Outsourcing Care for the Elderly

By sam

Outsourcing resulted in the degradation of the terms and conditions of the workers in care homes. Privatisation of care homes was much more marked in England than Scotland. It is likely to be easier to take social care out of private hands in Scotland than England.

Here is why.


In England

“Market Penetration:….In 1979, 64% of residential and nursing home beds were still provided by local authorities or the NHS; by 2012 it was 6%. In the case of domiciliary care, 95% was directly provided by local authorities as late as 1993; by 2012 it was just 11% ….

Market Fragmentation:….The care home sector supports around 410,000 residents across 11,300 homes from 5500 different providers….

Market Fragility:….Much of the Southern Cross provision was eventually taken over by another major provider, Four Seasons, which is itself now at high risk of going under. Either through financial collapse or strategic withdrawal the market model is at tipping point.”

In Scotland. Dr Donald Macaskill of Scottish Care, which represents private care homes, says there are significant differences between here and the rest of the UK. He said that around one in five of Scotland’s 725 private homes are owned by the biggest operators.

Both Scotland and England provided support for infection control in care homes. The provisions of these can be found at these links.


The Scottish provisions do not include agency staff or the self employed (of whom there are likely to be few).

In England, there were provisions relating to a fund to support infection control in care homes.

It said, “Local authorities must ensure that 75% of the grant is allocated to support the following measures in respect of care homes:…

…ensuring, in so far as possible, that members of staff work in only one care home. This includes staff who work for one provider across several homes or staff that work on a part-time basis for multiple employers and includes agency staff (the principle being that the fewer locations that members of staff work in the better, for example compensating staff whose normal hours are reduced due to restrictions on their movement)”

So, if the owner of a certain private care home operating in Kent received financial support for infection control while sending agency staff to another care home in Scotland, that would be funding that would be inappropriate, would it not?.

Kate Belgrave is a journalist whom I admire greatly.


“Thus, the Infection Control Fund – a thin paper to stretch over another yawning central crack. Needless to say, at the local level, interpretations of the use of the ICF have been intriguing – ie absolutely random and often a circus. This ALWAYS happens when government attempts to address a major structural problem (such as Statutory Sick Pay) in a crisis (such as covid-19’s razing through carehomes) by lobbing a handful of cash at it and hoping for the best.

The problem is that you don’t always get the best, no matter how much government hopes for it. The social media screenshots I received of a conversation about the ICF with a carehome manager were certainly an eye-opener. The manager in that dialogue said that they wouldn’t use ICF money to pay full wages for careworkers who were off work with covid symptoms, because it wouldn’t be fair to careworkers who were off sick with illnesses other than covid (the ICF is aimed at careworkers with covid symptoms, or who’ve had a positive test, etc). That manager in that post said the choice was a “moral” one – ie that it would be unfair to pay full wages to one group of sick careworkers, but not to another.”

Kate, and our Hetty, are right on the money.It is the inadequate levels of sick pay that makes all this crap necessary.

In the absence of any action on the part of the Scottish government we need to discuss the political system we want. A Nordic model or an Irish model. Both discounted by the Growth Commission report which should be put in the bin.

20 thoughts on “Outsourcing Care for the Elderly”

  1. “… we need to discuss the political system we want. A Nordic model or an Irish model. Both discounted by the Growth Commission report which should be put in the bin.”

    Whilst having similar interest and perhaps even a similar view, Sam I am reminded of the wise words of Peter A Bell written in his typically thought-provoking, pro-Indy blog on 2 October, 2020. I’m minded to veer close to Mr Bell’s view.

    Source: https://ihavequestions.scot/2020/10/02/what-cause-will-you-fight-for/

    “If we are focused on the fight to restore Scotland’s independence then are these policy agenda’s even relevant? If we are debating the core constitutional issue of who decides, is discussion of what might be decided not a serious distraction? If we are campaigning for a Yes vote in a referendum then surely it can only be Yes to ending the Union. It cannot possibly be Yes to any particular policy agenda or ‘vision’.

    “Precisely no policies will be decided by that referendum. What will be on offer is not a complex choice among various manifestos where many competing priorities must be considered as in an election, but a straightforward choice between the Union and independence. Between the British state and Scotland. Between our right and our capacity to develop our own distinctive political culture and submission to an imposed British political culture that is increasingly alien and anathema. The only priority is the preservation of Scotland’s democracy and national identity.

    “The issue to be decided in our new constitutional referendum is not what Scotland will be like for future generations of the people who live here, but whether those future generations will be able to decide for themselves what kind of Scotland they want. Or whether those decisions will be made for them by a government they didn’t elect in a parliament where they are effectively unrepresented.”

