How do we create a healthier, fairer Scotland? Ensure that interventions aimed at making positive changes result in better outcomes for people? People across Scotland have been debating these questions over the last six months through a series of national conversations on health, social care and social justice.
With just months to go before the next Scottish Parliament election, at the Health and Social Care Alliance Scotland (the ALLIANCE) these discussions have been brought into sharper focus. Our 2 Million Expert Voices manifesto, launched earlier this year, aims to strike a balance between the need to prevent issues before they arise, creating a socially just Scotland and ensuring the voice of lived experience is well heard.
One concerning theme our members keep returning to is the waning level of social connectedness and its impact on Scotland’s health. Last year the Scottish Parliament’s Health and Sport Committee received evidence that loneliness contributes to the development of depression and other mental health problems, high blood pressure, stress and a higher use of medication.
Our members, including the Food Train, the British Red Cross, Good Morning Service and many more, work closely in communities on innovative, effective models of addressing and preventing loneliness. Indeed, our own National Links Worker programme – a pilot project working in GP practices in seven of the most deprived areas of Scotland – is built on a model which aims to utilise community strengths to tackle loneliness.
Our manifesto highlights this need to prevent social isolation and loneliness. Anne from Edinburgh says: “I support the ALLIANCE’s call for care and support that helps to prevent loneliness and social isolation. I want a future where everyone in Scotland can stay connected to family, friends and local community with a strong sense of shared purpose and citizen wellbeing.”
As a society, our response must be strong and we must continue to raise the political agenda. The last five years have seen some steps forward, but policy shifts such as self-directed support and greater acknowledgement of the role of community transport must be accompanied by an added duty to prevent people from experiencing the scourge of loneliness.
This type of work within communities has led to a strengthened role for third sector organisations working in partnership to design and deliver solutions, but further capacity building support is required if we are to maximise the third sector’s ability to keep on finding new solutions. This doesn’t just mean funding, but being serious about delivering preventative services and greater engagement of third sector organisations in strategic decision-making processes.
These are some of the principles which have been key to the success of the ALLIANCE’s Self-management Impact Fund. The Fund, a partnership between the ALLIANCE and the Scottish Government, has sought to invest in the capacity of communities and the sector to encourage innovative self-management techniques and support. We believe with additional support this can encourage improved access to high-quality information about local sources of support and targeted investment.
The voice of disabled people and people who live with long-term conditions is integral to this type of work and our manifesto calls on public authorities to make their communication more inclusive and to deliver services that are accessible and effective for us all. However, changing the way that public authorities communicate with us is just the tip of the iceberg. We must now look at how decision makers are representative of the wider community they serve. The recent “One in Five” campaign has highlighted that political participation among disabled people in Scotland must increase. We need advocates for the rights of people who live with long-term conditions, disabled people and unpaid carers, specifically with a ministerial post attached. “If not us, who? If not now, when?”
As new powers come to the Scottish Parliament, including control of social security related to disability and employability programmes used by many thousands of disabled people, we must again look at how systems are set up. The longer term aim must be to humanise this process, creating the opportunity for better understanding of what they should be able to expect of the process and how decisions can be challenged.
Looking forward to May gives us an opportunity to look at the policy landscape with renewed hope and vigour for the future. The next challenge is creating a society fit for disabled people, people who live with long-term conditions and unpaid carers to enjoy their right to live well.
l Ian Welsh OBE is chief executive, Health and Social Care Alliance Scotland (the ALLIANCE)