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The voice of Scotland’s vibrant voluntary sector

Published by Scottish Council for Voluntary Organisations

TFN is published by the Scottish Council for Voluntary Organisations, Mansfield Traquair Centre, 15 Mansfield Place, Edinburgh, EH3 6BB. The Scottish Council for Voluntary Organisations (SCVO) is a Scottish Charitable Incorporated Organisation. Registration number SC003558.

The economic role of Scotland’s third sector in shaping health and social care

This opinion piece is 9 months old
 

Sara Redmond: The third sector’s economic contribution and development seems to be too often overlooked

You only need dip your toe into domestic politics to recognise that there are major financial dilemmas facing both the UK and Scottish governments.

And it’s not only in the here and now – we know there are further pressures in the pipeline. There will be changes in the demographic profile of Scotland over the next 50 years, with projected growth in public spending, and particularly on health and social care. Yet the money that is going to be needed is likely to far exceed the estimates of what will be available unless changes are made.   

The ALLIANCE’s campaigning and influencing work centres the voice of lived experience and advocates for third sector’s contribution to improving the population’s health and wellbeing.

When people think about health and care services and policymaking in Scotland, it’s often the role played by government, the NHS and integration authorities that comes to mind. However, this overlooks the vital function played on a daily basis by thousands of third sector organisations up and down the country.

The range of work done by the third sector is enormous and the health and care system couldn’t run without us. Whether it’s direct support from the likes of community links workers and social care professionals; running clubs and hubs that help keep people connected in their communities; or informing and influencing national and regional policy that will have a direct impact on people’s lives.

Despite the Scottish Government’s commitment to a wellbeing economy, and the UK Government’s pledge to grow the economy, the third sector’s economic contribution and development seems to be too often overlooked. 

Worse, though, are the inefficiencies and systemic inequality which is built into the dominant funding models – grant funding and service contracts – which often undermine the sector’s sustainability and growth. One way this is demonstrated is in the growing divide between the pay awards being offered to the public sector workforce in comparison to the third sectors. It is also evident in the requirements on the third sector to meet ‘fair work first’ principles, without any equivalent funding adjustments taking into account the increased real living wage or cost of living increases.

recent report by the RSE found that despite the inherent complexity of the third sector, its economic contribution – through employment, purchasing and commercial activities – remains substantial. Many analyses show it to be greater than other sectors, including health and life sciences and creative industries – all of which enjoy considerable Scottish Government support.

Yet there are still gaps in the evidence, and in Scotland there has so far been no attempt to estimate the overall economic contribution of the third sector. Rather, there has been a growing expectation on individual organisations to find ways to demonstrate the contribution they make to national, system, service level or personal outcomes and prove their impact and performance.  

I am supportive of evidence-informed policy and investment decisions, and of robust scrutiny and review, upon which to learn lessons and identify improvements; yet I have real concern about the continued onus being placed on individual organisations (and sometimes even individual programmes) to effectively demonstrate their impact to secure funding and contracts. 

This overlooks the way in which social change really happens in a complex world where actions are part of a web of relationships — most beyond our control and many of which are beyond our influence. We need a systemic means of measuring and evaluating social agendas such as improving health and wellbeing, enabling independent living and reducing homelessness.  

I share the concerns expressed by Toby Lowe  from the Centre for Public Impact: “it is impossible for organisations to “demonstrate their impact” if they work in complex environments. Asking them to do so requires them to create a fantasy version of the story of their work. This corruption of data makes doing genuine change work harder because it is difficult to learn and adapt from corrupted data.”

The ALLIANCE enjoys good relationships with our funders and sponsors and is a valued and trusted bridge between the public sector, the third sector and people who access health and social care services.  We have recently undertaken work in an attempt to better describe the impact we contribute. In 2022 alone, the ALLIANCE generated:

  • health and wellbeing benefits of at least £26.6 million (£5.39 for every £1 received in core grant funding),
  • cost savings of at least £0.8m, 
  • £7.7m gross value added (GVA) to the Scottish economy and supported 160 jobs
  • and tax contributions of £1m from staff wages.

This impact sits alongside a range of other benefits stemming from our work that could not be quantified. This includes directly contributing to eight of the 11 national outcomes for Scotland, helping to build and improve a person centred health and social care system, enhanced services for people who access health and social care, job satisfaction for professionals in the health and social care sector, and staff retention for service providers and increased wellbeing for the families of those supported.

At a time of competing demands for the public finances we have available, it is crucial that we don’t overlook the essential third sector which operates in our communities, often responding where public services don’t or can’t. 

We cannot continue to take the sector for granted, or we risk losing much of this vital social fabric of our civil society. Perhaps a key question we need to keep asking is: what would our economy look like without the third sector?

Sara Redmond is chief officer for Health and Social Care Alliance Scotland (the ALLIANCE).

 

Comments

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Tressa Burke
8 months ago

Agree with Sara's analysis and note her useful reference to Toby Lowe- far too much emphasis on community and third sector proving, demonstrating, evidencing impact and not enough scrutiny of impact of public sector or governments own impact on people and communities. You just have to talk to Glasgow Disability Alliance members for 2 minutes to see and hear evidence of the impact of our programmes, interventions and support. Life-changing, life enhancing and life-saving at times- this is how disabled people describe support from GDA. But this is not ONLY what we need to be looking at- fine to oversee how funding and investment are used and this is welcome. But structural inequalities will only be tackled if there is transformational change in the systems themselves. We can help for sure. We can shared lived experience, participate in Co-Design and offer life-lines when all other supports are slashed or vanish completely - like at the height of the Covid-19 pandemic. But where is the learning from this? Promises of working closely and sharing parity of esteem have vanished. Funding has become entirely about counting numbers of things courses, people, sessions and reports instead of focusing on the learning and the nuggets of wisdom and expertise which have the potential to contribute to transformational change. Community- led orgs such as Disabled People Led Organisations and third sector orgs must be treated as more equal partners with stable and longer term funding. We need courageous politicians who are willing to seriously consider fiscal powers and reforming taxation- utilising existing powers and creating reforms to get more. And we must invest in public services and community and third sector orgs. The development of the National Care Service still remains an opportunity for disabled people to have a more dignified life and access rights to Independent Living - freedom, choices and control over the support we need to participate in our families, communities and wider society. So too is Incorporation of UNCRPD - contingent upon including a duty to comply with the Treaty's Articles which do not exist in any other legislation including the Equality Act. The Economy includes and benefits from the third sector - including Disabled People Led Organisations. And as importantly, so do the lives of our most vulnerable disabled people experiencing deep poverty and entrenched structural inequalities. Power differentials must be acknowledged, reset and balanced. We are a fundamental part of the solution - both in meeting needs of Scotland's people and in brining the "People Power" we have at our disposal, to the centre of strategic and structural change.

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