    Liked by 1 person

  2. Needless to say, stewart, I disagree. Policy for an independent Scotland exists already in the form of the Growth Commission report. This report has come in for considerable criticism. Here is some, there is more.


    A current account deficit is not necessarily a problem for countries with their own currencies, but under sterlingisation the current account position becomes crucial. This is because it becomes a key determinant of the money supply. As the economists Angus Armstrong and David McCarthy put it, under sterlingisation “the balance of payments would become the key barometer of whether Scotland’s economy prospers or declines.””

    Indyref1 failed on the currency issue. It also failed because the aim outlined by the Scottish government for independence was to change as little as possible, except to make it “fairer”. Did anyone mention redistribution?

    A clear vision of what independence means is what people need to know before they vote. Repeating indyref1, which is what I think you and P Bell espouse won’t do.

    I’m happy to debate more, if you wish. Not tonight.


    1. A clear vision of what independence means is what people need ?

      Sorry Sam but that is nonsense.

      An independent Scotland will choose its future once we have jettisoned England
      What we don’t want is a few setting the future road map for the majority
      That’s what we are trying to escape from

      People already understand exactly what they are voting for in Scottish independence they are voting for decisions about Scotland’s future being made by people in Scotland with a government chosen by the people in Scotland which can be sacked and replaced by the people in Scotland it’s as simple and straight forward as that , everything else including anything you or the growth commission or others who wish to dictate the future can be decided once we are independent
      There’s no hurry
      We don’t need people setting the road map now for how Scotland will be in the future because right now we can’t sack or replace the people who set that road map

      Keep it simple , clean , straight forward , that way we won’t put people off with growth plans and other forward planning that people in Scotland don’t agree with or don’t want.
      The majority in Scotland will decide our growth plan once Scotland is independent and I can assure you whichever growth plan is chosen will be top class because those presenting it will know they can be voted out and replaced by the people of Scotland

      Liked by 2 people

    2. Sam,

      It may be a fine line between too little and too much policy prescription going into Indyref2 campaign. Where to draw that line in the case- making is a tough call – many may want absolute clarity or certainty over what next – but IMHO there is a ‘line’! This is a subject well worth debating in terms of both strategy and tactics – but probably not in terms of my policy preferences once we are independent versus yours! save that important debate till after we dissolve the Union.

      Too many pre-conditions set now by pro-Indy supporters can only lead to factionalism. In the words of Mr Bell that I quoted: “Precisely no policies will be decided by that referendum ” This must be the truth if we are to have a functioning democracy AFTER we become independent.

      The Growth Commission report is not even agreed, official SNP party policy as I understand it: it’s a contribution to party policy making. It has already received robust, credible challenge within the party. And there is no certain evidence that in totality or in large part it will be policy of the SNP (led by whom?) after independence is achieved.

      There can be no evidence today that it will determine the policy of the first democratically elected government of our newly independent country. We don’t even know what parties will stand in that election; we don’t know what the competing manifestos will promise – we might even have a national unity coalition for a time; we don’t know what the Scottish electorate will vote for in that first election; and we don’t know what our first Parliament will support.

      You and I may both think that an independent Scotland should be a ‘currency issuer’ immediately and espouse the principles of Modern Monetary Theory. We might even find that the SNP leadership will be persuaded to endorse some or all of this at the time we enter an Indy2 campaign – who really knows with any certainty at this precise moment. But regardless, what is offered to Scotland’s people by independence is fundamentally ‘agency’ i.e. the ability to make such decisions for ourselves. An independence referendum is not about obtaining a specific mandate for policy prescriptions – only to dissolve the Union.

      The first elected government of our newly independent country, because of its political principles (laid out in its first manifesto) and influenced by the actual situation it faces at the time, may decide on something different, something that you and/or I may not agree with. But this will still have democratic legitimacy if in receipt of majority support at the first general election.

      My commitment to Scotland’s independence is NOT conditional on the detailed policies of the first or any subsequent government of an independent Scotland espousing always what I personally want!

      Rather, what independence will bring is government that a majority in Scotland chooses to have, always – but maybe not one that you and/or I always vote for. Tough but so very, very much better than we have now!

      Liked by 2 people

      1. Absolutely Stewart. As things stand, Scotland is in a weird situation where every political party at Holyrood bar two, who are working for the English based government and not in the interests of the country they are meant to represent. Independence is crucial to there being an effective, functioning democracy for Scotland. Yes, it can and must be much better than what is foisted on Scotland now that’s for sure.


