There is a hidden crisis in this city and its name is social care.
I’m not talking about a problem with the people who deliver personal care and support in our community, they are, in many ways the unsung heroes of our public service workforce, there just aren’t enough of them.
It isn’t a glamourous line of work, but it can be hugely rewarding, many workers stick with the profession for the tremendous pay-off they get in the form of personal contact and friendship, but that reward isn’t mirrored in pay packets.
Considering you can earn more stacking shelves in a supermarket, then small wonder it is getting harder and harder to recruit staff. Add the possible impact of Brexit to those European workers delivering social care in the Capital and the problem has the potential to worsen still further.
This time last year, a family came to see me, their 86-year-old farther George had suffered a fall in early February. He was admitted to Liberton Hospital and despite contracting a mild infection, was declared fit to go home a few weeks later. The family got ready to welcome George home and the hospital prepared to discharge him and then suddenly everything fell through.
The social care package they needed to be in place for George to return home required a night time check, but providing staff for that check proved to be impossible. George went on to wait more than 150 nights in hospital (at a cost of £400 per night) in a state of near perfect health, while the authority cast around for care staff to deliver the necessary package (at a cost of £80 per night). It was only after I raised his situation with Nicola Sturgeon on the floor of the Scottish Parliament that we finally got some movement and George was allowed to return home.
The thing is, George isn’t alone, and “bed blocking”, as it’s called, has a knock-on impact throughout the health service. It leads to cancelled operations, longer waiting times and an interruption in flow through every stage of the patient journey. It costs a fortune. The chronic underfunding of our social care system has an impact at the younger age of the care spectrum as well. I’ve lost count of the number of families, affected by autism who’ve come to my constituency surgery because they aren’t getting the support they need.
They’ve followed a well-trodden path of waiting patiently for an official diagnosis (that process alone can take over a year) only to then join another queue for social care assessment. The wait can be eye-watering and then when all is said and done, they’re often only offered a bare minimum of just a few hours of support each week. This can in turn lead to disruption in the classroom, parents having to give up work to focus on caring and even family breakdown.
The cost to the state in terms of mopping up the impact of our broken social care system is potentially catastrophic and with our ever-expanding elderly population, the demand we exert on that system is driving relentlessly north.
The right social care package can help children grow up with autism with the right support both in the family setting and at school, it can also help older people to stay at home and out of hospital for much longer. But that vision is slipping increasingly out of reach.
We need to make social care a career of choice, which pays well and attracts workers from home and abroad; we need to ensure that children with autism no longer have to wait for diagnosis or the provision of meaningful support; and we need to stop treating the provision of social care as an after-thought, but instead give it as much political energy as we currently do the NHS and primary care.
Alex Cole-Hamilton is Lib Dem MSP for Edinburgh Western