Ahead of its annual conference this month, healthandcare.scot talked to the Health and Social Care Alliance’s Chief Officer Sara Redmond about her hopes for the conference and the state of health and social care in Scotland.

From the need for person-centred care to addressing the underpinning societal issues contributing to poorer wellbeing, she emphasised that the time is now for the government to listen and work in true partnership with those across sectors to deliver change.

This year’s ALLIANCE conference theme of “Our Voices Matter” speaks to the call for collective engagement in taking forward positive change for Scotland’s health and wellbeing, Ms Redmond explained:

“We represent a broad range of voices – organisational and individual lived experiences – and people have quite consistently over the years voiced the problems they encounter with the current institutions and systems.

“What people have said is that we need action, we need reform and we need to redesign the way things work that takes account of people’s diversity.

“Designing a solution based on just one group in society will not work, it won’t reflect the needs of all.”

Allowing all sectors to help plan and deliver reforms will, she said, reflect the “strength of diversity in Scotland” and create a fairer, more equitable society that better serves the people – adding that setting a new direction is vital to ensure that  the health and social care system meets the needs of people across Scotland and the UK.

Ms Redmond added that the upcoming conference is an opportunity to “drop an anchor” and bring these voices together to help set that direction:

“There’s a storm raging around us and we’re very aware that we cannot try and solve today’s problems with yesterday’s actions.

“The decisions that are facing us are political decisions – choices over the ways we want to support and care for people and address the challenges we’re facing as a society.

“For us, we feel it’s really important that the decisions that are made are person-led and human-rights based.”

Put simply, she added, this means ensuring individuals are involved in decisions about their health, care and support – and those wider, systemic decisions that affect their wellbeing.

“We must stop redefining the problem”

Ms Redmond hopes that those in power – particularly Scotland’s Cabinet Secretary for Health and Social Care who is set to speak at the conference – share her sense of urgency for systemic reform, adding:

“We can’t spend another ten years, or another five years talking about the problem. We need to see action.

“The problem has been defined, and people have set out their priorities. This is not about needing to describe the problem again – that’s been asked and answered.

“This is about those in power demonstrating that they have heard people’s voices and they are committed to taking action based on the changes people have said need to be made.”

Recognising the social care system as a “critical component” of supporting people’s health and wellbeing, and that reform is needed to reflect how vital it is, will be a strong thread in this year’s conference, she said.

From enabling people to live healthily, stay socially-connected and participate in their community – she highlighted that social care is the “springboard” to living a good life for many people.

Chilling policies

Ms Redmond said the last 15 years from the UK government, she has seen an “increasingly cold” and often inhumane narrative emerging around how society meets the increasing demand on health and social care systems, from austerity policies and rolling back help for people to live independently to the under-resourced health and care workforces.

But, going into an election year for Scotland, Ms Redmond highlighted the need to hold onto hope:

“It feels a very uncertain time, but I think it’s an opportunity – one of our reflections going into this conference is that we need to hold our nerve.

“It would be very easy to lose hope and forget that change is possible.

“We need to set the context around this, there’s conclusive evidence that austerity policies have worsened people’s health. We can see in other countries where healthy life expectancy has been increasing.

“Definitely, the election is an opportunity to platform this and other issues that matter to our members  and Scotland as a whole– to ensure there are messages that things can be different.”

She added that this must involve amplifying good community-level supports for people and supporting better collaboration across the system.

With “so much creativity and innovation”, Ms Redmond said the third sector remains a vital part of the solution to Scotland’s health and social care crises:

“There are so many great approaches being taken forward across all our communities and there’s a lot of hope you can see amongst those. Yet, we’re often brought into consult on things but not to develop and deliver the solutions.

“Our invitation is: how do we enable that, rather than undermine it?”

“Boldness” needed in our budgets

Ms Redmond believes the funding issues facing the third sector “undermine” both the sustainability of organisations and the trust within the communities they serve.

She cites the continued very short-term focus on balancing budgets and, while recognising the difficult fiscal context, she said the problems facing Scotland will only get worse if this doesn’t change.

The need she said has never been greater for policymakers to not just hear the voices that matter to understand the issues, but to  engage people during the implementation and evaluation of change:

“We’ve seen a welcome shift acknowledging the contribution that lived experience perspectives brings to policy-making, but there’s an accountability gap in whether or not the changes we want to see are delivered.

“There’s a huge amount of unmet need in our system. It cannot be acceptable to design approaches to health and social care that suggests some people’s lives matter more than others.

“We need a courage and a boldness from leaders that recognises that investing in services is a key part of realising the rights of all people.”

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