    3. The WHITE PAPER. 2014…it was trashed, ridiculed by the BritNats, they won’t be getting that leaverage this time though, to scare the beejezus out of people, nope, that’s done and dusted, people will not be conned this time.


      1. I hope very much you are right.
        SNP should simply say to the media and to Westminster etc that we have planned for an independent scotland and it would be imprudent to reveal those important strategic and fiscal details to competitor countries in advance .
        Let them guess
        Let us deflect their guesses as inaccurate
        We control


  3. What currency are we going to have in an independent Scotland?

    How will we deal with child poverty in an independent Scotland?

    How will we deal with health inequalities in an independent Scotland?

    How will we convince the unconvinced that Scotland will be economically better outside the UK? One important reason reason for NO voters was economic risk.

    Ms Sturgeon has been defending the Growth Commission report rather than taking a neutral stance on it. She said it would help us achieve independence.

    “7/ lastly, policy choices in an independent Scotland will always be for the government of the day, so we should welcome debate – but without independence, these choices will always be far too limited. That’s the case we must win – and #GrowthCommission helps us do it.”


    1. Hi Sam, all good questions
      Questions that will be decided by the Scottish people once we are independent
      These questions have not been answered for a long long time forever in fact, there’s no need to hurry into them before independence giving Westminster the media and others the opportunity to bend misquote and ridicule before we even get independence

      We don’t need a perfect plan before independence

      Independence will eliminate the dross interference from Westminster and their media that downplays our ability to have a perfect plan

      We don’t need to predict the future in minute detail we don’t need to show Westminster and it’s media how we will improve Scotland we will show them once we are independent that everything we do is decided by the people of Scotland and not the people of of England’s as at present


  4. Terrence, we will have to agree to disagree.

    According to the polls support for independence has been increased by 4 to 5 points as a result of Brexit. A further 4 to 5 points has been added because of the better handling of covid in Scotland than by the UK government. These effects may be transient.

    You say that no vision of the future is needed.The success of the FM with covid (despite some failures) has been because she has been able to articulate strong reasons for supporting particular actions while the UK government has been all over the place. Ms Sturgeon has been setting out a path, a vision that has brought the country with her. I think that is needed in an independence campaign.

    It is not enough to point, as we do here regularly, to the great deficiencies of UK government policies and the damage it does to lives. 54 per cent of Scots still wish to use the pound. They will want to know what currency an independent Scotland will have before they vote.

    The piece up above is about, among other things, the great failure to pay enough sick pay to support absence due to sickness. Decent welfare support (as in Ireland and the Nordic countries) requires the redistribution of wealth. We hear nothing about that from the Scottish government. Why?

    The Irish economic model has too much bust and boom in it for me. the Nordic countries have more economic stability. This relies on the stability of their good quality institutions, low levels of corruption and inequality and a strong sense of democratic freedom.These things take time and commitment to build. They need and have the support of the majority of the population. The result is better health outcomes than other political systems and regular, high scores on the happiness index. Why should we not aspire to that and articulate it as the vision for an independent Scotland?


    1. Sorry Sam, but did you not just so subtly shift ground there? It’s at the point you stated in response to Terence Callachan: ‘You say that NO VISION of the future is needed”.(my emphasis) At risk of introducing a ‘straw man’ argument?

      – a thought, concept, or object formed by the imagination

      – a definite course or method of action selected from among alternatives and in light of given conditions to guide and determine present and future decisions; or

      – a high-level overall plan embracing the general goals and acceptable procedures especially of a governmental body.

      (Definitions from the Merriam-Webster online dictionary.)

      There are distinctions to be drawn – there is a ‘line’ to be drawn – and selecting where to put it is non-trivial! The more we in the Yes campaign can agree on the position of the line, the more likely we can be coherent, consistent and ‘disciplined’ in the face of a hostile media, BritNat ‘celebrities’ and the assembled Unionist parties, as we focus on the prime (and the first in the timeline) objective: to dissolve the Union.


      1. stewart

        I was responding to what Terrence said up thread.

        “A clear vision of what independence means is what people need ? (sam)

        Sorry Sam but that is nonsense.” (terrence)

        “vision: the ability to think about or plan the future with imagination or wisdom.”

        Speaking of vision, how do you envision an independent Scotland and why do you think we should keep quiet about how it might look?

        My post started with the inadequacies of private social care and how it is unsustainable. Inadequate sick pay provision being one aspect of that. That raises, for me, the question of the kind of economic model that Scotland should have when independent.

