Ministers are under pressure to end the involvement of multinational consultants in setting up the public service
The Scottish Government has been told it must rescind contracts awarded to multinational consultancy firms as work to create Scotland’s National Care Service continues.
First Minister Nicola Sturgeon has been urged to end the relationship with both PriceWaterhouseCoopers (PwC) and KPMG, with campaigners claiming they cannot in any sense be described as independent or disinterested given their involvement with private capital in care homes.
Unison, the largest trade union in Scotland’s social care sector, has written to the government sharing its disappointment and disapproval that these private management consultancies have been given a role in the design of a National Care Service.
The union claims both these companies have an international record in promoting market mechanisms in health and care services and, the trade union argues, that constitutes a conflict of interest.
Lilian Macer, convener of Unison Scotland, said: “The new National Care Service must make a clean break from using private international capital firms to provide our care services.
“PriceWaterhouseCoopers (PwC) and KPMG have a track record of promoting private health and social care, this is not what most people in Scotland want.
“Care should be delivered in and for the community. It is a public service not a commodity. Big private equity firms have led us to the tragically dysfunctional care system we have now.
“The values and past record of both these companies, in our view, shows they are not fit and proper companies to be involved in any aspect of setting up a national care service. We urge the first minister to rescind their contracts now.”
Voices from within Scotland’s voluntary sector said while they understood the need for the government to utilise expertise in setting up the service, transparency and active participation should be at the core of its creation.
Sara Redmond, chief officer of the Health and Social Care Alliance Scotland (the Alliance): “The Alliance is committed to supporting the recommendations of the Independent Review of Adult Social Care, and notes the overwhelming support for this in the recently reported consultation process, whilst we understand the need for the Scottish Government to utilise private sector expertise to develop a business case, we will continue to advocate for transparency and active participation in decisions taken.
“The Alliance will support the developing internal Scottish Government team that will take this forward, and continue to be involved in the representative groups which Scottish Government has set up to reflect third sector and citizen and the public’s interests and will continue to loudly call for a transparent, compassionate, person-led service based on the lived experience of Scottish citizens underpinned by progressive human rights legislation.”
The calls come as representatives from Scottish charities working in the care sector presented at a Holyrood committee on Tuesday morning.
Fiona Collie, of Carers Scotland, Annie Gunner Logan, chief executive of the Coalition of Care and support Providers in Scotland (CCPS) and Dr Donald Macaskill, chief executive of Scottish Care all appeared in front of MSPs on the Health, Social Care and Sport Committee.
Questions from the MSPs centred on an Audit Scotland report published earlier this year, which outlined the challenges facing the social care workforce in Scotland.
The watchdog said in January that an overhaul of the sector cannot wait until the nationalisation, calling for huge reforms and urgent action.
Ms Gunner Logan, responding to questions on procurement and commissioning within the sector, said that the auditor is correct in saying that the sector still largely experiences commissioning as a “price-based, competitive exercise” for “large contracts that are not specified by the people who will receive support, but by procurement officials who have never met those people - far less understand their individual needs”.
She said: “For me, the push for ethical commissioning - which is a term we hear more and more now - procurement that recognises fair work and exploration of more collaborative approaches is hugely welcome.
“Collaboration is not only about providers collaborating with each other, it's about commissioners, providers, the people they support, families and unpaid carers all being around the table for better outcomes.
“The Independent Review of Adult Social Care called for a national improvement programme in this area and boy would we like to see that.
“The Scottish Government’s procurement directorate has recently issued an incredibly helpful policy note which says to commissioners and procurement officials - don’t wait for the National Care Service, start now. Check your procurement activity, make sure it’s in alignment with the principles of ethical commissioning and fair work.
“The Independent Review recommended a revolution in commissioning, but the National Care Service proposals which came out in the consultation last year didn’t really follow through on that. I would go so far as to say that competitive tendering for social care is, in itself, unethical and no amount of tinkering around the edges is going to change that. I worry that ethical commissioning is being interpreted as a way of making sure that providers behave ethically.
“But it has to start, for me, at the beginning, with a commissioning mindset that is itself ethical and that would rule out competitive tendering, in my view, as it would rule out any kind of procurement that didn’t involve the individual in choosing their support.”
The speakers were also asked about what parts of the sector’s culture could be overhauled with the creation of the National Care Service, with the chief executive of CCPS telling MSPs: “If all we do is rearrange the structure without addressing the culture sitting underneath a system that sees people who rely on social care as units of cost and their services as commodities to be traded on a market then we’re really not going to get very far.”
Scottish Care declined to comment, telling Third Force News it did not have “direct detailed knowledge” of the issue.
Community Integrated Care said they were not in a position to comment.
Minister for Social Care Kevin Stewart said: “The National Care Service (NCS) will be the most significant change in public services since the establishment of the National Health Service. We are committed to delivering a National Care Service by the end of this parliament, ending the postcode lottery in the delivery of care, and working to ensure everyone gets the high quality care they are entitled to.
“At its core will be human rights and person-led care and support that focuses on positive outcomes for people across Scotland.
“This specialist service has been brought in to provide support to bolster the resources available in developing the business case and operating models needed as planning progresses. The work supports that led by the civil service and social care professionals and will provide a baseline and framework on which we will build the new system.”