Malcolm's expresses concern about City of Edinburgh Council's tendering process
Debate on the services for older people Malcolm Chisholm (Edinburgh North and Leith) (Lab):
It is good that we are considering today and again tomorrow the care of older people, but it is important to set it within the broader framework of the wider agenda about the contribution of older people, the opportunities for them and attacking all forms of ageism. It would be good to hear from the Government before too long about progress on that agenda.

Sticking with care, we should remember that only a minority of older people require care services: 3 per cent of those between 65 and 74, and 40 per cent of those who are 85 plus. Of course, in relation to care, the welcome explosion in the number of over-85s in the next 20 years will be important.


The key issue for care is of course quality, and central to quality is personalisation. In many ways, we seem to be going in the wrong direction when it comes to that. Of course, we should acknowledge today the great deal of progress that there has been, from the setting up of the care commission a few years ago to the welcome initiatives that the minister described earlier. However, it is right that we should focus in this debate, as Johann Lamont did, on issues such as the "Panorama" programme, the articles in The Herald, the rising number of complaints to the care commission, the "Remember, I'm still me" report, and what is actually happening on the ground, which is often contrary to the stated policies and objectives.

The "Remember, I'm still me" report has been referred to by several speakers. Sticking with the theme of personalisation, I refer members to a couple of examples in the report of an absence of personal plans that meet the individual needs and preferences of people, and an absence of activities that are tailored to people's individual needs. Those examples and others send out a very important message to care homes, the providers of home care services and councils involved in the commissioning process.

That leads me on to an example of what is happening on the ground in my constituency. City of Edinburgh Council will soon introduce changes to home care services that I will come on to describe, but the council has already changed the tendering process for care-at-home services for people with learning disabilities, mental health problems and physical disabilities. In that process over the past few months, the views and wishes of those who receive the services have been ignored.

A central feature of personalisation is putting the person at the centre as a participant in shaping the services that they receive, but the views of service users in Edinburgh have been ignored. Many service users have said that they will take out direct payments rather than accept the new providers, so what has City of Edinburgh Council done over the past few days? The council has frozen direct payments, which are an important dimension of the personalisation agenda. I believe that the minister should look closely at what is happening in Edinburgh, which seems to me to be contrary to legislation.

On home care services, City of Edinburgh Council intends to move 75 per cent of provision into the private sector. Before the Conservatives leap to their feet to intervene, let me clarify that I am not saying that the private sector is necessarily worse. We need to look carefully at quality. In service reviews, the views of users of independent sector services contrast with those who use council services. On the basis of that evidence, it seems that the users seem to prefer council services, although that is not necessarily the case.

It is certainly wrong to award contracts solely on the basis of lowest cost - as appeared to happen in the evidence shown in the "Panorama" programme - but the changes in Edinburgh seem to be driven by the desire to make the services cost as little as possible. We should all be concerned about the implications of that for the quality of service.

Mary Scanlon (Highland & Islands( Con):
Will the member give way?

Malcolm Chisholm:
I have only two minutes remaining. I shall give way if I have time, but I will first highlight two other issues.

On the important subject of abuse, which we will also consider tomorrow morning, we should acknowledge the progress that has been made through the requirement for enhanced checks and through the Adult Support and Protection (Scotland) Act 2007. However, following a concerning incident in a council care home in my constituency - someone was convicted of sexual assault of the patient a few weeks ago - I wrote more than once to the minister about how the case raises serious issues about the effectiveness of checks when, as in this case, the member of staff comes from abroad.

I know that the Government will try to deal with the issue to some extent in the Criminal Justice and Licensing (Scotland) Bill, but there is still a wider issue about checks on agency staff. In the case in question, the member of staff was employed by an employment agency, which cannot be inspected by the care commission. More generally, I think that we need to look carefully at who is employed in care homes. As Johann Lamont said, continuity of staffing is important and part of the problem is that agency staff come and go.

My last point is about the wider agenda. There has been a lot of progress on personal care, but some of the wider agenda is being ignored. Last week, I had a meeting with Care and Repair Edinburgh. I know that the Government supports such services in principle, but I must pass on the organisation's concerns about the loss of ring fencing, which obviously creates worries about funding. Another project in my constituency is the Pilton equalities project, which is trying to fill some of those gaps by using volunteers to provide a handyperson service.

I will take Mary Scanlon's intervention.

Mary Scanlon: Given the tight budgets, does the member think that it is wrong that councils pay twice as much for care in a council home as in an independent home?

Malcolm Chisholm:
We need to look at the reasons - wages, pension rights and so on - for those differentials. I am glad to accept that intervention from Mary Scanlon, given that she hosted a recent meeting with clinical psychologists that I attended in the Parliament. Like her, I want to make a point that was raised at that meeting. Clinical psychologists have recommended the development of a national education programme that would target general practitioners and practice nurses to support better identification and management of depression in older people. They also propose more posts for psychologists with specialist skills in supporting older people. That is an important aspect of the care agenda for older people that we should remember.

October 28th 2009, (Column 20564-7)