        Ms Sturgeon favours the Growth Commission. Critics say it will lead to further austerity. What kind of economic model do you want? How do we convince the 54 per cent of people who want Scotland to keep the pound as currency that independence is a good thing?


  5. The Scottish Gov is redistributing wealth under it’s remit. Building bridges, railways, and hospitals. To improve the economy. Investing in renewables. Kinship payments. Social care, £100Million a year to mitigate Westminster welfare cuts. Increased investment in education. Nursery provision. No increase in student fees. Student support and care. Increased funding SNHS. MUP. 20% mature students. Life long learning. Closing inequality education gap. Higher employment. An investment bank. Etc, etc.

    If people want Independence for more they have to vote for it,


    1. Nothing to address the fundamental causes of health inequalities, the unequal, unfair distribution of wealth, power and income. That’s not me saying that, it is professional academic research. When I asked my MP why a more progressive Council tax might not be used to redistribute income, I was told there was a lack of political will.

      We (Yessers) have hardly begun in an organised way to engage unionists in debate about how an independent Scotland might look.We have not done it for ourselves. So I ask you, Gordon, what sort of economic model do you want for an independent Scotland? What would you say to convince the 54 per cent who want to continue to use the pound as currency of the benefits of independence?


      1. On Council Tax reform, this has a (too) long and troubled history. I don’t have time to give full details but there is certainly truth that political consensus has been impossible, so far, to achieve in Holyrood.

        When the SNP came into (minority) government in 2008 it laid out its plans for replacing Council Tax with a Local Income Tax (LIT) in a consultation document. An extract from the document is found below.

        “The Scottish Government believes that the Scottish people have the right to change the way local authorities are funded from local taxation and also to change the nature of that local taxation. That is why the current Government stood for election with a clearly stated proposal to abolish the council tax and replace it with a fairer local tax based on ability to pay. This consultation is the first part of making that proposal a reality, and we are asking for your views. Our proposals for a new local taxation system to fund local authority expenditure..”

        In the article (link below) we learn:

        “The only other party in the parliament that supports LIT are the Liberal Democrats, however they believe that the rate paid should vary from local authority to local authority and not be set a national level.”

        “The fiercest criticism to the SNP proposal has, unsurprisingly, come from the Labour party. The main plank of the argument against the tax is that the SNP’s figures do not add up and that the new tax would not provide sufficient funding for local authorities. “

        Then there is this: “The chance of success for the SNP tax reform is unclear, with one leading law expert speculating that the issue will end up in the courts.

        “Speaking at the local government committee, Professor Alan Page of Dundee University, said “This question of legality will cast a long shadow over the bill until it’s effectively settled one way or another… the nightmare scenario would be if you have a situation like the poll tax where people were refusing to pay because they say the Scottish Parliament does not have the power to do this.”

        Source: https://celticcountries.com/47-news/news/108-scottish-governments-local-income-tax-question

        In the time since, further attempts to reach a cross-party consensus on reform have, so far, failed. In the last few years, the SG has tinkered with Council Tax to make it a little more progressive following on from its earlier action to freeze the tax for a number of years.

        (The SG fully recompensed Local Authorities for the tax foregone by the national policy to freeze the tax which was introduced to mitigate some of the negative effects of the financial crash on households.)


  6. Building or renovating 6,000 affordable houses a year. Closing housing shortages. Improving prosperity and cohesion. That is why people support the Scottish Gov. 75%+

    Support for SNP/Independence rising. People have to vote for it.


  7. Thank you, stewart.

    I was putting my question to my MP in the context of doing what was possible to address the fundamental causes of health inequalities as identified by academic research. It is clear that the necessary devolved powers are not available to any Scottish government. I asked Phillipa Whitford why there was no strong campaign by the SNP to have those powers devolved. There was no answer. I put the same question to my MP while asking about using the Council Tax.

    I’ve found this article providing summaries of opposition from within the Yes movement to the Growth Commission plus some more.


    Neil Findlay, hardly a supporter, said this:”The report’s co-authors include Finance Secretary, Derek Mackay, Education Minister, Shirley Anne Somerville, senior SNP councillor Marie Burns, and MSP Kate Forbes amongst others. Its content is supported and endorsed by people at the very top of the SNP. That should alarm many who put their faith in that party to deliver a progressive vision for Scotland.”



    There is division in the party (of which I am not a member) over the Growth Commission report.There is division over other matters which may affect support. On the other hand, the actions of the Tory party are a good recruiting sergeant for Yes. The demography, the increasing support among the young and women, and the effects of time on older voters is in the favour of Yes each passing year.

    There is still time for the party to come together to form a convincing, unified stance on how an independent Scotland looks.


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