more of our citizens will need care as they enter their latter years. So high levels of turnover in the sector – at roughly 25% per annum – is a cause for concern. As is the fact that the number of care homes registered with the care inspectorate has fallen by 17.5% since 2012.

The National Care Service offers an opportunity to value and recognise the workers in Scotland who do so much to dignify our citizens. It’s about much more than a policy or manifesto promise. It’s about ensuring our society is built on the principle that every human being is worthy of excellent care because of their inherent value.

That principle is sound, but the path to get there requires us to face up to the reforms that are required. Some of those will be difficult – but surely our fellow citizens deserve politicians who will grasp the nettle and an electorate that understand this is worth fighting for.

In politics, chat is cheap and rhetoric is easy. But we’ve got an opportunity here to put human dignity at the heart of transformation.

It might be hard, but there’s a lot more at stake if we don’t.