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  • angela.constance.msp@parliament.scot

    Unit 4, Ochil House, Beveridge Square, Livingston, West Lothian, EH54 6QF

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Published date : 15 July, 2020



Angela Constance MSP is today issuing a national call for evidence in support of a National Care Service and calling for the Scottish Government to set up a short independent review to determine how this could be delivered.


The MSP for Almond Valley has been vocal in raising questions about the standards of care and poor performance of care homes for older people, particularly in the private sector, during the coronavirus pandemic.


In launching the call for evidence Angela Constance MSP said 


”I believe that the coronavirus pandemic has shown why it’s vital that we establish a National Care Service. While this would be a bold reform, it is necessary.


“The question is no longer whether there should be a National Care Service, but how it should be established, commissioned, and operated


“After speaking out against profiteering in the care home sector I received many emails and phone calls from people across the country.


“With much to learn from the pandemic it’s imperative that in any bold reform we take the people with us.


“The integration of health and social care has brought and number of benefits, and the creation of a National Care Service is its logical next step.


“Therefore, I am issuing a national call for evidence and views on how we make a National Care Service a reality. 


“Clearly legislative change would be needed, so I am calling for the Scottish Government to undertake and conclude an in-depth and detailed report before the 2021 elections. 


“There are many aspects to adult health and social care but my call for evidence will focus on those with lived experience of the care home sector for older people whether as a resident, staff or relative.


“I want to ensure that the voices of those with real life experience is heard and that we benefit from real life expertise about what matters and what works.”


For residents, staff and carers who wish to participate in the call for evidence they should email  Angela.Constance.MSP@parliament.scot or via my website https://www.angelaconstance.scot/constituent-contact


Notes - 


refer to Call for Evidence (BELOW) 




As we start to look at life beyond lock down it is now more important than ever that we ask and answer some fundamental questions about how we invest in and care for our citizens.


We need a new debate about how we achieve the very best of care for older people whether that is community, residential or nursing care.  This call for evidence specifically seeks the views of those with experience of residential and nursing care whether as a resident, a family member, a visitor or member of staff. 


Every life lost from coronavirus pandemic is a tragedy. We know that the virus poses the biggest threat to the vulnerable and across Europe adult care homes have seen a significant proportion of deaths due to Covid19 and Scotland is no exception. We must learn from our experience of the pandemic and the Cabinet Secretary for Health and Sport, Jeane Freeman MSP has said that it is right and proper to rethink the landscape of adult health and social care including care homes.


70% of care homes are operated by private providers, 20% by independent/third sector providers and around 10% by local authorities or health boards.  This landscape limits the opportunity for the Scottish Government to intervene in the same way as they would with our National Health Service. 


The pandemic has increased the urgency with which the Scottish Government has had to try to overcome these limits, including the passing of emergency legislation to ensure swift intervention if care home residents are at severe risk, NHS Nurse Directors taking on new responsibilities for infection control in all care homes in their area, the supply of personal protective equipment and stepping in to help with pay and benefits for staff when private employers refused to step forward.


Surely, then, the time is right to build on these interventions rather than roll them back?


The pandemic shines a light on serious concerns about some private care homes, particularly those operated by very large groups whose headquarters are off shore and pay very little tax on their profits. While it is important not to tar all providers with the same brush, there is a clear public revulsion about profiteering at the expense of care.  There are concerns that public money  is extracted from the care sector to support private interests and at the expense of the common good.


Therefore, there is a need to interrogate the ethics and fairness of the financial models that underpin care services and the impact that this has on the wellbeing of care home residents. Public money should be used to fund the right care at the right time.


We need full transparency about the tragic loss of life in care homes sector by sector and to dig deep into the evidence about performance and standards of care.


  1. Scottish Government statistics published on 7 July 2020 detail the percentage of adult care homes that have seen a suspected case of Covid19 by sector is 41% in the voluntary/not for profit sector, 62% in the public sector and 71% in the private sector.


  1. These statistics also show that a higher proportion of larger adult care homes have suspected covid19 cases.  For example, 20% percentage of adult care homes with 10 beds or less have had suspected covid19 cases, by contrast, 91% of adult care homes with more than 60 beds have had suspected covid19 cases. 


  1. Data from the Care Inspectorate shows that relatives of care home residents most frequently raise concerns about health and wellbeing and that 76% of private care homes have at least one complaint made against them with 34% of complaints upheld.  By comparison 20% health board run care homes have had at least one complaint made against then with 13% of complaints upheld.   


There are many aspects to building a National Care Service and integration with local GP and primary care services is crucial.  A National Care Service like our NHS should be a national service delivered locally, with no room for private profiteering at the expense of care, operating to a clear national plan and standards, with clear lines of redress and accountability. 


There are fundamental questions to be asked and answered about the future of residential care and the vision of a National Care Service and how together we make it happen.


Whether you are a care home resident, a member of staff, a friend or relative of a loved one in care please respond to the six simple questions below – you have the real life experience and expertise about what works and about what matters.




  1. Are you a resident, member of staff, friend or relative of a loved one in care?


  1. What is your experience of the Care Home Sector and what changes would you like to see? 


  1. Are you in favour of a National Care Service and why?


  1. What is your vision of a National Care Service?


  1. What steps should the Scottish Government take to make a National Care Service a reality?


  1. Please share any other information or views the you have.



Please send replies to Angela Constance MSP at Angela.Constance.MSP@parliament.scot


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    • angela.constance.msp@parliament.scot

      Unit 4, Ochil House, Beveridge Square, Livingston, West Lothian, EH54 6QF

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