On 28 September, the Edinburgh Integration Joint Board met to discuss plans to change Drumbrae Care Home to a hospital based complex clinical care unit (HBCCC) and to close the NHS-run community hospital at Ferryfield.
The Council trade unions organised demos throughout the day with the support of community activists and Labour councillors. Once again, Unite gave a deputation to the EIJB to speak out against cuts to publicly owned-residential care homes, the unaccountable nature of the EIJB and the lack of consultation with staff, residents and citizens. Watch Unite’s deputation in the Council’s webcast or read it below.
Another Edinburgh is Possible has details of EIJB outcome and the other deputations and demos from 28 September.
Political backlash
We are glad to see some political backlash to the EIJB’s plans to cut care homes. Labour MSP’s Sarah Boyack and Foysol Choudhury have been supportive of the campaign to Save Our Care Homes and we were pleased to see Councillor Melanie Main’s article standing against the closures and containing some salient words:
…as services are redesigned, more consideration is needed on the balance between the private and public sectors. Edinburgh has more private care than elsewhere in Scotland, with around 70 per cent in private hands.
And private companies, as we know, can walk away when things go wrong. Some run a good-quality service; others do not. Some staff are still paid piecemeal per visit, without travelling time. No way to treat some of the most valued staff in our city.
These points are key. The move from residential care homes to home care is a move to services provided predominantly by the private sector—a cut to public services. A recent freedom of information request found that home care in Edinburgh is provided as follows
- Local authority: 880 people / 7,225 hours per week
- Private, for-profit providers: 3,188 people / 54, 595 hours per week
- Third sector, not for-profit providers: 1,229 people / 48,463 hours per week.
Any increase in home care provision must ensure this is in the hands of the public sector to ensure high standards of care and continuity of care for service users and fair pay, fair conditions and a fair voice for all care staff, including the right to collective bargaining.
Another point to note is the quality of home care, with many Councils commissioning providers that offer 15 minute visits. We understand that people prefer to stay at home, rather than go into a care home. However, this needs to be understood in the context of the services that are on offer to support people to stay at home and difficulty around getting care packages.
Despite home care being the focus of the Bed Based Care strategy and the initial proposals containing a £3.79m budget for increased home care, the EIJB have provided no details on how this would be spent or plans for provision.
The public consultation will allow citizens, residents and staff to have their say. It is crucial that we use this opportunity to fight against cuts to public services and moves to privatise yet more of the services for our most vulnerable.
Deputation
Unite CEC Branch deputation to the Edinburgh Integration Joint Board 28 September 2021
Consultation
Unite CEC Branch are glad to see decisions on the proposals related to the four older care homes suspended pending a public consultation. The papers presented today show some positive steps in ensuring the citizens of Edinburgh have a say in the future provision of care in their city, however we note with concern the apparent reluctance around this and focus on the requirements to consult.
As we have raised before, consultation is the way to provide better services informed by the needs and opinions of those that use and deliver them, rather than a hurdle to overcome. As we progress with improving services for our citizens I would call upon the EIJB to take note of this and ensure consultation is open, earnest and meaningful, and understood as something that can shape proposals, rather than as an onerous checkbox task that does the minimum you can get away with.
Equality impact
While we can see there has been work to provide evidence to support the proposals in the Bed Based Care Strategy, we have to note concerns with the lack of evidence to support meaningful assessment of the impacts on those with protected characteristics and of socio-economic disadvantage and the impact on the environment, as can be seen in the integrated impact assessments in today’s papers.
In many cases the sources cited are simply links to guidance on that topic, with no specific data. More work needs to be done here.
For example, population projections are given only for the entire population. This could be enriched with projections for those with protected characteristics and those who are at a socioeconomic disadvantage. The Health and Social Care Partnership has data that would be valuable here—for example, the Joint Strategic Needs Assessment acknowledges the North East locality as that with greatest deprivation and the fastest growing population; factors to consider when half of the care homes originally mooted for closure are within this locality.
Furthermore, the absence of data on the climate impact—especially considering the request of one EIJB at the last meeting— and the misrepresentation that this would come from consultation, continues to be a cause for concern.
I’m reassured to hear that the impact assessments are still draft and would call on all members of the EIJB to look for suitable evidence in the impact assessments to ensure we protect the most vulnerable in our city and take due notice of our responsibilities to the planet, especially as we approach COP26.
Recruitment
My last comment is on the acknowledgement of recruitment issues in the care sector.
Unite CEC Branch firmly believes that services can be best delivered by public sector staff, who benefit from terms and conditions arrived at through collective bargaining. The noted crisis in recruitment by partner providers is a crisis of underpaying and undervaluing workers. Care staff take on immense responsibility in roles of huge social value, and this is all too often paid for with precarious hours, risks to health and wellbeing and a career with little opportunity for progression. We will not solve recruitment problems simply through marketing—if anything, the current crisis shows that the public are not so easily duped—but through improve the jobs on offer and valuing care staff as much as we value the care they provide.
Of course, we as a union, would like to see this translated into more public sector jobs, but short of that, we see here an opportunity to influence the sector with our support. It doesn’t stand that the Partnership simply helps providers recruit to poorly paid, undervalued jobs.
We call on the EIJB to note that work in this direction should ensure that the providers that receive the kind of assistance described in today’s papers are doing their bit to provide jobs where workers have a fair voice, fair pay and fair conditions.
Questions
There are some points in today’s proposals that we would like clarify on:
The recent motion to Full Council on Thursday changes the landscape in which we find ourselves. Unite are delighted to see the Council’s motion support the expansion of publicly owned and operated residential care provision and we will watch eagerly to ensure this translates into action and protects against cuts to the publicly-owned bed base.
My first question to the Board is what are your reflections upon the Council’s motion and how do you anticipate this will shape the Bed Based Care strategy?
Secondly, can you clarify the reasons for keeping to the original timescales for the Ferryfield lease, despite the option to extend for a year, and what consequences using the time of the extension would have?
And finally, can you please let us know when the Bed Based Care Strategy was first discussed by the EIJB? When would members of the strategic advisory group first have seen the plans?