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‘Future Visions for Social Care:’ What is next for Social Care Reform in Scotland?

GDA's Dr Richard Brunner, Maree Todd, Minister for Social Care, Mental Wellbeing and Sport, and Tressa Burke, GDA CEO, sit at a table speaking into microphones.
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“When Social Care works, it adds depth, richness and opportunities for disabled people. It provides freedom & choices to take up opportunities like learning, volunteering or even looking for work. But at the centre of all of this, it enables people to participate in and lead their own lives” 
Tressa Burke, GDA CEO

 Photograph of GDA’s Purple Poncho Players. There are 15 of them in a line on a low stage. They are singing. In the foreground of the photograph you can see the backs of the audience who are watching them. The audience members are seated at tables.

On Friday 14th March, 180 disabled members of Glasgow Disability Alliance and external partners met online and in person for our ‘Future Visions for Social Care’ event. The session centred on social care reform in light of the Scottish Government’s new Care Reform (Scotland) Bill, previously the National Care Service (Scotland) Bill (NCS).

Our event began with a performance from the Purple Poncho Players (PPPs), a group of GDA members who have collaborated with professional writers, actors and musicians to produce a portfolio of songs, sketches and poetry to share their real life experiences of the barriers and oppressions facing disabled people in Scotland including social care – and solutions needed!

The show kicked off with the PPPs sharing disabled people’s reflections that the energy, time and commitment contributed in good faith by disabled people, carers and others over the last 4 years, has been ruined by a tug of war over power and resources between COSLA, trade unions, political parties and Scottish Government. A powerful performance of the poem, ‘A Time to be Bold’, asked those in power to:

“show honest reflection now, on what has gone so badly wrong, and a reenergised commitment to building trust and moving on.”

Photograph of GDA’s CEO Tressa Burke. Tressa is standing on a low stage behind a lectern giving a speech. She has blonde hair and is wearing a dark top and skirt. Behind her is a large screen on which her image is showing next to the title of her speech ‘Reflections on Social Care’.

GDA CEO, Tressa Burke, followed, emphasising the disappointment felt by the scrapping of Part 1 of the Bill which had assured disabled people there would be a shared ambition for reform of social care and key principles, alongside legislating for national control, accountability and consistency. These are crucial measures essential for system change and supported by Feeley’s 2021 Independent Review of Adult Social Care. Tressa asked:

“What other options are open to us? Because disabled people very much still need, and are calling for, radical changes and improvements and feel that the de-railing of the NCS was a demonstration that many of the agencies involved had lost sight of the very people that social care support is supposed to be for.”

Tressa laid out the clear case, built by GDA members, for disabled people to be at the heart of social care reform. This includes disabled people and their mandated organisations, Disabled People-led Organisations (DPOs) participating in local and national decision-making.Cartoon drawing of a man standing on a platform along the edge of which are the words social care in large capital letters. The man is wearing a top that has the word me written on it followed by an exclamation mark. Next to the man is a service dog wearing a high visibility vest and harness. There are scaffold poles around the platform the man is standing on which have social care written on them. At the top of the cartoon it says social care should be a scaffold and there man is saying that’s built for people. At the man’s feet is the image of a love heart which has the word you written on it followed by an exclamation mark. There is a speech bubble coming from the heart which says and it should be worthy of the people it supports.

In particular, GDA members argued that DPOs must be represented on the proposed National Advisory Board and reformed Integrated Joint Boards with the necessary resourcing and support. Tressa highlighted the vital role of DPO’s in the Scottish Government’s co-design process, emphasising that we should use this time to learn from past mistakes, re-centre the voices of those needing and using social care, and swiftly set about rebuilding a shared understanding of social care as an investment in a support system that is based on human rights. Tressa asserted:

“The National Advisory Board might offer an opportunity to come up with recommendations and actions to rebuild social care as a safety net that supports people when we need it – like scaffolding, it should be built and rebuilt around the needs of every person.”

Maree Todd, Minister for Social Care, Mental Wellbeing and Sport, then delivered the keynote speech, acknowledging the importance of social participation:

Photograph of Maree Todd the Scottish Government Minister for Social Care, Mental Wellbeing and Sport. She is standing on a low stage behind a lectern from which she is giving a speech. She is wearing a green and black tartan jacket and a black skirt. She has greyish brown hair and wearing glasses. Her image is being shown on a big screen behind her. To her left, GDA CEO Tressa Burke is sitting at a table with a white tablecloth listening to Maree Todd.

“I’m a firm believer in holistic approaches to care and social prescribing plays a crucial role in that, especially for [disabled people] who may experience isolation or even exclusion. So connecting to community activities and support networks can have a profound impact on our mental and emotional well-being allowing people to live fuller healthier lives.”

In addition, the Minister reported on the progress made towards establishing the Advisory Board, stating it plans to meet in spring. She emphasised the importance of individuals and organisations from across the sector being represented on it and offered reassuring commitments that those who have first-hand experience of accessing social care will be involved.

The Minister told us:

“The Advisory Board will play an absolutely critical role in the efforts to drive improvements and it will make sure that services are consistent and fair and of high quality across Scotland.”

