Guest blog by Pam Duncan-Glancy – NHS Health Scotland
For people like me who have been campaigning on social justice and human rights for many years, the First Minister’s commitment to “do even more, even better at incorporating human rights in Scotland” felt a bit like all our birthdays had come at once. Add the Scottish Government’s National Conversations on a Fairer and Healthier Scotland to the mix and one could be forgiven for quietly saying to fellow campaigners, ‘our work here is done’. Both signal strong assurances of a commitment to human rights and both are long awaited and much welcomed. But, as ever, complacency is not an option; warm words are not enough, or as I have recently heard it put, hope is not an action. If we are serious about a socially just Scotland, then we must do everything we can to ensure that human rights are explicitly built into everything we do, to borrow the wise words of Kofi Annan, it’s time to move from an era of declaration to and era of implementation. Simple. Well…not quite, but it’s certainly not rocket science either and with the Political wind in our sails, what better time than now to launch into action.
Where to start? Well, first we need to be specific, we need to pick a theme and focus relentlessly on threading human rights all the way through it. For many disabled women like me, social justice means a lot of things, but a crucial part of it is about having access, by right, to enough, fairly funded, good quality and appropriate social care. So (since you’re asking) in our move from declaring our human rights intentions to acting on them, our theme should be social care and we should work to create a social care system in Scotland that is available, accessible, appropriate, fairly funded and of a high quality. That is what human rights would mean in social care and a human rights based approach can help us get there. And here’s why.
Without social care, I couldn’t get out of bed in the morning, go to work, see friends, play my part in our society, and oh yeah…7 other people would be out of a job. Put quite simply, I wouldn’t be healthy, I wouldn’t have fair and equal access to society and I wouldn’t enjoy my human rights on an equal basis to non-disabled people. But, (as my husband often tells me) it’s not all about me! And here’s the thing, if we get it right, if we take a human rights based approach to social care there won’t only be individual benefits, but countless societal and economic benefits too. Good social care can support people into employment and it can provide employment, it can support people to participate in society and lead an ordinary life and it can help them to stay healthy – and of course, a healthy society is a more prosperous one – and so the cycle continues. Social care is an all-round essential infrastructure of a fair, equal and prosperous society. So that’s why I think it’s a perfect place to start, but I didn’t say it’d be easy!
Social care as it stands is not readily available or accessible, so there’s a way to go if we are to make it live up to our human rights intentions. When it comes to divvying up the coffers social care is always left behind: spending on social care in Scotland has decreased by 5% between 2009 and 2013* and the Scottish Government predicts that to meet demand on current trends, spending would need to double by 2031*. We just don’t seem to appreciate or understand the social or economic value that comes both from having and providing enough good quality care and support. The questions we need to answer in Scotland to change this and ensure our social care is fit for the future are biggies – how can we end the post code lottery of social care provision; how do we disinvest to support prevention; how should we pay for social care in Scotland; should people have to pay for something that is essential for them to enjoy their human rights and if not where will the money come from; what is social care for, who is it for and what can they expect from it; and those are just some. Tinkering around the edges is not going to cut it. If we are serious about social justice we have to address social care on a system-wide basis and we have to be brave. But fear not, for this is where our human rights based approach comes into its own.
If the first thing we need to do in our era of implementation is pick a theme, the second thing to do is to work in partnership and take the bold and necessary steps needed to make sustainable change happen, together. We need a national, focussed conversation directed at creating a human rights proofed system of social care. That means listening to and involving the people who need our support, the people who work in social care and the people with the purse strings (remember, resources will need to follow our ambitions). Now there’s a lot of perspectives in that list, and some of them competing. But a human rights based approach can support these discussions. It brings focus to the people who need most support whilst at the same time ensuring the systems in place to do this are sustainable. And bingo, we have our common ground on which to move from intentions to action.
I am in the privileged position to have worked on human rights and health in a variety of settings, including in the Third Sector for over 15 years, and now in the public sector where I work for NHS Health Scotland, focussing on health inequalities. In both jobs I have heard frustrations that change isn’t fast enough or actions and policies don’t go far enough. And I’ve heard each say of the other that they are ‘missing a crucial point’ be that of sustainability or reality. But you know what heartens me; across both sectors the desire for change is so strong that the people are impatient for it. That’s how I know change must be coming.
So there you are, I said turning human rights from intent to action wasn’t rocket science and I hope you can see that our launch pad is a strong one. We have our shared ambitions for social justice, a human rights based approach to help us put our hopes into action and the theme of social care to get our teeth into. All we need now is the bravery to get on with it and show the world how it’s done.
NHS Health Scotland
Twitter – @NHS_HS
*1 Audit Scotland; “Self Directed Support”; 2014
*2 Scottish Government, COSLA and NHS Scotland, 2010; “Reshaping Care for Older People – A Programme for Change”; 2011–21
SNAP – Scotland’s National Action Plan for Human Rights – was launched on 10 December 2013, marking International Human Rights Day.