Left to care
Photo credit: Jon Davey Photography
Neil Findlay hasn’t been well. He’s been complaining of ‘man-flu’. Sitting down to chat with Holyrood before Scottish Labour’s spring conference, Findlay has just returned from a trip to London for party meetings, where any hopes of enjoying the ‘bright lights’ were curtailed by “a five o-clock bedtime tucked up with my teddy. I was shivering like a bloody wreck.”
By his own admission, Findlay is a terrible patient. Being Labour’s health spokesman has given him a different perspective on his own health. “It challenges you, and makes you aware of your own hypocrisies. For example, I lost a crown, and that happened two months ago and I’ve not been to get it fixed, because I’m ‘going to do it over Easter’. We pontificate to other people, you’ve got to go and get these things done, yet the politicians who are pontificating aren’t doing things to look after themselves.
“I’m quite lucky in that my wife works for the NHS, so she kind of knows how to deal with the everyday things. If you’re generally well, when you do become unwell, it hits you for six. I wouldn’t say I’m a Commonwealth Games athlete, but I’m active and I keep myself generally well-ish,” he says.
Holyrood reminds him of a tweet he made shortly after his promotion to the health brief regarding enjoyment of a greasy pasty from a high-street baker. “Actually, I think that’s part of a bigger issue, and people do see a real disconnect between people who are politicians and the rest of the world, and I absolutely pride myself in being completely and utterly grounded. I’m living in the same place I’ve always lived in, I go about with the same people I’ve always gone about with.”
Surely eating yourself to an early grave is no way to prove yourself a man of the people? “Absolutely not, but come on, we all like a bit of Greggs now and again,” he laughs.
There was some surprise at Findlay’s promotion to the front bench last summer, most of all from him. “Politics constantly surprises me. I was first of all surprised to be accepted as a candidate, given where my politics have been over the years, and where my politics remain. That was a very pleasant surprise because I think it shows a greater maturity in the party, that we’re now back to being that broader church than we were during the 90s and the 2000s. That’s a very good thing, because there’s a whole range of people across the Labour movement who have a great deal to bring to politics, and we should be encouraging them. So that was the first surprise. The second surprise, following on from that, was people with my political background weren’t promoted or put into positions like this, and thirdly, because I didn’t have the parliamentary background.”
Given Findlay’s reputation as a left-wing activist, it is perhaps unsurprising he has focused on the workforce, from responding to staff surveys to pushing for an amendment to the Public Bodies (Joint Working) Bill to secure a living wage for those working in the care system. “That’s where I come from politically, but that’s maybe a secondary point in this debate. Because the reality is the people who are squealing the most on behalf of patients are the staff. They have very high professional standards. They, in the main, love their job. They balk at being patronised as angels, and all of that kind of guff, because they’re doing a serious piece of work. They are the ones screaming at us to do something.”
Alongside the Royal College of Nursing, Findlay has called for a system-wide review of the NHS in Scotland. “If you look at the Cabinet Secretary, he’s by nature a fixer. He fixes things. If you’ve got an old bike and you fix one bit it won’t be long until another bit goes, so you have to fix that. You can’t just keep fixing it because it’ll fall to pieces at some point. I think that nature of being a fixer could be at the root of the problem. I’ll give you an example. We’ve got a problem with A&E; the pressures on A&E. If you resolve that problem, you then fill up all the beds. If you fill up all the beds, you then have bed blocking, because you haven’t fixed the problem of social care. And part of the reason that won’t be fixed is because of the appalling terms and conditions employees in social care are working in.”
However, the age-old question about the social health model is it is a bottomless pit for funding. The Scottish Government has increased the health budget every year, and it is the biggest budget it has.
“The Government will say, largely, they’ve protected the health budget. But council budgets are hammered. It’s maybe not so much about naming a figure of what the budget will be, it’s about how we use that budget appropriately. That’s the whole budget pot for public services, because many of these services are absolutely interconnected.”
Isn’t the integration of health and social care designed exactly to deal with this problem? Findlay believes it has “not a cat’s chance in hell” of being achieved under the current social care system. “All this talk about integration, absolutely 100 per cent behind it, but what does that mean to Mr and Mrs Smith sitting in their house getting a 15-minute care visit from a young member of care staff on £5.13 an hour? What does integration mean to them? Is that what the White Paper calls ‘world-leading social care’? The idea we have world-leading social care in Scotland is, frankly, an insult to both the people receiving social care and also the staff delivering it,” he says.
During his time as a councillor in West Lothian, Findlay saw integration in action. “The cultural barriers were broken down by the staff working on the ground, but the challenge is to break through resistance at a higher level to transfer cash and pull budgets,” he says.
Findlay’s time with the council also showed him the value of what Chief Medical Officer Harry Burns calls community assets. He undertook a consultation in the two villages constituting his ward, and got 350 responses. The findings revealed local facilities were in poor condition and poorly utilised. He presented them to the council’s chief executive. “Interestingly, about an hour after the presentation, one of the officials came down and said the chief executive’s spitting blood up there, because your village was not anywhere near top of the priority list, but it is now because you’ve provided the evidence,” he says.
The end result was a purpose-built centre comprising sport and fitness facilities, a community café, two GP practices, a jobcentre plus, a library and a pharmacy. The project costs £7.5m, and Findlay argues a hundred such centres could be built for the cost of one large general hospital. The last Labour administration saw a move to centralise some health services, but Findlay believes localised integrated services can tackle health inequalities head-on. “If Labour cannot be about addressing deep-seated health inequalities then we don’t deserve to exist, in my view,” he says. “We see the Scottish Government tinker with this stuff. If we’re going to deal with health inequality, we can’t do it with just tinkering. If you don’t have a job, if you live in a crap house, if your environment is an area with a lot of crime, a depressed looking environment, is it any wonder you’re unwell?”
On his London trip, Findlay learned from Islington Council’s Fairness Commission, an example which “cheered him up no end”. Updated last month, the commission’s recommendations include fair pay and tackling health inequalities. The council has signed up to Unison’s ethical charter on social care at a time when £26m is being cut from their budget. For Findlay, the council’s priorities are admirable: “I think it is heartening that, despite appallingly difficult times, they’ve said actually this is our politics, this is where we’re coming from, we cannot allow the standard of care to slip to that level, or the terms and conditions of people employed to fall. Now I’m sure they’re making horrendous decisions elsewhere in order to make that decision, but that’s politics for you.”
He also had a chance to discuss the coalition’s sweeping reforms of NHS England with his UK counterpart, Andy Burnham. “They’re absolutely clear they will repeal the Act that established all the competitive commissioning, all that nonsense that’s going on down there. There is recognition in Scotland, and I think Jackson Carlaw said, ‘we don’t hold a candle to the reforms happening in England’, which I think just reflects the realpolitik; people up here just wouldn’t accept it. In terms of that lot down south, these are rabid right-wing sons and daughters of Thatcher. I just get the image of Osborne bubbling at Thatcher’s funeral, and you know who they are.”
Conference will be the culmination of 40 meetings on the constitution for Findlay: “My argument has always been I’ll be voting No for change. The idea anybody would be urging anybody to vote No for the status quo is nonsense. We have to be arguing vote No for change, and that will bring in a whole series of proposals to change Scotland to a fairer, more just society. That’s why I’m in politics.”