The National Care Service - a tool for justice?

Cyrenians Chief Executive Ewan Aitken looks at the National Care Service bill currently in progress from the Scottish Government and asks - what can we do to make this a tool for social justice and equity?

The 20th February is the UN International Day of Social Justice, and in 2023, the theme is ‘overcoming barriers’. At the same time, the Scottish Government is in the midst of developing a bill that could do a lot to help address barriers for the most marginalised in our society – or could widen the gulf. 

That bill is the National Care Service bill, which aims to redesign how social services are delivered across Scotland.

And especially now, with the news of our First Minister's resignation still fresh, it’s past time for the government to step back and take on board all that is being said by those on the frontlines. 

We welcome change to the social sector - there are definite improvements that can be made in Scotland, and at the moment social care isn’t working as well as it could and should be. In our work at Cyrenians, we so often see people who’ve been failed again and again by the systems that should support them.

And this is an issue not just of basic humanity, but also of justice in our society – some people are facing barriers because of circumstances outside their control, where others just aren’t. Failures in the social support system will always hit some people harder than others - for example, people who are disabled, care-experienced, struggling with their mental health, or facing other systemic disadvantages. When someone's repeatedly failed by systems that are meant to address these disadvantages, the inequalities in our society continue to grow wider and wider.

So if we believe in building a fair, equal Scotland, then yes, social care is overdue for reform. 

The Feeley report, which was the catalyst for the proposed National Care Service reform, put the most exciting opportunity in our hands – a complete overhaul!  

But the National Care Service as it looks just now seems to miss this opportunity, and, importantly, really doesn’t feel like it embraces the importance of a home within any of the planning. It feels like the writers forgot that age old saying ‘Home is Where the Heart Is’, and went straight to the spreadsheets. 

What's wrong with the National Care Service bill?

The proposed Bill raises the question of how we ensure statutory duties work with the new design; it currently appears to be an idea without considering implementation and application. It does so, whilst unpicking the principles of Christie. It risks undoing and significantly slow down the implementation of some of the Promise, whilst frustrating local partnerships and connections between wider local services needed by children and families such as homelessness and education – and right now, these barriers seem ever increasing. 

And probably one of our biggest concerns - the bill in its current form doesn’t even mention homelessness. Nor does it approach housing and community inclusion as the key building blocks we know them to be. 

As someone who’s been involved in homelessness and poverty work for decades now, I have seen first-hand how easy it is for people going through difficult times, especially those with a history or present of homelessness, to slip through the cracks. And these are the folks who are most in need of support, and who are most likely to have been let down by the support systems we currently have in place. 

It is absolutely vital that we see the social care system in this country change for the better. I have been really excited to see so much chat in government about centring lived experience and building a social care system which genuinely works for those it serves. But if that ends up being just hollow words without any real meat behind it, a system change could do more harm than good for those facing the most barriers to support. 

What do we want to see happen?

When considering what positive change might look like, we don’t need to start from scratch. We can look at the good stuff that is happening – the drive for change, the desire to connect up services and deliver them in a way that centres the people they’re built to serve - and look at how we can make that good stuff great. But it is the case that there are improvements to be made; nationally, locally and on a community and organisation level. 

Together, let’s ask the real questions. How we communicate better across sectors? Do we have the right systems and answers to do this? How do we ensure that the decisions on social support are being made by those most affected? And how do we make sure we have the right support, the right organisations, the rights systems in place, to not to just do this but to do it brilliantly - to embrace human rights, break down barriers, and make sure we’re accountable at all levels to those we support? 

We may not have all the answers, but after decades of research and frontline support, I think we have a pretty solid idea of the direction we need to be headed as a country. What we need from a National Care Service that genuinely focuses on social justice, accountability, and offering lasting support, is: 

• A system that recognises the importance of a safe, suitable and stable home for everyone’s wellbeing. 
• Space for organisations both big and small to offer support in the most tailored and effective way possible to people across all of our society. 
• Records that help us monitor our work and, importantly, to reflect, learn, and grow as a sector. 
• Recognition of the skills and expertise required to undertake the work that takes places 365 days a year. 
• Better communication between services and organisations, break down siloes and make sure there’s ‘no wrong door’ to support. 
• Systems that put people in control of their own care and remove the need for someone to tell and re-tell their story over and over to access support. 
• A service that places human rights and social justice at its core. 

At Cyrenians, we’ve been banging the drum for many years now that homelessness isn’t a unique issue that stands alone. A home is the foundation for social change, and social support must be built in at all points in people’s journey from homelessness.  

For a fair, just and rights-led Scotland, we need to do better than either the current system and better than the half-cocked state of the current National Care Service proposals.

That’s why Cyrenians will continue to push for the radical change in the sector that the most marginalised in Scotland need and deserve.