Only just hanging on – a crisis in care

Last Tuesday, in a hot and crowded meeting room in the City Chambers, and despite passionate and well-evidenced pleas from the community on the grounds of safety and welfare for residents, £8.8 million was cut from Edinburgh’s health and social care services. How on earth did we get to this point, when ordinary people end up in tears in front of a committee trying to express the danger of cuts to social care?

First of all, let me run through the numbers. In Edinburgh this year we have a budget of £809.4 million to spend on health and social care services but we expect it will actually cost £856.4 million to deliver, because of factors like inflation and our growing population. In addition to this shortfall of £47 million, we also know that many people are not getting the health or social care that they need or are entitled to, so if we met their true needs the cost would be even higher.

Let’s also take a moment to think about how much care is provided but not measured by budgets. The estimated number of unpaid carers now stands at 759,000 people across Scotland, according to the Scottish Health Survey. So we can assume that the value of unpaid care has also risen from the last estimate of over £36 billion per year nation-wide. In Edinburgh, where we have a strong and vibrant culture of volunteering and charitable work, you can also add on the hours of unpaid time spent providing services in the care sector by local groups and charities.

Carers and volunteers give their time, skills and love willingly, and so of course their labour could never be replaced by paid-for care. There is a huge amount of dignity, humanity and value for everyone involved in providing and receiving voluntary care. However, in every meeting and conversation I’ve had with carers in the run up to this budget, they have told me how close to breaking point everybody in the care system, both paid and unpaid, is feeling. After years of austerity budgets followed by the pressures of the pandemic, unpaid carers are only just hanging on and may not be able to do so for much longer.

These unpaid carers are the rock upon which our meagre budget is sitting. Eroding support for and placing more and more expectation upon unpaid carers is taking us dangerously close to a complete system failure. The people who are cared for are often not visible, do not have a voice in the room where decisions are taken, and are in the most vulnerable circumstances. So when carers break down in tears while telling their truth to those in a decision-making role, we must sit up and listen.

I’m more certain than ever that Governments in London and Edinburgh must face up to the financial crisis in care and set out a plan to fund care properly and to also recognise and fully fund support for unpaid care. After this year’s traumatic health and social care budget process, it is clearer than ever that politicians of every shade must put aside their fears of ballot box repercussions and fund our social care sector properly.