“I know, that there’s more work to be done to ensure that we collectively meet our aim of a fairer Scotland for disabled people and realise our ambitions. But, I also know our challenges are significant. I firmly believe that collaborating through events like today by leveraging our diverse expertise, the vision is within reach.”

We were then joined by Dr Richard Brunner, Research Associate from the University of Glasgow’s Centre for Disability Studies, who works with GDA on our Future Visions project.

Photograph of Richard Brunner a researcher from Glasgow University. He is standing on a low stage behind a lectern from which he is giving a speech. He is wearing a greyish blue shirt and light brown trousers. He is bald with a short beard and is wearing glasses. Behind him is a large screen on which his image is showing next to the title of his talk Transforming social care and independent living outcomes. To Richard’s left, GDA CEO Tressa Burke is sitting at a table with a white tablecloth listening to him.

Richard shared findings from his research into the barriers disabled people face accessing social care, based on GDA members’ experiences of complex systems of service and supports. Richard reported that too often these multiple parts of the system do not communicate and fail to work together, creating gaps in services. Richard pointed to formal research by Audit Scotland which echoes disabled people’s experience in that:

“Self Directed Support is yet to significantly achieve independent living. The reality is far from the intent of the SDS Act”.

Richard described GDA’s Community Navigator’s role in supporting disabled people, who are highly marginalised and face intersectional barriers. These include basic health needs, abject poverty, inaccessible housing, and result in people needing support to navigate a range of services, often outwith formal social care. The project’s intention is to support disabled people in Scotland to find pathways to independent living. One person supported by the Navigator reported:

“The impact on my life of the failure of my social care has had much more impact than my medical condition and impairments. This failure contributes to disability – to poverty, inequality and exclusion.”

Richard shared findings from 5 in-depth case studies included in the most recent stage of his research. He explained the 5 cases are all impacted by a set of service gaps:
·        health, housing and social care services are not always sufficiently integrated to support people effectively.
·        social care services are not identifying and acting on unmet needs.
·        some disabled people face intersecting barriers and experience marginalisation by multiple public services.
·        health, housing and social care services are not sufficiently supporting disabled people to achieve independent living outcomes and wellbeing.
·        health and social care services are not always upholding human rights.

The full research report, Breaking Barriers to Social Care, contains a wealth of data and provides recommendations for dismantling the barriers and improving services and supports.

The event closed with questions from the floor and online for Minister Maree Todd and Dr Brunner. GDA members asked tough questions of the Minister, making clear the depth of their disappointment at the rolling back of the NCS Bill. They also emphasised the breakdown of trust between the Government and disabled people, stemming from doubts as to whether our priorities and experiences remain at the heart of social care reform.

Photograph of the panel taking questions. From left to right are Richard Brunner, Researcher from Glasgow University, Maree Todd, Scottish Government Minister for Social Care, Mental Wellbeing and Sport, and Tressa Burke, GDA CEO. They are sitting in a row behind a table with a white tablecloth. Maree Todd is speaking into a microphone. Behind the panel is a large screen showing a close up image of Maree Todd. Photograph of a GDA member sitting at a round table and speaking into a microphone asking a question. In the background a several other GDA members listening.

Members also questioned the Government’s commitment to embedding dignity and human rights into design and delivery of services, as a result of the scrapping of key principles outlined in Part 1 of the Bill, as well as asking for detailed actions which outline the Scottish Government’s commitment to scrapping non-residential care charges by the end of 2026. 

At the end of the event, GDA’s Social Care Expert Group: Future Visions for Social Care Photovoice project exhibited a selection of their work depicting their lived experience of social care through a series of photographs and accompanying text. Themes surfaced including of social isolation and loneliness; lack of flexibility and consistency in supports; and persistent lack of choice, control and bodily autonomy.

There will be further opportunities to view the Photovoice project in the future.

Photograph of the back of a man looking at the Photovoice exhibition. He is standing in front of three large boards on easels which have photographs and text on them. The boards are too far away in the photograph to make out in detail what they show. Photograph of the back of a woman looking at the Photovoice exhibition. She is standing in front of three large boards on easels which have photographs and text on them. On the board on the right can be seen a series of photographs showing the same view at different times of the day and evening. The other two boards are too far away in the photograph to make out in detail what they show.

To conclude, GDA’s Future Visions for Social Care Event emphasised an unwavering commitment from disabled people’s and their support to work alongside the government and others to arrive at an effective model of change.

In the Minister’s speech, we were pleased to hear a restated commitment from the Scottish Government to listen to the voices of lived experience. Following the event, the subsequent appointment of Susan Douglas Scott, a disabled woman and long-time disability rights campaigner, as the National Advisory Board’s Chair is welcomed by GDA members who applaud this as “a step in the right direction”.

However, GDA members remain unwavering in their determination that much more must be done. Indeed the National Advisory Board must centre and prioritise the issues and voices of disabled people by including DPOs on the Board and related structures. Disabled people, supported through capacity building, dialogue and deliberation within DPOs, can use their individual experiences and expertise towards collective solutions and proposals which can transform social care in Scotland.

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