Wraparound care: An interview with social care minister Kevin Stewart

The pandemic has shone a spotlight on how we care for each other. Holyrood speaks to the minister for well being and social care, Kevin Stewart, about building on what he has learnt.

Caring for each other is at the heart of every restriction imposed during the pandemic, how have you felt about the way Scots responded to the Covid rules and how does that bode for the future as we rebuild better

I think the overall response in Scotland to the pandemic has been admirable. Throughout this extraordinary and difficult period, most people have followed the rules, often while making considerable sacrifices and in many cases while facing personal loss. We are all grateful for the incredible efforts of frontline health and care workers. I have also been struck by the many ways we’ve supported each other as a nation through this extraordinary and difficult period.

We’ve seen communities rally together and often learned a great deal by the way they have responded. That’s why I’m so keen that as we reshape Scotland’s social care services, we learn from the communities and individuals affected – that lived experience can teach us a great deal.

There are few positives to be drawn from something so awful as the pandemic but has it put in sharp focus the real need to re think our approach to care for the vulnerable and the elderly?

We already knew change was needed in social care. Although the integration of health and social care has been the shared goal of national and local government for many years, the Independent Review of Adult Social Care found the current way of working has not fully delivered the improvements we want to see.

Our ambition is to create a comprehensive community health and social care service that wraps around families, with smooth transitions between different categories of care. The introduction of the National Care Service will be the most significant and radical reshaping of social services since the National Health Service was established 73 years ago.

A National Care Service has long been mooted, has the pandemic helped accelerate those plans and how do you think it has contributed to how that NCS might be shaped and how quickly we might see it take shape?

Clearly the pandemic brought the issues within social care into sharper focus.

This is a very significant public sector reform, and it will take time, but we are working as quickly as possible to get the NCS established by the end of this Parliament.

I think the pandemic has made the case for change even more urgent. I am keen that we do not delay unnecessarily and start now so that we get to the point of delivering consistent, high standards of support for everyone who needs it as soon as possible.

At the same time, what the pandemic has also highlighted is that improving access to social care cannot wait for the NCS. So we are already putting in place measures to strengthen the implementation of self-directed support, and to make caring as a profession more attractive – with fairer pay and a route to career progression, for example.

What would you like to see as the ideals that should be baked into the setting up of a new National Care Service?

We want to create comprehensive support that is consistent and fair, supports people of all ages and improves co-ordination between different aspects of care and support.

This is an exciting opportunity. We can lead by example and build a service that puts human rights at the heart of it. By that I mean a service that is truly people-centred; one that focuses on how what we do improves the lives of people who need support, their families and their carers.

It is only by doing this that we can help people to live the kind of lives they want to live - lives that aren’t limited by overly focusing too much on processes or funding.

Another ideal that is integral to a successful National Care Service is respect, and I want to make sure that we include the social care workforce here. It is fundamental to our plans that those who deliver services feel respected and fulfilled in the jobs that they do. We will improve the position of the social care workforce by improving terms and conditions, pay and training and development for the workforce.

Most of us have been in awe of the social care workers who have worked so heroically throughout the pandemic, do you feel that there may be a different respect afforded them as we go forward?

I think people have come to respect social care workers and give much more credit to the work they do. But that only goes so far. That is why we invested around £180m with a £500 (pro rata) ‘thank you’ payment to over 300,000 health and social care workers, and provided £1.6m in ‘thank you’ payments to Personal Assistants.

More importantly, we are increasing the minimum hourly rate of pay to £10.50 per hour, higher than the Real Living Wage rate and higher than the National Living Wage which applies to many social care workers in England. And we are working with the Social Services Council, social care employers and trade unions to establish clearer options for a career pathway with opportunities for staff to grow and develop.

The plight of unpaid carers has been particularly hard, do we undervalue the work they do?

Well, I can tell you that I certainly don’t. The care given by family members and other unpaid carers is hugely valuable and I know the pandemic has put, and continues to put, added pressure on those who care for loved ones.

That is why I have committed to publishing a Carers Strategy in the Spring, with a focus on helping people as we move into the recovery phase from COVID-19 and the goal of significantly improving carer support in the longer term.

More immediately, we have also provided an additional £4m to help organisations working with unpaid carers to extend the services in place this winter, £200,000 for the Young Carers Package delivered by Young Scot, providing £3m for local carer centres for both young and adult carers across Scotland, an additional £377,000 to expand the Family Fund and investing £590,000 to expand wellbeing and support services for unpaid carers looking after a family member or friend with dementia.

The pandemic has affected everyone in many ways, do you feel we have yet to fully process what we have all been through and like other national traumas, do you worry about how it will affect us all going forward almost like a collective PTSD?

I doubt there is a single one of us who hasn’t thought about our mental wellbeing, or worried about that of others, at some point during the pandemic.

Many of us have been anxious or worried about our health, our family and friends, and changes to our way of life. Some individuals, families and communities will have found the past two years really tough.

We also know the mental health impact of Covid-19 will not have been felt equally across Scotland. Inequalities play a significant role in this.

We are taking action now and will continue to look at what is needed to handle this aspect of Covid recovery. In October 2020 we published a Transition and Recovery Plan setting out a range of actions in response to the mental health impacts of the pandemic. We’ve made funding of £1.5m available immediately from our Recovery and Renewal Fund for support within GP practices and community settings, which will increase to an expected £40m a year by 2024-25.

This will enable patients who need mental health support to find it from a range of professionals through their doctor’s surgery, rather than having to rely solely on their GP or a referral elsewhere, such as mental health nurses, psychologists, peer support workers, occupational therapists, and link workers.

But grassroots community groups and organisations have an important role to play alongside primary care in supporting peoples’ mental health and wellbeing and we’ve seen some great examples emerge throughout the pandemic. I think that, with the right support in place, people can be very resilient.

Most of us have felt isolated and lonely during these unprecedented times, what resilience have you drawn on to get through it and who have you held particularly close?

The pandemic period has been trying for all, but I have been lucky in the fact that I have had the support of my family throughout. We have like everyone else found it hard, but we have tried our best to keep our spirits up even though we have had a lot less contact than we had previously. I have missed regularly seeing my nieces and nephew, my great nephews and great niece most of all.

Are there times that you have felt overwhelmed and how have you cared for yourself and your own mental well-being?

I have felt strained, frustrated and irate at times, but have not been overwhelmed thank goodness. I have a good support network of family, friends and colleagues, who have been amazing. I have missed human contact, cuddles or bosies as we call them in the north east and the ability to just drop in and visit someone. It has been tough, tiring and sometimes lonely, but I have been lucky compared to many.

If you could sum up in one sentence of how you would like Scots to care for each other going forward, what would it be?

The pandemic brought out the good in so, so, many people and most folks have gone the extra mile to help others in many ways and it would be great if we could all continue to be as understanding, helpful and supportive of one another as we move forward.